On April 27, Ohio Governor Mike DeWine announced the Responsible Restart Ohio plan, outlining the state’s efforts to slowly revise the public health orders for COVID-19. After facing significant pressure and criticism from some in the business community, these changes reflected the administration’s efforts to balance the dual imperatives of proactive public health measures with the economic challenges of decreased consumer activity, which includes state sales tax collection. Certainly, part of the rationale for Ohio’s strong, early response to COVID-19 was the intention to limit spread and flatten the curve so hospitals and health care professionals could build the necessary capacity for treatment. It should be noted, though, a “second wave” is a likely to happen this fall. The mortality risk of virus is still high and likely will be until more is understood about transmission rate, immunity and, ultimately, a vaccine is widely available. With reports of other states seeing their case rates climb, and the recent resignation of Dr. Amy Acton from her post as the Director of the Ohio Department of Health, it may be worthwhile to look at where Ohio is in terms of its own numbers and to determine which metrics can help us understand the success of the administration’s choices in the long term.
The level of testing needed to re-open is a minimum of 152 tests per 100,000 people.
As we have written about previously, testing is a key activity the state can do to understanding the prevalence of the virus. According to research from the Harvard Global Health Institute (HGHI), the level of testing needed to re-open is a minimum of 152 tests per 100,000 people. That means Ohio, with a population of 11.7 million, would need about 17,767 tests per day to accommodate that recommendation. On April 27, the governor announced a new testing capacity plan, indicating that Ohio would be able to accommodate 18,200 tests per day by May 1. Unfortunately, Ohio is well below that stated goal and short of the 17,767 recommended by HGHI. The state has averaged 8,858 tests/day since the announcement. So when should we expect to hit the stated goal?
Using historical data for a forecast, Ohio’s testing numbers are clearly trending upwards, but the potential to hit the target varies. As of June 17, data suggests that the target will be hit sometime between now and mid-August with a forecasted date of July 27. While this date is much later than the DeWine administration identified, Ohio made a significant update last week, announcing that anyone who would like a test is now able to receive one. For anyone interested, you can find a testing center on the state’s COVID-19 website. And while this is good news, how is Ohio fairing relative to new cases and positivity rate?
Positivity rate reflects the percentage of individuals who are tested that receive a positive result.
Positivity rate reflects the percentage of individuals who are tested that receive a positive result. As we increase testing, however, it is likely that this rate decreases as the total number of people tested increases. Case rate is expressed as the number of people who test positive per 100,000 people. In other words, it’s the total number of cases in the state per 100,000 people, which is useful to see how the state’s performance is relative to containing the spread. Looking across the U.S., we have seen recent, troubling trends in case rates. In states like Florida, Tennessee and Kentucky, all states which saw significant pressure to “reopen,” where there were once trends in declining case rates we are now seeing case rates climb again. In Ohio, we see somewhat of a different story:
Since the announcement of the reopening plan, Ohio’s positivity rate has decreased from 13.1 to 7.5 percent and the number of cases per 100,000 people – or the case rate – has declined from 10.05 to 2.57. That means we have seen cases per 100,000 be reduced by 75 percent. Overall, this would indicate that Ohio’s efforts to slow the spread and contain the impact of the virus has gone well. But this is not the end of Ohio’s journey with COVID-19.
Until we regularly hit our testing rate goal, the true impact of the virus will not be understood.
First, it’s important to understand that Ohio is still falling short of its testing goals. Until we regularly hit our testing rate goal, the true impact of the virus will not be understood. Additionally, travel is an important economic input in Ohio, decreased travel already represents $181 million lost from state tax revenues and $108 million lost from local tax revenues, but as travel begins to pick back up, so potentially will the spread of the virus. Another effect of resuming widespread travel via plane and car will be increased air pollution, which new research shows may increase the severity of the virus and its death rate.
Lastly, with nationwide protests of police violence toward Black Americans, epidemiologists have raised concerns over the potential for large gatherings to increase the potential for spread. However, as evidenced by the flurry of legislative actions locally and nationally, racism, in and of itself, is a public health crisis with epidemiolocal roots dating back to 1619. This is, in part, why we have seen such significant racial disparities in the impact of COVID-19, prompting Governor DeWine to convene the Minority Health Strike Force to address these very issues. This is also why, for protestors, the issue of gathering in public is a matter of balancing the risk of spread versus the risk of maintaining entrenched racial inequalities. And while good distancing and prevention practices (like wearing a mask and quarantining) can aid protestors in containing spread, many still may be subject to the use of corrosive tear gas by law enforcement, which has been shown to intensify the effects of the virus.
Until there is a vaccine, limiting spread is a matter of personal responsibility.
Regardless of the inputs which may influence the outcomes we are seeing in the positivity rate and case numbers, it is important that everyone take advantage of testing and contact tracing. Until there is a vaccine, limiting spread is a matter of personal responsibility. For business owners and individuals, it will ensure they follow the guidelines put forward by public health authorities to maintain safe practices and encourage the use of the testing and tracing tools we have. For local and state governments, it will be a conscious effort to enact policies that limit the harm of the virus, including an effort to meet the calls of justice by protestors while not deploying tactics increasing the impact of the virus. And, finally, it will be a matter of collective will to support our communities through these personal actions and the advocacy of public policies to protect all Ohioans, whether they be small business owners, medical providers or families in need of healthy food.