Summit County COVID-19 Activity Summary, - scph...168.0 137.9 102.5 . ... This provides SCPH and...

Summit County COVID-19 Activity Summary, MMWR Week 6 (2/7 – 2/13/2021); OPHAS Reporting Week of 2/10 – 2/16/2021

Note: There should be a sustained decrease in most OPHAS indicators for 4-6 weeks to be considered a substantial decrease in community COVID-19 activity

Other Indicators 1/24 - 1/30/2021 1/31 - 2/6/2021 2/7 - 2/13/2021 Current Status School-associated (including sports) COVID-19 cases 149 143 119 Decreasing ↓ Pediatric testing capacity at Summit County Public Health (available to symptomatic students who cannot locate testing through other COVID-19 testing providers) 30 tests / day 30 tests / day 30 tests / day No change Pediatric case rate (per 100,000 residents aged 17 and under) 168.0 137.9 102.5 Decreasing ↓ MIS-C associated with COVID-19 (Summit Co. cases reported) 1 3 0 11 cases total Source: Ohio Disease Reporting System (ODRS)

Full report (including Summit County COVID-19 indicator data and definitions) can be obtained here: https://www.scph.org/covid/maps-data Data is provisional and subject to change

Date prepared: February 18, 2021 Prepared by: Summit County Public Health Communicable

Disease Unit ([email protected])

OPHAS Indicators (from Ohio Dept. of Health) Three weeks ago

(1/27 – 2/2) Two weeks ago

(2/3 – 2/9) Previous week (2/10 – 2/16) Current Status

1) Population Case Rate (previous 14 days) 396.5 (High) 338.8 (High) 283.4 (High) Above ODH threshold 2) Sustained increase in new COVID-19 cases No Sustained increase No Sustained increase No Sustained increase No Sustained increase 3) Proportion of cases not in a congregate setting (See also Figure 7 on page 4 of this report) 86.5% 75.6% 60.0%

Above ODH threshold (see page 4)

4) Sustained increase in COVID-19 ED visits No Sustained increase No Sustained increase No Sustained increase No Sustained increase 5) Sustained increase in COVID-19 outpatient visits No Sustained increase No Sustained increase No Sustained increase No Sustained increase 6) Sustained increase in COVID-19 hospital admissions No Sustained increase No Sustained increase No Sustained increase No Sustained increase 7) ICU bed occupancy (total and COVID-19) Total: NC, COVID: ↓ Total: NC, COVID: NC Total: NC, COVID: NC Not above ODH threshold

OPHAS Alert Level Level 3: Red Level 3: Red Level 3: Red Level 3: Red

Source: Ohio Disease Reporting System (ODRS) and Ohio Public Health Alert System (OPHAS): https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

Summit County COVID-19 Case Data by Age, as of 2/13/2021 Cases Hospitalizations Deaths Count 38,570 3,373 926

Range < 1 year to 106 years < 1 year to 103 years 30 to 103 years

Mean 44.7 years 64.9 years 79.2 years Source: Ohio Disease Reporting System (ODRS)

https://www.scph.org/covid/maps-data

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

Summit County 2021 COVID-19 Weekly Report, MMWR Week 6 (2/7 – 2/13/2021) Page ii

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Summit County 2021 COVID-19 Weekly Report, MMWR Week 6 (2/7 – 2/13/2021) Page 1

Summit County Public Health COVID-19 Community Surveillance Report

Report #24 Centers for Disease Control and Prevention

MMWR Week 6: February 7 to 13, 2021

Summit County Surveillance Data:

COVID-19 Case Data: Data based on the reporting date (Figure 1) indicates that there has been a sustained increase in the 7-day average of COVID-19 cases in Summit County through the first two weeks of January. Following the holiday season, the average daily count again increased from 302 cases per day on January 1 to 364 cases per day by January 12. Since then, the 7 day average gradually decreased to 143 cases per day on February 13. Even with this decrease, case rates in Summit County remain elevated and widespread community transmission continues.

Based on symptom onset date (Figure 2), the 7-day average was 308 cases per day on January 1, decreasing to 181 cases per day by January 30. Data with a case onset after January 30 are considered to be incomplete and trend determinations generally cannot be made at this time, but the elevated case onset counts continue to be concerning and indicates high levels of COVID-19 activity and community spread in Summit County.

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Figure 1. COVID-19 cases reported in Summit County in 2020, based on date reported, 1/1 - 2/13/2021

Source: Ohio Disease Reporting System (ODRS)

COVID-19 Case Data: Public health data can be presented in different ways. For COVID-19 case reporting, Summit County Public Health (SCPH) reports case count data by the date each case is reported. This provides SCPH and community partners a real-time picture of case reporting and public health response, such as case interviews, contract tracing, outbreak investigations and mitigation efforts. Summit County reports confirmed and probable cases that active cases at time of reporting, and does not include cases reported due to positive antibody test results.

