The Cuyahoga County Board of Health holds press conference updating citizens on the coronavirus pandemic on Monday, Wednesday and Friday mornings.
Cuyahoga County Board of Health (CCBH) commissioner Terry Allan recapped in the Cuyahoga County Board of Health’s Friday, April 10 briefing that the county is continuing to respond to complaints that come in to the hotline.
“We continue to address complaints as they come in by the hundreds about non-essential businesses, social distancing and workplaces and public gatherings. We're working with the Ohio Department of Health and our colleagues in other counties as we make fair and protective interpretations of the state order,” said Allan. He reiterated that the spirit of the order is not to punish but is to protect as many people as possible.
He said that the county continues to encourage businesses to voluntarily close so fewer people are out and about.
None of this has been easy and we have to maintain our resolve to get through this together.
“None of this has been easy and we have to maintain our resolve to get through this together. Current data trends are indicating that all the sacrifice that we've made all of it has made a difference in preventing illness and saving lives in our community,” said Allan. “We can't let up now we can't let up now particularly as the weather begins to change.”
He said that it’s important to not gather in groups “so that we don't unknowingly and unintentionally start new chains of transmission across the state here in our community.”
Allan quoted Governor Mike DeWine in regards to religious gatherings during this religious season saying, “anyone who brings people together in close proximity to each other is making a huge mistake.”
He highlighted that several religious organizations have moved to online or other ways to gather while maintaining social distance.
“We've made way too much progress to stop now,” said Allan. “Please know that all of you are making a big difference you get to carry that with you for the rest of your lives and this response, and this point in time is something that we'll all remember in the way that we handle it. The way that we interact together. The way that we followed the science and the data and the guidance will reflect the story of Ohio and of Cuyahoga County.”
The way that we followed the science and the data and the guidance will reflect the story of Ohio and of Cuyahoga County.
Allan then introduced medical director Dr. Heidi Gullet and deputy director of health and wellness, Romona Brazile, who is also a nurse, saying that they would talk more about racial data and COVID-19. He did stress before turning over the podium, “it's important to remember that these disparities and inequities did not emerge with COVID-19 they relate back to our original sin of racial injustice in this community.”
Gullett then shared data about the numbers of cases in Cuyahoga County, minus the City of Cleveland. There are 746 total lab confirmed cases, with an age range of one week to 100 years old. Twenty people, eight women and 12 men, ages 55 to 93 have died from COVID-19.
“I want to remind all of our viewers and the public …these are not numbers these are our invaluable community members every single one of them and we need to support them and also respect their privacy,” said Gullett.
One hundred and forty-three people have been cleared.
Gullett said that 737 isolation orders have been issued, 1,427 quarantine orders have been issued and 143 people have been cleared.
“These again numbers change literally by the minute an hour so you will continue to see that these change very frequently we're reporting them out on Friday but as by the time I've said these numbers they're probably higher now,” said Gullett.
She then pivoted to talk about the racial implications of COVID-19, while first explaining the history of racial disparities.
We know that communities of color in our community and others across the nation have different opportunities.
“We know that communities of color in our community and others across the nation have different opportunities, and those opportunities relate back to systems and structures and bias that have existed in our country for many, many, many years,” said Gullett.
She then brought up the history of redlining and how there are links to the present, “contemporary injustices around differences in life expectancy and other health outcomes that have occurred in our community long before COVID-19 arrived but also set up members of our community and communities of color here for different outcomes for an emerging infectious disease like COVID-19.”
Gullett mentioned that Cuyahoga County had made a priority of eliminating structural racism. She urged people to visit their website to see the most recent community health needs assessment report.
She also stressed that if there are groups who haven’t been able to access testing – there are many in our community who haven’t been able to be tested – that data wouldn’t be included in the current report.
“We need to continue to be determined about increasing the amount of testing for everyone in our community not just those who are hospital employees, health care employees are those who are hospitalized this is part of the equity-based approach we have to take as a community to ensure that no one is affected by this and not getting what they need,” said Gullett.
She urged people to not celebrate any holidays this weekend with family members outside of their immediate family who lives with them.
Gullett then shared a new ZIP code map that shows that overall the county is seeing more infections.
“What we are seeing the takeaway from this is that the infection is everywhere,” said Gullett. She said of the tests that the county is performing, between 11 and 13 percent of the tests done are positive and she said that high number is due to most of the people who are getting tested are sick, in the hospital or have had specific exposures like health care workers or first responders.
If we were testing the general community including people who didn't have symptoms to see if they might have the infection it would probably be lower.
“If we were testing the general community including people who didn't have symptoms to see if they might have the infection it would probably be lower,” said Gullett.
Thirty-three percent of those who have tested positive have need to be admitted to the hospital and 13 percent of the cases have been admitted into the intensive care unit. She also said that 33 percent of all those who have tested positive are health care employees.
Gullett then shared age data for those who have tested positive, and highlighted that the highest number of infections came from people age 20 to 44.
“This virus affects people of all ages so you are susceptible every single one of us is susceptible to this infection,” said Gullett.
