The Cuyahoga County Board of Health holds press conferences updating citizens on the coronavirus pandemic on Friday mornings.
Terry Allen, the Cuyahoga County Board of Health (CCBH) commissioner, began his comments on May 29 by recapping remarks Governor Mike DeWine made about COVID-19 testing in long-term care facilities. He said the Ohio National guard is helping with a statewide plan to expand testing in nursing homes and other places where a lot of people live together in close quarters. Allan said that the testing has already started, and guard members will work with medical professionals and state and local public health officials deployed across the state. He said testing is a priority at places where there have been COVID-19 exposures, starting first with testing staff and then residents.
“It's important to folks to recognize when we're concerned about community transmission. If we have staff that are going into facilities, potentially having been out in the community, potentially exposing folks in those facilities, the staff may go home, they may go out to other community sites / potentially other jobs and then start new chains of transmission in the community, and so starting with staff is an appropriate place to begin,” said Allen.
In terms of visiting nursing homes, Allen expressed concerns about people hugging and kissing and not maintaining social distancing guidelines and potentially unknowingly spreading the virus.
He also said that guidance on who can be tested in Ohio is expanding and also there are now pharmacies that can provide tests which he said people can find out more about at Coronavirus.Ohio.gov website under testing community health and the community health centers tabs.
He also announced that new guidance allows outside visiting for those in nursing homes on June 8. He said the governor required facilities to provide a few things for this to start including screening of visitors for temperatures and symptoms; scheduling hours and time limits for visitors; proper social distancing measures; face coverings; providing residents families and visitors with education about the risks associated with COVID- 19.Allen then began to break down the calls the county’s call center has received since the beginning of the pandemic. He said the county has received about 1,900 calls about topics including personal protective equipment, nursing homes and essential businesses.
“What we don't want to see is outbreaks expand in community settings the way that we've seen concerns and cases in these congregate facilities we have to remain vigilant there are lives in the balance,” said Allan.
One-hundred-thirty people have had to be admitted to the intensive care unit over the course of their illnesses.
Dr. Heidi Gullett then took the podium, beginning by recognizing what a painful time this is in the country, especially for those in the African-American community.
She then went on to report that Cuyahoga County, excepting the City of Cleveland, had 3,063 cases with a date of illness onset of February 28 through May 26. She also said that CCBH has identified 4,896 people who have had contact with people who have the disease.
The number of recovered cases in the county has reached 1,070 people. Those who have contracted the virus in the county range from one week old to 102-years-old. A total of 465 people – including one child – have had to be hospitalized over the course of their illnesses. One-hundred-thirty people have had to be admitted to the intensive care unit over the course of their illnesses.
Gullett then showed a chart of new cases since the beginning of the pandemic which showed, “we've had the largest number of cases that largest increase in cases since this all started week to week.”
More than 20 percent of cases are in health care workers and 43 percent of cases involve people with pre-existing conditions. More than 80 percent of those who are hospitalized due to the virus have pre-existing conditions.
In the county, 40.1 percent of cases are in people who identify as Black, 46.7 percent identify as white, 1.7 percent identify as Asian, 3.5 percent identify as other and 8 percent of cases are of unknown race.
For the racial breakdowns of those who have recovered from the virus, Gulllett reported that 56 percent of people identify as white, 34 percent identify as Black, 6 percent are unknown, 3 percent identify as other and 2 percent identify as Asian.
In terms of hospitalizations in the county, 46 percent of those with COVID-19 are white, 45 percent identify as Black, 5 percent identify as other and 1 percent identify as Asian.
What that means for our community is that every single person has to do their part we need people to wear cloth facial coverings or masks
“You'll see that this is a different distribution than our total cases, a higher representation of African-American individuals are hospitalized as compared with a full case count,” said Gullett. She said that trend continued for the races of those who were admitted to the ICU. Forty-eight percent of those in the county admitted to the ICU identify as Black, 45 identify as white, 5 percent are other and 2 percent identify as Asian.
