ASHLAND -- As the pandemic shatters records on state and national levels, the same can be said locally where more than half of all the COVID-19 cases within Ashland County residents were reported in the last month.
Between Oct. 30 and Nov. 30, the Ashland County Health Department reported 640 (56 percent) of its total 1,147 COVID-19 cases since March. Of this number, at least 1,035 are confirmed -- not probable -- COVID-19 cases.
The numbers of active cases and hospitalizations are up since last month, too. On Nov. 30, the Ashland County Health Department (ACHD) reported 153 active cases, which compares to 100 active cases on Oct. 30.
Eighteen Ashland County residents were hospitalized on Nov. 30, while only three were hospitalized late last month. Prior to November, the number of hospitalizations peaked at seven on Oct. 19.
“Because of winter, the colder months and not having the ability to be outside anymore, people are inside, cooped up and there’s lack of ventilation,” said Hena Samdani, a tier 2 epidemiologist with the Ashland County Health Department. “The state is surging. The country is surging. And so are we.”
Other factors could include gatherings and the lack of masks and social distancing. Samdani mentioned the influence of leadership, too.
“You listen to them. You follow them, so our leadership needs to lead by example,” she said.
These factors are the same factors that play a role in the spike across the country, she continued.
Further, as more cases arise, the health department cannot contact those affected by COVID-19 or their contacts as quickly. Samdani advises people who test positive to take action before they are contacted by the health department.
“It is taking us time to get to you. So what we want you to do is when you get tested and you have a positive result, stay at home, call the people you have been around in less than six feet for 15 minutes or more, tell them you have tested positive and they need to be at home, too,” she said.
In November, deaths due to COVID-19 have risen more sharply than before. Twelve deaths due to COVID-19 were reported on Oct. 30 by the ACHD, and 20 were reported on Nov. 30.
Samdani explained the ACHD has changed how its reporting deaths over the past month. The health department was recording the number of Ashland residents who died with COVID-19 listed as a primary cause of death, but recently changed to record the number of individuals who die in Ashland County with COVID-19.
This change was made to be more in line with how the state was tracking deaths, Samdani said.
When COVID-19 is listed as a secondary or tertiary cause of death, the deaths were not and still are not included in the health department's counts.
A red rating
Last week, Ashland County remained “red” in the Ohio Public Health Advisory System and is still considered "high incidence" for spread of the coronavirus by CDC standards.
The county triggered five of the seven indicators, including ICU bed occupancy for the first time.
The indicator for ICU bed occupancy is flagged when the percentage of ICU beds in a region goes above 80 percent for three or more days in the previous week -- with more than 20 percent of the ICU beds being used for COVID-19 positive patients also for three or more days.
From Nov. 18 to 24, the percentage of ICU beds used in Region Five was 80 percent or higher, peaking at 84.55 percent on Nov. 24. The percentage of COVID-19 positive ICU patients ranged from 22.11 percent to 26.1 percent. This region includes Ashland, Richland, Wayne and 10 other counties within Northeastern Ohio.
On Monday, more than 5,000 patients with COVID-19 were being treated in Ohio hospitals, according to Chief Medical Officer of OSU Wexner Medical Center Dr. Andy Thomas, who spoke during Gov. Mike DeWine’s press conference. This compares to 1,700 who were hospitalized on Nov. 1.
Ashland also triggered the indicators for new cases per capita, sustained increase in new cases, proportion of cases not in a congregate setting and sustained increase in emergency department visits for COVID-like illness. These indicators had all previously been flagged.
How the pandemic progressed
COVID-19 made its Ashland debut on March 18 and has increased its presence in at least one record-setting way every month since.
Case number two was reported more than a week later on March 27. The third followed on April 2.
By the end of April, eight positive cases of COVID-19 were recorded in Ashland County residents.
The number of local cases continued to rise steadily into the warmer months. Cases spread, and testing became more available. On May 27, the ACHD reported 22 cumulative cases of COVID-19. On June 18, there were 38 cumulative cases with 10 considered active.
On July 17, 99 cases of COVID-19 in Ashland County residents were recorded. Thirty-four were active. Four deaths had been recorded.
The next update, on July 24, showed cases had eclipsed 100 in total. The health department reported 116 cumulative cases with 35 active. No more deaths had occurred.
During August, Ashland saw the largest increase in COVID-19 cases it had yet seen. The cumulative number of cases rose to 168 on Aug. 31. However, active cases at any given time remained low compared to July’s reports. The highest number of active cases reported via the ACHD’s regular Facebook and website posts was 17 on Aug. 14.
September marked the largest percent increase in cases Ashland has seen in any given month. The cumulative number of cases rose by at least 66 percent that month. On Sept. 28, 253 cumulative cases were counted. At that time, 30 were active.
Between Sept. 28 and Oct. 30, another 254 cases were recorded. On Oct. 30, 100 cases were active for the first time. Active cases haven’t dipped below 100 since.
The number of active cases peaked at 181 on Nov. 18. The number of hospitalizations due to COVID-19 peaked on Nov. 27 when 13 Ashland residents were hospitalized -- some at UH Samaritan and others at other facilities.
Moving forward, Samdani predicts further increases in COVID-19 cases, as well as hospitalizations and deaths associated with the pandemic.
"The surge is probably going to get worse because we’ll see the after-effects of the Thanksgiving gatherings in this week and the weeks to follow," she said.