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ASHLAND -- As Ashland County remains red yet again in the Ohio Public Health Advisory System, three surrounding counties are now designated purple. 

While Ashland County triggered one less indicator this week than it did last week in the color-coded system, Lorain, Medina and Richland County are now considered purple.

Lorain was marked as purple last week, but both Medina and Richland Counties are new additions.

When a county reaches purple, it has met at least six of seven indicators of concern for COVID-19 spread for at least two consecutive weeks.  A county can reach the purple designation the week after it meets six of seven indicators for one week is placed on a “Watch List.” 

At this level, the Ohio Department of Health advises residents should only leave home for supplies and services. Purple counties are considered to be under a level four public emergency.  

On Nov. 19, Franklin County was the first county to turn purple. It improved to red, or level three, on Thursday. 

Four were counted as purple last week, and now the trend has continued for another week. Eight counties are considered purple in Thursday's update of the Ohio Public Health Advisory System. Outside of the three surrounding Ashland County, this includes Summit, Portage, Stark, Montgomery and Lake counties.

All Ohio counties remain listed for high incidence of COVID-19 spread. All counties had active cases of coronavirus at or over 100 cases per 100,000 population.

At his bi-weekly press briefing, Ohio Gov. Mike DeWine during said it seemed clear vaccines were on the way, but said the continued spike in numbers was overwhelming the state's hospitals and medical staffs.

Dr. Andy Thomas, chief clinical officer with The Ohio State University Wexner Medical Center, said the rise in cases and hospitalizations do net yet reflect the impact of the Thanksgiving holiday, during which people may have traveled and gathered despite government recommendations.

"Usually, people are admitted a week after they're diagnosed. This is not the beginning of the end. This is not even the end of the beginning," Thomas said during the briefing.

"We're in a really difficult spot here, and we're just now heading into the most challenging three months of this pandemic. ICU beds are the area of capacity where we have the biggest strain across the state - especially in rural areas," Thomas said.

Dr. Nora Colburn, associate medical director for clinical epidemiology at the Wexner Medical Center, said the state was in a crisis.

"Healthcare workers are burned out and stretched thin. Our hospitals are stressed to the extreme and we haven't even seen the infections resulting from Thanksgiving," she said.

"We will be overwhelmed if things don't change. Hospitals around the state are delaying non-emergency procedures. This will impact routine healthcare. People need their diagnostic screening procedures," Colburn said.


COVID-19 in Ashland County 

For the first time since Oct. 29, Ashland County did not trigger the "sustained increase in new cases" indicator. 

Ashland County triggered four of the seven indicators in the Dec. 3 update of the Ohio Public Health Advisory System. 

These indicators include new cases per capita, proportion of cases not in a congregate setting and sustained increase in emergency department visits for COVID-like illness and ICU bed occupancy. 

The "sustained increase in new cases" indicator is flagged if there is an increasing trend of at least 5 consecutive days in overall cases by the onset date over the last three weeks. On Nov. 15, there was a seven-day average of 34.57 cases of COVID-19. On Dec. 1, the seven-day average was down to 13.43.  

Last week, Ashland County triggered the indicator for ICU bed occupancy for the first time. The other current indicators have all been previously marked. 

The county remains red in color and is still considered "high incidence" for spread of the coronavirus by CDC standards. 

The Indicators 

New cases per capita -- Flagged if greater than 50 cases per 100,000 residents over the last two weeks. In Ashland County, there have been 276 new cases over the past two weeks, or 516.07 per capita. This is up from last the Nov. 26 report of 267 new cases over the past two weeks, or 499.21 per capita.

Proportion of cases not in a congregate setting --  Flagged if proportion of cases that are not in a congregate setting goes over 50 percent in at least one of the last three weeks. Ashland County’s non-congregate case rate has exceeded 72.19 percent over the last three weeks. 

Sustained increase in Emergency Department (ED) visits for COVID-like illness -- Flagged if increasing trend of at least five consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last three weeks. In this week's report, Ashland County saw its seven-day average of ED visits peak at 9.57 on Nov. 27.

ICU Bed occupancy -- 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. 25 through Dec. 1, the percentage of ICU beds used in region five was as low as 77.60 on Nov. 25 and as high as 85.36 on Dec. 1. The percentage of COVID-19 positive ICU patients ranged from 24.45 percent to 26.45 percent.

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.

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