The Ohio Department of Health (ODH) reports data the date that symptoms were first experienced (onset date). All confirmed and probable cases are reported by ODH, including probable cases due to positive antibody tests. The case graph by onset date (also known as an epidemiological curve) provides valuable information on the dynamics of disease transmission and outbreaks. However, the data in the most recent two weeks of the onset date curve will be incomplete, as many of the cases first experiencing symptoms on those dates have not yet been diagnosed and/or reported to the health department.

In this report, graphs for case counts, hospitalizations and deaths include data for the past 6 weeks. Graphs with data for the entire pandemic are included at the end of the report. In the graphs with daily data, 7 day averages are calculated to correct for data variability


Weekly cases by age distribution: Figure 3 and 4 display the weekly age distribution of new cases reported since August 30, based on date reported. Through Memorial Day, over 90% of reported cases were adults aged 25 and older, and children and young adults represented less than 10% of the cases. Since the early summer, the proportion of children (0 to 17 years) and young adults (18 to 24 years) remained at 18% to 25% of total cases. During the past reporting week, children accounted for 11.5% of the cases reported; cases aged 0 to 24 accounted for 23.5% of cases during Week 6.

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Figure 2. COVID-19 cases reported in Summit County in 2020, based on symptom onset date, 1/1 - 2/13/2021

Source: Ohio Department of Health (ODH) COVID-19 Dashboard

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Figure 3. Age distribution of COVID-19 cases and weekly totals in Summit County, by MMWR week


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100%Figure 4. Age distribution of COVID-19 cases by percent in Summit County, by MMWR week



Summit County Hospitalization and Death data:

Due to the progression of the COVID-19 illness and reporting delays, hospitalization data in the previous two to four weeks may be incomplete. On January 1, the 7-day average for hospitalizations due to COVID-19 was 24.7 admissions per day (Figure 5). The admission rate decreased through January to 15.3 admissions per day on January 30. Even with the decreasing trend, the elevated hospitalization rate continues to be concerning and is a result of the widespread community transmission that is occurring in Summit County.

Eleven COVID-19 deaths were reported in July, and twenty-four deaths were reported in August (Figure 6). Seventeen deaths due to COVID-19 infections were reported in September, thirty in October, and 144 deaths in November. In December, there were 307 deaths reported due to COVID-19, and 151 deaths in January. Twenty-seven deaths have been reported through February 13. COVID-19 deaths can occur up to several weeks following the initial diagnosis and test result.

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Figure 5. COVID-19 hospitalizations reported in Summit County in 2020, based on admission date, 1/1 to 2/13/2021


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Figure 6. COVID-19 deaths reported in Summit County in 2020, based on date of death, 1/1 to 2/13/2021



MIS-C Cases in Summit County

According to the CDC, Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or fatigue. Although we cannot yet definitively say what causes MIS-C, many children with MIS-C tested positive for the SARS-CoV-2 virus, had COVID-19 symptoms, and/or had been around someone with COVID-19.

Summit County: As of February 13, 2021, 11 cases of MIS-C have been reported in Summit County (8 confirmed, 3 suspected status). The age range of these cases is 5 to 18 years old, with an average age of 11.1 years. All of these cases were hospitalized, with an average stay of 5.3 days.

For more information about MIS-C, refer to: https://www.cdc.gov/mis-c/index.html

Ohio Public Health Alert System (OPHAS) Indicators OPHAS Indicator 1: New cases per capita (past 14 days) OPHAS Summary: Flagged if greater than 50 cases per 100,000 residents over the last two weeks. Allows for counties with different population sizes to be appropriately compared. The population case rates reported by OPHAS has exceeded the threshold of 50 cases per 100,000 residents during the three most recent reporting weeks, at 396.5, 338.8 and 283.4 cases per 100,000, respectively.

1) Population Case Rate (previous 14 days) 1/20 to 2/2/21 1/27 to 2/9/21 2/3 to 2/16/21

Number of cases based on date reported: 2884 2460 2058 Population case rate 533.1 454.7 380.4

Number of cases based on symptom onset: 2145 1833 1533

Population case rate 396.5 338.8 283.4 Source: Ohio Disease Reporting System (ODRS) and Ohio Public Health Alert System (OPHAS)

OPHAS Indicator 2: Sustained increased in new cases OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in overall cases by onset date over the last 3 weeks. Reflects disease spread in the population.

New case data are displayed in Figure 1 and Figure 2 (pages 1 and 2), and OPHAS reported no sustained increase in the 7-day case average based on onset date during the past 3 reporting weeks.