She then moved on to data showing racial breakdowns.
The highest number of infections came from people age 20 to 44.
Thirty-nine percent of cases have been in folks who identify as Black, while only about 30 percent of the population overall identifies as Black. Forty-four percent of people who are positive for COVID-19 in the county are white, and according to the U.S. Census Bureau 63.8 percent of the county population is white.
Romona Brazile, the deputy director of the prevention and wellness area for the Cuyahoga County Board of Health, who is also a registered nurse, then addressed the briefing.
“I don't know how many more times we can say you know testing is hampering our ability to show what a clear picture is of the spread of COVID-19 in our community. We know that people who need to be tested do not have access to testing, that includes people who are sick that includes people who have been sick who could be tested to see if they're not sick anymore and it also includes people who don't have access to testing,” said Brazile. This data that we see so far is really more representative of who's had access to testing versus necessarily what is the actual prevalence.”
This data that we see so far is really more representative of who's had access to testing versus necessarily what is the actual prevalence.
Brazile said she was focusing on other underlying health conditions and says that she as a nurse is really paying attention to those conditions like heart disease and asthma. She also said it’s crucial for people to pay attention to the second week of illness because that’s when people tend to get very sick. She also said as a community it’s important to not just pay attention to what those conditions are but to what is causing those conditions at a different rate in one part of the community than the other. She then quoted Bishop Desmond Tutu saying, “there comes a point where we need to stop just pulling people out of the river we need to go upstream and find out why they're falling in.”
“We know that past policy and system decisions as well as things that still occur today have shaped our communities and they have created a familiar pattern of poor health outcomes in our most under-resourced communities including many African-American communities in Cuyahoga County,” said Brazile. And while she stressed that while everyone will be affected by COVID-19, those who are in the most underprivileged communities are going to be affected the most.
“Our under-resourced communities are often already living on the edge, and emergencies like COVID-19 in many ways push them into crisis and for some families it's not going to be a temporary crisis it'll be one that will be years of impact,” said Brazile. She then brought up issues that people may face – including the digital divide and also the fact that people are being told to stay home but for some families staying home just isn’t a financial possibility.
One day COVID19 will no longer be a public health emergency but when that happens we have an opportunity to not just return to who we were before.
“One day COVID-19 will no longer be a public health emergency but when that happens we have an opportunity to not just return to who we were before but to carry the lessons in the gratitude that this situation has brought to our attention so many other things that we have done as a community,” said Brazile. She said this includes things like being concerned about homelessness, workers we rely on for our everyday lives and children who don’t have access to food unless they are in school.
Allan then returned to the podium to point out that 100 years of public health in Cuyahoga County is bookended by the 1918 flu.
“We want people to recognize that about three cents out of every dollar you pay in health care related costs and health-related costs goes into prevention that's a bargain prevention is the best buy,” said Allan. He also reiterated that those who are “often invisible and ignored are at the forefront are the North Star of what public health is about here in Cuyahoga County.”
Three cents out of every dollar you pay in health care related costs and health-related costs goes into prevention.
Answering a question about how the racial data is represented in Cuyahoga County, Allan again pointed to racial disparities and the compounding disadvantages that they face like poverty. Gullett said that underlying conditions are very important in the COVID-19 epidemic, but she also highlighted a social determinant of health – housing.
“If you live in a footprint of a home that has small square footage and a lot of people living in the home it's a lot harder to isolate,” said Gullett. She also said other things like food and water are important.
“It's not just about chronic conditions it's also about the environmental context in which people live which is affected by these inequities, these systems and structures that have created these conditions, that set people up to have a higher rate of transmission and those are preventable. They're avoidable. They're unjust and they're the things we need to continue to fight for as a community through COVID-19 and long after that,” said Gullett.
When asked if she thought the African-American community was under represented in the data and under tested she said that she knows that there are people of many races that haven’t been tested, but she said she does worry more about those people who don’t have access to transportation or a primary care doctor.
It's not just about chronic conditions it's also about the environmental context in which people live which is affected by these inequities.
She also said that the Board of Health is determined to get enough testing to get a better picture of the spread in the community but admitted that she doesn’t exactly know how that's going to happen.
Responding to a question about why there are more deaths in the Cuyahoga County jurisdiction that in other jurisdictions like Cleveland, Gullett said it’s important to remember that the county has more cases than many other places and with more cases there are expected to be more deaths. She also pointed out that many long-term care facilities are located within the CCBH jurisdiction.
“We're trying to make sure everyone gets the level of care they need in the moment,” said Gullett.
Gullett ended her comments by again urging people to stay home this holiday weekend.
We still need to be vigilant. We still need people to stay home.
“We still need to be vigilant. We still need people to stay home. We still need people to worship virtually because it will not take much to swing over that dotted line and reach our hundred percent utilization [of hospital beds and ventilators] if a lot of people become ill and one to two weeks from now and we see the surge from the holiday weekend. So it's encouraging but we remain vigilant,” said Gullett.
