The Ohio Public Health Advisory Alert System has four levels of alerts, based on seven different indicators of how prolific coronavirus spread is in a community. A level four alert is the highest alert level and means that people in that county are advised to only go out in public for essentials.
Montgomery County is at a level three alert. People in counties considered level three are advised to decrease in-person interactions with others, consider necessary travel only, and limit attending gatherings of any number. Public Health - Dayton & Montgomery County said in a statement that with the level three alert, everyone should work from home where possible, no one should attend large social events, the elderly and those with weakened immune systems should stay at home as much as possible, churches are encouraged to provide in-vehicle or online services, and personal travel should be limited. More guidance is at phdmc.org.
Due to the uncontrolled surge of cases of COVID-19 in the area, some of which are linked to large parties, Public Health - Dayton & Montgomery County is advising people not to host or attend large gatherings, stating that while private homes are exempt from the 10-person mass gathering limit in Ohio, hosting such an event is “creating a significant risk for you and your guests and endangering the community at large.”
People who hold gatherings are advised to limit the group to less than 10 people, keep a list of names and contact information of everyone, have the event outside, wear masks when near each other, don’t share food and keep at minimum 6 feet apart.
Under the new data released Thursday, as of July 21, Montgomery County had 732 cases during the past 14 days, which is considered “high incidence” by the CDC definition. Cases increased from an average of 63 cases on July 1 to 70 cases on July 16.
From July 1 to July 15, visits for COVID-19 to the emergency department increased from an average of 14 per day to 18.
More people are also visiting their doctors and being diagnosed with COVID-19. From July 1 to July 14, outpatient visits increased from an average of 49 visits per day to 79.
In recent weeks, more than 60% of the cases are not in congregate settings, such as nursing homes. This is a signal of transmission in the broader community, where if most cases are in congregate settings that’s a more contained outbreak that needs less sweeping measures.
Recent outbreaks in Montgomery County include long-term care facilities, day cares, and workplaces.
Montgomery County is part of an eight-county region that is coordinating on bed capacity during the public health emergency, and there are about 375 ICU beds in the region. A little under 80% of ICU beds were occupied as of July 22 and a little under 10% were occupied with COVID-19 patients. The threshold for concern under the alert system is at least 80% of the region’s ICU beds occupied and 20% occupied with COVID-19 patients.
Sarah Hackenbract, CEO of the Greater Dayton Area Hospital Association, which is monitoring bed capacity, said the reason that the data doesn’t just monitor Montgomery County ICU bed capacity, but rather the region’s capacity, is because during emergencies situations hospitals coordinate together to meet the capacity needs.
Hackenbract said when hospitals are operating efficiently in normal times, they are often at the 75-85% mark. The 20% benchmark for COVID-19 patients is because they are often hospitalized for longer periods of time than other patients and Hackenbracht said it is important to distinguish between patients.
“We need our hospitals to have a certain number of patients in them for all of the machines, equipment and staff to be used efficiently all across that large organization,” she said.
Summary of Ohio Public Health Advisory Alert System 7 indicators
When determining whether a county is a level one, two, three or four alert, the system looks at how many of the following seven indicators counties meet:
New cases per capita: Flagged if greater than 50 cases per 100,000 residents over the last two weeks. Allows for counties with different population sizes to be appropriately compared.
Sustained increase in new COVID-19 hospital admissions: Flagged if increasing trend of at least 5 consecutive days in overall cases by onset date over the last 3 weeks. Reflects disease spread in the population.
High proportion of cases that aren’t congregate cases: Flagged if proportion of cases that are not in a congregate setting goes over 50% in at least one of the last 3 weeks.
Sustained increase in emergency visits for COVID-like illness: Flagged if increasing trend of at least 5 consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last 3 weeks.
Sustained increase in outpatient visits: Flagged if increasing trend of at least 5 consecutive days in the number of people going to a health care provider with COVID symptoms who then receive a COVID confirmed or suspected diagnosis over the last 3 weeks.
Sustained increase in new COVID-19 hospital admissions: Flagged if increasing trend of at least 5 consecutive days in the number of new hospitalizations due to COVID over the last 3 weeks.
ICU bed occupancy: Flagged if percentage of the occupied ICU beds in each region goes above 80% for at least three days in the last week, and more than 20% of ICU beds are being used for COVID-19 positive patients for at least three days in the last week.
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