The Cuyahoga County Board of Health holds press conference updating citizens on the coronavirus pandemic on Friday mornings.
The Cuyahoga County Board of Health (CCBH) briefing on May 15 started with comments from the Cuyahoga County Medical Examiner Dr. Thomas Gilson.
Gilson said that while the majority of deaths due to COVID-19 are not under the jurisdiction of the medical examiner’s office as they are deaths due to natural diseases that frequently occur in hospitalized people. He said despite this, his office has been working with CCBH to monitor the number of deaths and over the past two months have seen an about 10 percent increase in the number of deaths compared to the same time period in the previous year.
“Right now we can only speculate to what extent COVID-19 is responsible for that. I think in the midst of a global pandemic it would be naive to think it has no role, but it's equally disingenuous to think all of this is related to COVID-19,” said Gilson.
"Misinformation is worse than no information"
He did says that the concern right now is that health care facilities and those, like funeral directors, who care for the dead are able to keep up with the demand placed upon them. Gilson said that’s something his office is keeping a close eye on and he said that neither field is overwhelmed.
Gilson pivoted to talk about how deaths due to COVID-19 are counted, stating emphatically that, “we're not hiding deaths, we're not over-reporting deaths. The Centers for Disease Control and the National Centers for Health Statistics gave guidance [on] what constitutes the coronavirus death. We follow those.”
He went on to say that it can be difficult to determine if someone died due to COVID-19. He said that if someone contracts coronavirus but already has a compromised immune system due to an underlying condition dies, it’s more difficult to determine what ailment was the actual cause of death.
“I think that one of the great mistakes that happens, and we've seen it already in this pandemic, is misinformation is worse than no information. I want to give you honest accurate information, everybody in the county does, and I think that it would be fair to say some questions I can answer now, some questions are gonna take longer to sort out, but as we do know I want to give you the best information for the public so that we're not overreacting and not underreacting, said Gilson.
CCBH Health Commissioner Terry Allan then took over to recap what the governor stated was opening and when in the coming weeks. He also stated, citing the Health Policy Institute of Ohio, that the number of COVID-19 deaths have already overtaken the number of deaths due to car accidents and may soon overtake the number of suicides.
“We are still early on in this response. We are preparing for the possibility of a fall surge and so there's many more months left in 2020 and the concern about COVID circulating with influenza in the fall and we will return to that reminder in the coming weeks and months as we go forward,” said Allan.
The number of COVID-19 deaths have already overtaken the number of deaths due to car accidents and may soon overtake the number of deaths due to suicide.
Allan discussed how important it is to maintain health guidelines and do things like wear masks, socially distance and wash hands.
He then discussed how the CCBH is working with high schools in the county to figure out how to put on safe graduation ceremonies. As far as when school will start again, Allan said they are waiting for guidance.
CCBH Medical Director, Dr. Heidi Gullett, then talked about how CCBH has seen more workplace infections over the past week and urged that people wash their hands as much as possible, clean routinely touched surfaces and wear face masks.
Gullett then shifted to share the numbers of people who have been affected by COVID-19. In Cuyahoga County, excluding the City of Cleveland, there have been 1,782 lab-confirmed cases and 472 probable cases – making the total number of likely cases in the county 2,254. The date of illness onset was February 28 through May 13, and the CCBH has tracked down an additional 3,572 people who have had contact with those people who were infected. She also noted that 762 people in the county have recovered from the disease.
The age range of cases goes from one week old to 101-years-old and about 55 percent of the cases are women and 45 percent of the cases have been men.
Gullett said that 21 percent of the cases are in health care workers and about 40 percent of people who have contracted the disease have said they have underlying conditions.
She then went on to explain the racial breakdown of cases in the county. More than 26 percent of cases were in people who identified as Black, more than 51 percent of cases were in people who identify as white, .8 percent were in people who identified as Asian and 2.8 percent of cases were in people who identified as “other.” The race was unknown for 9.1 percent of cases. Three percent of cases are in people who identify as Hispanic, 75 percent of cases were in people who did not identify as Hispanic and 22 percent of cases were unknown.
Gullett said that 372 people have been hospitalized with COVID-19, and of those, 51 percent of patients identified as white, 41 percent of patients identified as Black, four percent were unknown and two percent were unknown. Of those who were hospitalized, 105 were admitted into intensive care units. Forty-seven percent of those in ICUs were white, 46 percent are Black, 5 percent are other, unknown were 2 percent and about 1 percent of ICU cases were in people who identify as Asian.
She then went on to discuss the number of deaths due to COVID-19 in the county, prefacing the numbers as she usually does with a message for the families of those who have died.
“We all want to remember that we need to ensure those families are supported in their time of grieving because it's different in being able to honor those who are deceased with COVID-19 given social distancing and other measures that are in place so we're thinking of all of the families affected,” said Gullett.
