The Cuyahoga County Board of Health holds press conference updating citizens on the coronavirus pandemic on Tuesday and Friday mornings.
Cuyahoga County Board of Health (CCBH) commissioner Terry Allan began the April 24 press briefing by noting that some elective surgeries and other medical procedures may begin to be rescheduled, but stressed very quickly that returning to normal will be a phased approach and, in the words of Governor Mike DeWine, “the entire health care system is not ready … to be turned back on.”
Allan said that it’s important as the country begins to open again, to expand testing; protect the most vulnerable, especially those who live in congregate settings like long-term-care facilities, jails or shelters; continue contact tracing, quarantine and isolation to reduce community spread; and rely on data and science to take the next steps.
“There are a range of data-driven considerations that we must take into account as we work through the phased approach of reopening,” said Allan. “Let the data describe what the next step should be. Use data to make decisions on what's best.”
Twenty-three percent of Cuyahoga County’s COVID-19 cases are hospitalized at some point during their infection
Allan reiterated the testing protocols that are in place currently, the top priority group to be tested is hospitalized patients and health care workers with symptoms. The second tier is those age 65 and older who have symptoms, patients with underlying conditions with symptoms and first responders with symptoms. The third priority is critical workers with symptoms, all health care workers and first responders and those with mild symptoms in communities with high numbers of COVID-19 hospitalizations.
“What we have to do is to use these priority areas to make decisions the best decisions about how to test in our community,” said Allan. He said that fewer than one percent of Ohioans have been tested and said the resources need to be saved for those who are most at-risk. He stressed this is why abiding by social distancing guidelines and other preventative measures like masks remain important – especially as case numbers and deaths continue to go up in Cuyahoga County.
“It's not time to become complacent it's time to recognize that we need to be thoughtful about this space reopening the precautions that you take today could prevent a case or a potential death tomorrow,” said Allan.
CCBH medical director Heidi Gullett began her comments by thanking the media and thanking other in the community including those who maintain the outdoor park system, behavioral health care professionals in Cuyahoga County and the state. She urged people who are having mental health concerns to reach out to the state’s new COVID-19 care line for mental health concerns at 1-877-443-6276.
Gullett then went on to explain the current numbers for Cuyahoga County. In the county, excluding the City of Cleveland, there are 1,094 lab-confirmed cases, 411 probable cases, with an age range of one-week-old to 101-years-old. The date of illness onset ranges from February 29 through April 21 which Gullett said shows that there is still ongoing transmission and spread within the community. So far, 340 people have recovered from COVID-19. Those people are out of isolation but still must abide by the state’s stay-at-home order. There have been 67 deaths in Cuyahoga County due to COVID-19, with a victim age range of 53 to 93 years old. The dates of death are from March 20 through April 22. Gullett again reiterated that these people are not just numbers but represent loved ones who have been lost and families who are grieving.
Twenty-three percent of Cuyahoga County’s COVID-19 cases are hospitalized at some point during their infection, with eight percent of cases being admitted into the intensive care unit. Gullett stressed that due to lack of testing and some people recovering at home the county doesn’t yet know the actual total number of cases in the county and the percentages are only in relation to the number of lab-confirmed cases.
“We see public health as a utility like water and like electricity…"
About 22 percent of cases are in health care workers, and more than 43 percent of cases are in those people who have underlying health conditions.
Gullett then moved to racial and ethnic breakdown of cases in the county. She said that .9 percent of people with COVID-19 identify as Asian, 31.4 percent identify as Black, 55.6 percent identify as white, 3.3 percent identify as other and the county still doesn’t have racial data for 8.8 percent of cases. Seventy-six percent of those with COVID-19 identify as non-Hispanic, two percent identify as Hispanic and 22 percent are unknown.
“It's critically important to us to understand the racial and ethnic breakdown of cases so we can ensure everyone is receiving everything they need at the moment that they need it,” said Gullett.
