Two years ago this week, Ohio Gov. Mike DeWine ordered widespread shutdowns in hopes of stopping the spread of the coronavirus. Multiple surges — and more than 37,000 deaths in Ohio — followed over the past 24 months.
But now, Dayton-area coronavirus cases and, more importantly, hospitalizations and deaths have plummeted in recent weeks, and area health leaders are cautiously optimistic that we’re transitioning out of the pandemic. Some even said the pandemic is already over in Ohio. But all cautioned this virus isn’t going away anytime soon, and there will always be costs to living with it.
Greater Dayton Area Hospital Association President Sarah Hackenbracht said admissions have fallen dramatically in the past month and local hospitals — which a month ago were packed with hundreds of coronavirus patients — feel much closer to business as usual. In the past 60 days, hospitalizations have fallen statewide by about 90%.
“All the numbers are good. Clearly things are going in the right direction, and we’re a lot better off than we were,” said Rick Hodges, former director of the Ohio Department of Health and current director of the Ohio Alliance for Innovation in Population Health.
But Ohioans should think of this as a transition to a new phase of living with the virus, rather than an end to the pandemic, he said.
“This is just an opportunity to look at the disease and its impact on us differently, and it’s not time to let our guard down,” Hodges said. “I think now is an appropriate time (to stop wearing masks). But this will get out of control again if people aren’t aware. Let’s be happy we’re at this point — but be prepared and be aware.”
Butler County Health Commissioner Erik Balster said he doesn’t believe there will ever be a time when we reach zero COVID-19 cases.
“It’s at a point where mandates or anything like that aren’t needed, and it’s just something where people can utilize the tools that are now available to them,” he said.
Certain we’re in the clear?
We’ve been here before. Remember July 4, 2021, when President Joe Biden declared our independence from COVID-19? Coronavirus cases and hospitalizations were lower than they are now and everyone, not just the president, thought we were in the clear.
“What’s different now is we have a lot more immunity in our current population than we did last year,” said Sara Paton, the director of the Master of Public Health Program at Wright State University. “Not only because of vaccinations, but omicron was so contagious. A lot of people have had the virus, whether they know it or not. So we have a higher level of immunity than we did.”
Since Independence Day last year, about 1.6 million more Ohioans have gotten vaccinated, and over 1 million more COVID cases were reported to the Ohio Department of Health.
“I am cautiously optimistic, but I still think we don’t know what the future will bring with this pandemic yet,” Paton said.
We’re still learning about how long immunity gained by catching the virus lasts, she said. And new variants of the virus will crop up. The virus could mutate in a way that means our current vaccines are less effective against it. Although it’s worth noting that this isn’t all-or-nothing; it’s unlikely a variant will arise that current vaccines are 0% effective against, Paton said.
“We’re going to have new variants, and some of them will be worse and some of them will be milder,” Paton said. “When those happen and what our state of immunity is at that point, it’s hard to say.”
Viruses often evolve to be more transmissible, Paton said.
“And there’s a misconception the virus will get milder every time, and that’s not necessarily the case,” she said.
Endemic or epidemic?
“While the nature of coronavirus probably does not lend itself to truly being what’s considered endemic, that’s probably the best sort of more generic term that the public would understand about where we’re going with this,” Patterson said. “We compare it to influenza and how the influenza virus mutates every year and different forms, different strains are always coming in and have to be protected against.”
It’s important to define what endemic means, Hodges said.
“It doesn’t mean milder. It doesn’t mean the problem is solved,” he said. “It just means that the balance between new infections and recovery is about even, just means it’s not spreading rapidly. That doesn’t mean it can’t spread rapidly. It can go from endemic back to pandemic pretty quick.”
Based on that definition of endemic, we are not there yet, Paton said. In the past two years, we haven’t seen the virus reach long-term stability where case rates remain constant.
“I don’t know that COVID will ever be an endemic-type disease where the rates are stable all the time. I think it might more likely be an epidemic-type disease where we have surges now and then with new variants or waning immunity,” she said.
The term epidemic still sounds scary — and experts say these diseases should be taken seriously. But Paton pointed out that flu in the winter here is an epidemic disease.
“A pandemic is global-wide,” Paton said. “So it’s all over the world. We’re having a surge worldwide, basically. Epidemic is more local. It could be with certain demographics, certain times a year, that becomes a little more predictable.”
The World Health Organization will announce when it downgrades COVID-19 from a pandemic, and Paton said that could happen soon.
Why COVID-19 isn’t going away soon
COVID-19 won’t be eradicated in the near future, Paton said, and there are three main reasons.
“First of all, we need an effective intervention that stops transmission. We also need readily available diagnostic tools that can rapidly detect the infections. And one other thing that we don’t think about is we need a lack of the disease among non-human animals,” she said. “COVID fails in all three of those right now.”
Current coronavirus vaccines are highly effective at preventing severe illness and death but do not completely stop transmission of the virus, she said.
“It would take extreme effort to test everybody continuously when they’re not even experiencing symptoms when you don’t know who has the disease,” Paton said. “And we’re also seeing that COVID is in a lot of different mammals. The deer population, mink population, we’ve seen it in felines, and we think it originated possibly in bats.”
While the virus is circulating in animals, that means other hosts could foster new variants, as well as spread it to humans.
“It would take a lot to get rid of it right now,” Paton said.
What does being prepared look like?
Late last month, the Centers for Disease Control and Prevention released a new framework for measuring COVID-19 levels and based mask guidance on local risk. The system designates counties as low, medium and high based on the number of new cases and hospitalizations.
All area counties are currently designated as medium or low.
In high counties, the CDC recommends wearing a mask indoors in public. In medium counties, the CDC recommends those at high risk for severe illness consider masking up. At all three levels, the CDC recommends getting vaccinated and testing if you have symptoms.
Local health experts took this new guidance as an indicator that we’re in a better place with the disease, but everyone should hold on to their masks and be prepared to act more cautiously if local spread gets high again.
“I’m not throwing away my masks,” Paton said. “They are in my closet to stay … We will have surges, and it may be prudent when we do have surges to wear masks again.”
Balster from Butler County said we shouldn’t forget the important lessons from the past two years, such as wash your hands, and stay home and get tested if you’re sick.
“Those kinds of lessons are things that we can keep pushing and keep applying in the future that can even decrease our flu numbers and other diseases,” he said.
Patterson from Clark County urged people to be patient with those who are hesitant about removing masks and returning to the way things were, because they’re high risk or any other reason.
“It’s going to take many of us, including myself, a long time to get all the way back to normal, to go to all of the different venues and restaurants and everything,” he said. “It may be a slow reintroduction to society for some people.”