A total of 129 people have died in the county due to COVID-19 from March 20 through May 12. The age range of those who have died is age 52 to 99 years old, and 72 percent identified as white, 27 percent identified as Black, fewer than 1 percent identified as Asian and fewer than 1 percent identified as “other.”
Gullett went on to show a graph showing the epidemiological curve of the virus in the county, and highlighted that the number of cases of those who have recovered is increasing.
She also showed a heat map of the number of COVID-19 cases by ZIP code. It shows that the number of cases continues to climb. She also reiterated that the ZIP code map represents where people live not where they contracted the virus.
Gullett moved on to show how many hospital beds are in use.
“We want to help the public understand the full scope of how this is affecting our community each week understanding that we're staying below that dotted line on the [epidemiological] curve is really important and we have still remained underneath that which is very good news for our community,” said Gullett.
About 70 percent of general hospital beds for adults are in use, about 72 percent of critical care beds for adults are in use and 32 percent of the county’s ventilators are in use. Fifty-three percent of pediatric general beds are in use.
“These numbers have stayed relatively stable from week to week which is really good news and that our community has not had the number of COVID-19 infections that would overwhelm our hospitals and really force our healthcare providers to make really difficult decisions about resources. We're very grateful that has not happened here, and very grateful to our hospital partners for creating surge capacity and increasing the number of beds available to serve our community during this time,” said Gullett.
Gullett also shared that 14,088 tests were performed last week – an increase of 3,500 tests in a week - with an average positive rate of 6.5 percent.
“I feel it's still useful for the community to see that our testing is going up each week the overall percent positive, which means the percent of cases tested who are positive compared with all of the tests done is 6.5 percent this week and that's lower than last week which I think represents that we're now testing people outside of the hospital a little bit more, outside of health care workers a little more and so it represents a little bit wider net of those being tested,” said Gullett.
Despite the wider testing net, Gullett said the county is still not testing everyone in the county, and are not testing people without symptoms unless they live in a congregate living facility.
Romona Brazile, the deputy director of prevention and wellness at the CCBH, then addressed the briefing about the county’s efforts to identify and slow the spread of COVID-19 – especially within the county’s vulnerable populations.
“It's not true just because someone said it on the internet. Please continue to seek information from valid and trusted sources of information such as the Cuyahoga County Board of Health as well as our state health department and other local health departments.”
She took time to recognize funeral home employees and those in faith communities who are supporting those who have lost someone from COVID-19.
“They've had to adapt their services to decrease the risk of spread at gatherings such as funerals but still provide the comfort and care that is needed by grieving families,” said Brazile.
She then stressed that although many parts of the state are reopening, that doesn’t mean that the risk of contracting COVID-19 has gone down. She urged people to continue social distancing, wash their hands and continue to wear masks.
Brazile then touched upon a point that Gilson raised earlier in the briefing – conspiracy theories. “It's not true just because someone said it on the internet. Please continue to seek information from valid and trusted sources of information such as the Cuyahoga County Board of Health as well as our state health department and other local health departments.”
Allan then returned to the podium to answer a question about those who defy the public health orders. He said that “far and away” people want to comply with the orders but that there are differences of interpretation on some of them and there have been a handful of court proceedings.
“There is no perfect solution here, what we're doing is trying to reduce risk as much as possible during this reopening,” said Allan. “There is no way to eliminate risk in society, we all recognize that, but I would anticipate going forward there will be a lot of questions and we're poised in our call center to take those. We anticipate a lot of field visits to create clarification and if people are – we’re having difficulties with people that aren't complying we'll certainly address those as they come.”
Gullett then responded to a question about if the state is reopening too quickly. Gullett responded by saying the CCBH is committed to respond to the pandemic at all steps, and from a medical perspective they will continue to identify risks and try to do more testing, contact tracing and quarantining.
“Our rule here at the Board of Health is to work with our state officials and our local government, as we do very closely, to ensure the safety of the public at the pace in which this is moving,” said Gullett. “So our goal here, [is] we are committed to doing everything we can to minimize infection and the spread of infection. What I will say is that even though we have had lots of cases there are still a very small percent of our population in this community who's been exposed that means the vast majority of the rest of us are still at very high risk for this infection and our immune systems have no idea how to respond to it so we need to keep that in mind because until there's a vaccine we've got to prevent the spread of this.”
Gullett also urged people not to go out and try to expose themselves to the virus because it can be a very serious infection.
She also urged kindness out in the community with businesses that are reopening.
“I would ask you to be very patient and kind to those who are working in these businesses because they too are trying to figure out how to protect their customers and each other,” said Gullett. “We're all learning how to do this together while we've been through other pandemics this is a little different and we're all learning how to wear masks in places we wouldn't normally do that we're all learning how to appropriately talk to one another six feet away we're learning how to provide services that we normally require human touch where we can't do that anymore.”
