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Cuyahoga County's COVID Spread Is In The Red — What Does That Mean?

This map shows the risk assessment level for each county [Ohio Department of Health]
This map shows the risk assessment level for each county . [Ohio Department of Health]

Cuyahoga, Lorain, Richland, and Summit Counties are all in the red public health alert category, according to the state of Ohio's coronavirus risk level assessment.

That means there is very high exposure and spread in those communities.

The red counties are also considered Level 3 out of 4 in the state's assessment chart. But what does that actually mean? And how are these risk levels determined?

According to the Ohio Department of Health (ODH), there are four  public emergency levels colors. Level 1 is yellow, Level 2 is orange, Level 3 is red, and Level 4 is purple.

There are different indicators that are used to determine the level of virus spread in each county. Based on those indicators, the county is given a number 1 - 4  and there are certain requirements for people in that county based on the corresponding number.

Ohio State University Wexner Medical Center’s Dr. Andrew Thomas explained these risk level assessments aren’t meant to feel like a grade. Instead, it is meant to be a warning system.

“Much like a weather forecast might be a warning of a storm coming in the future,” he said during the governor’s press conference on Thursday. “It doesn’t do much good to get a weather forecast when you can already see it raining outside. What this system is designed to do is to look forward. Where is the virus going in our community to make sure that the proper messaging, the proper steps are taken in that community to try to reverse any trends of worsening infection.”

Right now, no Ohio county is in the purple category, which is Level 4, but Cuyahoga County came close. Just this week, the county was taken off the state’s “watch list.”

“I wish I could say that overall, we’re moving in a good direction with our COVID-19 cases, but it seems that’s not the case,” Cuyahoga County Executive Armond Budish said during a press briefing Friday. “While I’m glad we’ve been moved off the “watch list” for turning from red to purple under the governor’s standards, but we’re still deep red, and that’s bad.”

According to Cuyahoga County Health Commissioner Terry Allan, this week the county saw the highest weekly totals to date, and more younger people are getting sick.

So far no county has been declared a Level 4 because Ohio has been able to use this assessment as a warning system and reverse any trends, although there are a few counties that are getting close to moving to that next level, Dr. Thomas said.

The risk level is determined by a mix of indicators. One of the indicators is how many cases there are per capita in each county. But they also look at trends to see where those numbers are going, and who is becoming infected. If the numbers aren’t going up because of a cluster, like in a nursing home or local jail, then it might be an indicator of community spread.

The state also looks at hospital trends. Thomas said they pay attention to the symptoms reported to healthcare providers, and increases in emergency room visits, outpatient visits, and hospital admissions.

The last indicator has to do with how many ICU beds are filled in an entire region. The state is divided into eight emergency management regions. If the region has more than 80 percent of their ICU beds occupied for three of the last seven days, that will flag the system and could make a county go up a level.

Why is Cuyahoga County in the red?

According to the Ohio Department of Health, over the past two weeks, COVID-19 cases in Cuyahoga County increased by 22 percent. Those new cases triggered three of the metrics looking at the trend in coronavirus cases.

The average outpatient visits with suspected or confirmed COVID patients more than tripled, which was another indicator. And the state also said the number of hospital admissions per day nearly doubled in about a two-week time frame.

Gov. DeWine issued an order requiring anyone in red counties must wear a mask in public places. People in red counties should also consider limiting unnecessary travel, decrease in-person interactions, and limit gatherings.

No matter what county you are in, there is some level of COVID-19 spread, said Thomas. There’s no county in the green, because every county is, on some level, in a public health emergency, he said.

Anyone, in any county, should wear a mask, keep their distance from people, avoid traveling to high-risk areas, and practice good hygiene, like washing hands frequently and washing high-touch surfaces


lisa.ryan@ideastream.org | 216-916-6158