Gullett also broke down the racial and ethnic data about those who have been hospitalized and those who have been admitted into the ICU. In terms of hospitalizations, 53 percent of those admitted to the hospital identify as white, 36 percent as Black seven percent as unknown, four percent other and Asian around two percent.
In terms of ICU admissions, Gullet said the racial data was a little different, with 49 percent of cases in people who identify as white, 42 percent identify as Black, five percent other, three percent unknown and one percent Asian.
She also presented data about hospitalizations and intensive care unit admissions for health care workers and those people who have pre-existing conditions. That data is shown below.
Gullett then showed a date of illness onset and recovery graph, and said they have had so many people calling to be removed from isolation that they’ve established a special phone number for people to call. She also said that there appears to be a drop off in cases at the end of the graph but not to interpret that as meaning there are no more cases. Gullett said that those numbers more represent lack of testing and a lag time in reporting cases and contact tracing.
Gullett showed an updated ZIP code map showing that the virus is spread throughout the county. She also said that the ZIP code represents where the victim lives and not necessarily where he or she contracted the virus or where a patient works.
Gullett said the health department understands a lot of things contribute to health, including have a job and a healthy economy. She then asked people who are contacted by CCBH staff to please consider talking to them. She also stressed that any information shared with CCBH is confidential.
“Please consider giving us the information that would help you and your family and your friends get through this we can't do this work of case identification, contact tracing isolation and quarantine without your help,” said Gullett. “Those are precisely the pieces of this puzzle the tools and our toolkit that will allow us to continue to flatten the curve and get us back to work and get our economy strong again.”
In terms of hospital utilization, the county’s general hospital beds are 68 percent full, 43 percent of pediatric beds are full, 63 percent of ICU beds are full and 28 percent of the county’s ventilators are in use. She also said that since the county has a lot of hospital and medial resources often more rural counties will send patients to Cuyahoga County for care.
Brazile also said if there is any concern that someone calling may be a part of a scam to call the CCBH main line at 216-201-2000.
Romona Brazile, the deputy director of prevention and wellness at the CCBH, then took the podium and talked about the process of contact tracing. She said they receive a call or secure email or a positive COVID-19 result from the state’s reporting system. She said they will call people and ask about symptoms and any underlying conditions they may have. Brazile said they try to confirm racial and ethnic data, and also ask who people have been around two days before they started feeling sick and also asks for contact names and phone numbers of anyone they have been around. Once they reach those people who had contact with someone with COVID-19, those contacts are either placed in quarantine or isolation.
Quarantine is for people who are well and anyone contacted who doesn’t have symptoms will be put in quarantine for 14 days since they last had contact with the person with a positive COVID-19 case. Isolation is for people who have symptoms who have had contact with someone who has tested positive and those people are considered a probable case. Brazile said over the past few weeks that the CCBH has been able to identify more than 400 probable cases of COVID-19 through contact tracing.
“We understand when we call that people are scared and in some cases people aren't angry they're confused on how we got their number, but we also want people to understand that when we do call we're calling to try and understand their risks as well as their families risks and their loved ones because we've seen enough circumstances where it has been spread among family members and among friend groups and so we want to help track that down and understand who may be at risk,” said Brazile.
Brazile also said if there is any concern that someone calling may be a part of a scam to call the CCBH main line at 216-201-2000.
Brazile thanked caregivers in long-term care facilities and said it’s important to remember to thank caregivers especially in those facilities.
“They need our gratitude and our empathy and our compassion,” said Brazile.
Allan then wrapped up the briefing by highlighting how the CCBH is not only responding to COVID-19, but CCBH staffers are also doing other things including inspecting restaurants, addressing opioid overdoses and trying to prevent the spread of HIV.
“We see public health as a utility like water and like electricity when you turn your faucet on when you flip your switch people expect that to work and the public health system has an obligation to be there to support people in many ways about their lifespan and that's what we do,” said Allan.
