New cases per capita: When the data show that a county has had an average of 50 cases per 100,000 people over a 2-week period, that triggers a flag for an increasing case rate. Using this data means officials are taking into account population of a county when monitoring case increases
Sustained increase in new COVID-19 hospital admissions: When the numbers show at least a five-day period of sustained growth in the number of county residents with the COVID-19 who are admitted to a hospital, the county will be flagged for meeting this indicator.
Proportion of Cases Not 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. Used as indicator of greater risk of community spread.
Sustained increase in ER visits: ER data will show the trend in the number of people who visit an emergency department with COVID-19 symptoms or a COVID diagnosis as a result of the visit. A county is flagged when there is an increase in such ER visits over a five-day period.
MORE: Coronavirus mask order issued for Butler, Montgomery counties
Sustained increase in outpatient visits: This data set looks at the number of people visiting outpatient settings, including telehealth appointments, with suspected or confirmed COVID-19 symptoms. A county is flagged when there is an increase over a five-day period.
Sustained increase in new COVID-19 hospital admissions: When the numbers show at least a five-day period of sustained growth in the number of county residents with COVID-19 who are admitted to a hospital, the county will be flagged for meeting this indicator.
ICU bed occupancy: This indicator looks at regional data for both COVID19 and non-COVID use of ICU beds. A county is flagged for this indicator when the regional ICU occupancy goes above 80% for at least three of the last seven days.
Montgomery County is considered one of seven Ohio counties on a "level three" alert as of Thursday, with one being a low level of alert and four being the highest level of alert. People in counties like Montgomery considered "level three" are advised to be diligent about additional precautions including to decrease in-person interactions with others, consider necessary travel only, and limit attending gatherings of any number.
DeWine announced a public health order requiring masks to be worn in all level three and level four counties on Tuesday. The order goes into effect 6 p.m. Wednesday.
Ohio Department of Health is reporting Montgomery County has had more than 100 new cases reported during the past 14 days, which means the county is categorized as "high incidence" for COVID-19 as defined by the CDC. The community is also experiencing early signs that more people are seeking medical care for COVID-19 symptoms. From June 9-29 visits for COVID-19 to the ER more than doubled from an average of 6 per day to 13 per day, and on the same time period the average number of people visiting their doctors and being diagnosed with COVID-19 quadrupled from 8 visits per day to 37.
“Here we’ve seen average daily visits to the ER more than double. Outpatient visits have more than quadrupled,” DeWine said.
MORE: Dayton approves mandatory mask law, cites rapid COVID-19 spread locally
In the west central Ohio region, the number of COVID-19 positive patients in the hospital or on ventilators has doubled over the past several weeks.
Butler County is meeting four of seven indicators and is also in a "level three" alert. Ohio Department of Health reported at the end of May into early June Butler County was holding steady at an average of 10 cases per day but as of this past week, the average new cases per day doubled to approximately 20 cases per day. Due to clinical reporting lags, ODH stated these numbers may continue to grow for this reporting period. data sugests the increase is not entirely due to increased testing, from June 17 to June 29, visits for COVID-19 to the ER went from an average of two cases per day to seven cases per day.
On the same time period the average number of people visiting their docotrs and being diagnosed with COVID-19 went from 10 to 25 visits per day on average. The number of COVID-19 positive patients in the southwest region’s hospital beds and ICUs and on ventilators have alo doubled since the second week of June.
Butler County’s recent outbreaks include a retail store and long-term care facility.
“As of this past week, the average new cases in Butler County per day doubled. The number of COVID-positive patients in the Southwest Region’s hospital beds and ICUs has also doubled since the second week of June,” DeWine said.
No county has become a level four emergency yet in Ohio though as of Thursday Franklin County was on that trajectory, according to the DeWine adminstration.