OPHAS Indicator 3: Proportion of cases not in a congregate setting OPHAS Summary: 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. Congregate settings are housing situations that may increase the risk of transmission of COVID-19, and include long term care facilities, inpatient rehabilitation facilities, group homes, and prisons or jails. Non-congregate setting calculations on the OPHAS dashboard may be incomplete and is updated each week. Non-congregate setting rates in Figure 7 are calculated by Summit County Public Health and are usually more current. The total percent of COVID-19 cases in a non-congregate setting for all COVID-19 cases in Summit County: 92.8% (3/13/2020 to 2/13/2021), and weekly non-congregate case rates have consistently exceeded 80% since Week 26 (6/21 to 6/27/2020), see Figure 7.

https://www.cdc.gov/mis-c/index.html


OPHAS Indicator 4: Sustained increase in Emergency Department (ED) visits for COVID-like illness OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus.

OPHAS Indicator 5: Sustained increase in outpatient visits for COVID-like illness OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of people going to a health care provider with COVID symptoms who then receive a COVID confirmed or suspected diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus.

Data from the OPHAS dashboard indicates that there were no sustained increases in the 7 day averages for ED visits or outpatient visits reported in the past three reporting weeks.

OPHAS Indicator 6: Sustained increase in new COVID hospital admissions OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of new hospitalizations due to COVID over the last 3 weeks. Important indicator of hospital burden and disease severity. Hospitalization data are displayed in Figure 5 on page 3, and OPHAS reported no sustained increase in the 7 day average for hospital admissions from January 27 to February 16.

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Reporting WeekSource: Ohio Disease Reporting System (ODRS)

Figure 7. Non-congregate COVID-19 cases reported by week (% of all cases)

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Figure 8. COVID-19 Emergency Department (ED) and Outpatient visits (7-day averages), 1/20 to 2/16/2021

Source: Ohio Public Health Alert System (OPHAS)


OPHAS Indicator 7: Intensive Care Unit (ICU) bed occupancy

OPHAS Summary: Flagged if percentage of the occupied ICU beds in each region goes above 80% for at least three days in the last week, AND more than 20% of ICU beds are being used for COVID-19 positive patients for at least three days in the last week. Provides an indication of the capacity available to manage a possible surge of severely ill patients.

Based on data downloaded from the OPHAS dashboard (Figure 10), the total ICU occupancy rate did not exhibit any trends and COVID-19 ICU occupancy rates reported at Summit County facilities indicated a decreasing trend since January 20. In the past four weeks, total ICU occupancy rates ranged from 67.5% to 81.8%, and the range for COVID-19 ICU occupancy was 9.8% to 18.5%. Total ICU occupancy did not exceed the 80% threshold in the latest OPHAS reporting week, but COVID-19 ICU occupancy did not exceed the 20% threshold.

About this report: Data used in the report was obtained from three sources:

1) ODH COVID-19 Data Dashboard: The State of Ohio COVID-19 Dashboard displays the most recent preliminary data reported to the Ohio Department of Health (ODH) about cases, hospitalizations and deaths in Ohio by selected demographics and county of residence. Data is reported to ODH via the Ohio Disease Reporting System (ODRS): The ODH data dashboard may be accessed here: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/overview

2) Ohio Public Health Alert System (OPHAS) Data Dashboard: The Public Health Advisory Alert System is a color-coded system designed to supplement existing statewide orders through a data-driven framework to assess the degree of the virus’ spread and to engage and empower individuals, businesses, communities, local governments, and others in their response and actions. The OPHAS dashboard is updated every Thursday afternoon and is available here: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

3) Summit County Public Health: Data reported by Summit County Public Health is acquired from the Ohio Disease Reporting

System (ODRS). In addition to this report, a COVID-19 data dashboard is available at: https://www.scph.org/covid/maps-data This dashboard is updated daily (Monday-Friday by 4:00 pm).

Numbers may change as updated reports are received. For questions, please contact Joan Hall at the Summit County Public Health Communicable Disease Unit ([email protected]). Report was issued on February 18, 2021.

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Figure 10. ICU Occupancy in Summit County health care facilities: 1/20 - 2/16/2021

Source: Ohio Public Health Alert System (OPHAS)

https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Ohio-Disease-Reporting-System/welcome/

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/overview

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/




APPENDIX. Daily COVID-19 case counts (by report date and symptom onset date), hospitalizations and deaths since the start of the pandemic

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COVID-19 cases reported in Summit County based on date reported, 3/13/2020 to 2/13/2021


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COVID-19 cases reported in Summit County based on symptom onset date, 3/10/2020 - 2/13/2021

Source: Ohio Department of Health (ODH) COVID-19 Dashboard


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Hospitalization Count 7-Day Average

COVID-19 hospitalizations reported in Summit County in 2020, based on admission date, 3/11/2020 to 2/13/2021


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Deaths 7 Day Average

COVID-19 deaths reported in Summit County in 2020, based on date of death, 3/11/2020 to 2/13/2021


Summit County COVID-19 Activity Summary, - scph...168.0 137.9 102.5 . ... This provides SCPH and...

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