Coronavirus: Ohio positive test rate rises, ‘cause for concern’

The number of new COVID-19 cases reported per day to the Ohio Department of Health surged on June 18 and has remained elevated, as Gov. Mike DeWine has urged residents to take precautions as reopening activities continue.

So what exactly do these state statistics show?

The good news is that from mid-April to mid-June, Ohio’s rate of positive tests, hospitalizations and deaths reported per day from COVID-19 all declined. Also, current hospitalization and death numbers per day remain below April-May levels.

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The bad news is that after a long decline, the percentage of Ohio COVID-19 tests coming back positive has increased again in the past two weeks, and hospitalizations ticked upward last week.

Glen Solomon, chairman of internal medicine at Wright State University’s Boonshoft School of Medicine, said the state’s increase in new cases reported per day is tied to both increased testing and a higher percentage of positive tests. Ohio Department of Health data bears that out.

After a slow start to testing, many more Ohioans are now being tested for the disease. Ohio had an average of 15,729 tests per day last week, compared with an average of 9,508 per day for the last seven days of May.

But ODH data shows the amount of testing is not the only reason for the increase in positive tests. After bottoming out with just under 3.8% of tests coming back positive the week of June 7-13, the percentage of positive tests has been rising slightly for two weeks now — hitting 5.3% of tests administered each day last Wednesday-Friday.

“If the percentage of tests coming back positive was declining, then increases in reported cases could be attributed to the increase in testing,” Ohio Department of Health spokeswoman Melanie Amato said. “(When) the percentage coming back positive is staying the same or higher, like it is now, that’s an indication that there are even more cases out there that are being missed.”

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According to Johns Hopkins University, Ohio's pattern follows national trends, although Ohio numbers are slightly lower. Nationally, the seven-day average for positive COVID-19 tests bottomed out at 4.4% in the second week of June, and rose back to 6.9% this weekend.

That comes amid more people returning to work, returning to restaurants and bars, participating in large protests, and enjoying traditional summer gatherings, whether for Memorial Day, Father’s Day or other events.

Ohio has not seen major surges like Texas and Florida, where close to 15% of people being tested in the past week have been positive and hospitalizations increased significantly. In the past five days, those states have gone back to closing bars and limiting restaurant seating.

Even with the recent increase in testing, Ohio is still below average nationally, ranking 41st among the 50 states in tests per capita so far, according to the Johns Hopkins data.

“If you do testing and find that someone who is asymptomatic or pre-symptomatic has a positive test, they can self-quarantine and not spread the disease to others,” Solomon said. “That’s really the key reason you need to do more testing.”

Will more cases equal more deaths?

Tracking the Ohio Department of Health’s data can show a COVID-19 timeline of sorts, from people first testing positive, then some of them being hospitalized days later, and then in the worst cases, people dying days or weeks later.

The percentage of positive tests in Ohio declined steadily through the second week of June, but have now risen for two weeks. Hospitalizations, the next step, declined through the third week of June but then increased again for the first time last week (from 50 per day back up to 63 per day).

Ohio COVID-19 deaths hit a three-month low this past week at 15 per day. The question is whether Ohio deaths will rise in the coming weeks, following the same pattern of positive tests and hospitalizations.

“That’s not too much to assume. It’s a very real issue,” Solomon said.

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ODH reported 30 new admissions to hospital intensive care units Sunday, the second-highest Ohio total for any day in June. The new ICU admissions number dipped back down to 15 Monday, but health officials are watching it.

While COVID-19 can be serious even in non-fatal cases, Solomon said he’s hopeful Ohio won’t see a major surge in deaths.

“We’re going to see an increase in hospitalizations, but I don’t think it’s going to be the dramatic jump like we saw in New York in April,” he said. “We’re starting to see the virus in younger people who may not get as sick or may not end up in the hospital as often. I think that’s biggest issue.”

COVID-19 data details

COVID-19 case data is reported multiple ways on the state's website. Statistics based on "illness onset date" are more accurate in the long run, but they take weeks to firm up, so they're not as useful for analyzing what's going on in the most recent days, according to ODH Chief Data Officer Brian Fowler.

"Current trends" data shows the information being reported to the state in each 24-hour period. Included in that data is the total number of tests administered per day, and how many tests are positive for COVID-19, although that testing data lags a day or two behind.

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In the first two weeks of June, Ohio reported between 10,000 and 12,000 tests administered most days. During that period, the state had between 300 and 490 new COVID-19 cases reported each day.

From June 16-27, testing totals were higher, ranging from 13,000 to 20,000 most days, and reported cases in that span doubled the early June numbers on some days, with highs of 892 on Thursday and 987 Friday.

For most of May and early June, as Ohio COVID-19 testing increased, the percentage of positive tests dropped — a good sign that the virus was not spreading as rapidly.

From May 23-29, each day saw 5.5 to 6.6% of Ohio tests turn up positive, according to ODH. Then from May 30 to June 4, each day had only 4.2 to 4.9% of tests positive. Then from June 5-14, the daily positive rate dropped again, with eight of those 10 days between 3.1 and 3.9%.

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But the favorable trend stopped June 15. Since then, most days have been between 4.2 and 4.8% of tests positive, but last Wednesday through Friday were at 5.3% — the worst stretch in the month of June.

An increase from 3% to 5% is not dramatic, but Ohio’s positive test numbers are not headed in the right direction.

“The fact that there has been an increase in the percentage of those tests coming back positive is cause for concern,” Amato said.

More positive tests

The percentage of Ohio’s COVID-19 tests that have come back positive:

April 21-27: 11.0%

May 21-27: 6.4%

June 7-13: 3.8%*

June 21-27: 5.0%#

* — lowest week

# — June 27 is most recent data available

Source: Ohio Department of Health

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