There have been 186 deaths in the county, with an age range of 36-years-old to 101-years-old. One point one percent of those who died identify as Asian, 23.9 percent identified as Black, 67.4 percent identified as white, .5 percent identified as other and 7.1 percent were unknown.
Gullett then showed a graph of the number of cases and when people were diagnosed and it showed multiple humps rather than one large curve. She said the data is likely because of ongoing transmission from different clusters of new infections related to the state reopening.
“So what that means for our community is that every single person has to do their part we need people to wear cloth facial coverings or masks, we need people to please do social distancing we need extensive cleaning regularly, especially on frequently touched surfaces, we need folks to please listen to guidance from establishments where their customers or where you work. This is really important,” said Gullett. She then shared a heat map of where cases were in Cuyahoga County.
In terms of hospital utilization, 73 percent of adult hospital beds are full – and increase of 3 percent from last week, 57 percent of pediatric beds are full – an increase of 5 percent, 74 percent of ICU beds are full – a decrease of 3 percent and 31 percent of ventilators are in use – a decrease of 2 percent.
Gullett then reported the number of tests in the county but said that it’s difficult as the CCBH doesn’t receive information about negative tests. She said working with hospitals they’ve been able to determine there were 13,310 tests the previous week, last week there were nearly 16,000 tests and the week before there were just more than 14,000 tests in the county. Overall, CCBH can determine about 7 percent of tests in the county are positive.
“We cannot address the disproportionate impact of COVID-19 on the African-American community while not acknowledging the pain the community is feeling,” said Brazile.
Romona Brazile, the deputy director of prevention and wellness at CCBH, began her remarks by announcing that Cleveland Heights – University Heights school district was selected to receive 2,000, 20 pound boxes of fresh produce each of the next four Thursdays, from 11 a.m. to 1 p.m. at Cleveland Heights High School.
Brazile then talked about her first home visit to monitor for lead levels and said she realized the family didn’t have enough to eat, and then realized “I had to understand the person or the community's priorities if I was going to address the health issue that was my priority.”
She then acknowledged that it has been a difficult week for the African-American community, due to racism and the global pandemic.
“We cannot address the disproportionate impact of COVID-19 on the African-American community while not acknowledging the pain the community is feeling,” said Brazile.
She then discussed how when someone is presented with a threat that doesn’t go away it can lead to chronic stress which can lead to other chronic diseases.
“Racism is a contributing factor to chronic disease, and chronic stress and chronic stress contributes to the development of chronic disease, chronic diseases contribute to sicker and shorter lives,” said Brazile. ‘Ultimately public health's responsibility is to work to improve the populations health and we cannot do that when we ignore root causes of poor health.”
Allan then responding to a question about testing, he said that the county has committed to performing 30,000 tests in the community with a focus of reaching vulnerable communities and communities of color.
In terms of visiting nursing homes, Allen expressed concerns about people hugging and kissing and not maintaining social distancing guidelines and potentially unknowingly spreading the virus.
In response to a question about the highest increase in total cases in the county, Gullett said, “This is the biggest weekly increase we’ve had since the pandemic hit our community.”
She did say that the increase isn’t necessarily an increase in the sickness in the community but rather also reflects an increase in the number of tests available.
“This is a significant issue for our community, it's going to be for many months and we cannot let up. We have to continue to protect each other, continue to protect those most vulnerable and continue to prevent new transmission. Prevention is the key to getting us all through this safely,” said Gullett.
Responding to a question about if the number of people not wearing masks in the community will lead to even more infections, Gullett said that she thinks perhaps people who aren’t wearing masks maybe don’t personally know someone who’s been affected, but she stressed that this is a significant disease in the community and that people as young as 36-years-old have died in Cuyahoga County from it.
"This is a significant issue for our community, it's going to be for many months and we cannot let up."
Allen then chimed in, saying the county and state want to know about businesses that aren’t following guidelines that may be creating risk.
Gullet, responding to another question also said that the county is seeing increased clusters of the virus in workplaces, “we're seeing now pivoting are clustered response strategy to reflect more community clusters and less of the congregate facility as we had before.”