CLEVELAND, Ohio – While coronavirus cases are surging in many states, especially just to the north in Michigan, the bad news in Ohio is merely that they have leveled off or just inched up a bit over the last couple of weeks.
This raises some important questions.
Why aren’t case numbers continuing to shrink in Ohio with so many more people being vaccinated each week? Are there pockets of big increases geographically in the state waiting to spread? What role are the more contagious variants of the virus playing? And could this somewhat modest increase in case numbers statewide of late just be the lull before the storm – the return of a fall-like surge in cases across Ohio?
There are indications that the vaccine is beginning to have a real impact in limiting the spread of the virus, yet even with vaccinations started on about 3 million people across the state, 3-in-4 Ohioans have not received a single shot.
“It’s literally a race between how fast we can get people vaccinated and how fast people are willing to take the vaccine versus the variant. It now looks like we have enough fire power to keep going and going,” Gov. Mike DeWine said Thursday, expressing confidence that the worst of the pandemic is within weeks of coming to an end.
Dr. Amy Edwards, infectious disease physician at University Hospitals in Cleveland, said that with 25% of the Ohioans vaccinated so far, that’s clearly not enough to turn back variants of the virus beginning to spread.
If Ohio could hold steady in the number of new coronavirus cases for about four to six weeks, the state could get closer to 60% of the population vaccinated and a fourth wave of the virus will be averted, Edwards said.
“I don’t think anybody thinks that’s actually going to happen, and so I think the fourth wave will be driven by these variants,” she said.
The good news is that even if those who have been vaccinated contract a variant of the virus, their chances of dying or even ending up in the hospital are extremely rare, Edwards said.
There was a rare jump in cases for Ohio on Friday, as the state reported 2,742 new cases – the highest number for any day since Feb. 23.
“Vaccinated individuals who get exposed to the variant, as opposed to the regular variant of COVID, they are more likely to get sick – the vaccine is not as effective – but it does still appear to protect against severe disease and death, even with a variant,” she said.
It has become apparent in recent weeks that the vaccines are making a difference in Ohio. The first groups targeted were older Ohioans.
Close to 70% of those age 70 and up have now received at least one dose, in comparison to less than 20% of Ohioans under the age of 50. And older Ohioans are now accounting for smaller and smaller shares of both cases overall and those severe cases that have resulted in hospitalizations.
For example, Ohioans age 70 and up accounted for 10.9% of the cases reported in January, yet just 5.8% of the March cases through Thursday.
Meanwhile the share of cases for those under the age of 30 has grown from 33.1% in January to 37.9% of all Ohio cases reported to date in March. Children under the age of 16 have not been approved to receive vaccines by the federal government, and vaccinations for young adults just recently opened up in Ohio.
More dramatic than the age change in cases has been the shift in hospitalizations. Among all coronavirus patients admitted in January, 49.5% were at least 70 years old. The share of hospitalizations for this age group has dropped to 32.4% for March.
Meanwhile, every other age group – Under 29, age 30 to 49 and age 50 to 69 – now take up larger shares of the hospitalizations.
Increases sharper than Ohio’s are being reported in more than 20 states across the county, with perhaps no better example than neighboring Michigan – going from close to 1,050 cases a day in mid- to late-February to about 3,900 a day recently, according to tracking by Johns Hopkins University.
Is the rapid spread in Michigan starting to show up in Ohio? So far, it does not appear so.
In a comparison of seven-day case totals from March 11-17, when Ohio hit its low for the year, to the seven days through Thursday with slightly larger numbers overall, the county-by-county changes were fairly sporadic across the state – not concentrated in a single region or two.
At least 100 cases were reported in the last week for 23 Ohio counties, offering a large enough sample for a better comparisons than in smaller places with just a handful of cases.
The change in case rates for these counties were generally within a range of plus or minus 20% over the last seven days versus March 11-17. And those with the largest swings were not clustered geographically.
Cases were up 72.6% in Hancock County, the sharpest increase among these 23 counties, while they were down 31.3% in Medina County, representing the biggest drop.
As for Ohio’s three large counties, cases were up 6.9% in Franklin and 6.6% in Cuyahoga, but down 2.3% in Hamilton County.
That leaves the question: beyond new variants, what else could be causing Ohio’s recent, modest increase?
Dr. Andy Thomas, Ohio State University Wexler Medical Center’s chief clinical officer, said COVID-19 fatigue may also be a factor in cases these days, with people taking fewer precautions.
“There are certainly people who, as the weather has gotten nicer, have gotten out more. I’ve gotten the sense of that COVID fatigue that we talked about in the fall” has returned this spring, he said.
Thomas believes variants will also become the predominant form of COVID-19, but he doesn’t have a timeline for when that will occur. He’s seen predictions for mid-April or the end of April, but he said he can’t be certain, since Ohio seems to be lagging in the spread of variants.
“We are nowhere near where Florida is or Southern California in terms of the percent of variants,” he said. “It’s certainly not a secret the variants are coming, and they’re more contagious.”
Thomas believes Ohio’s vaccine strategy in which older Ohioans were prioritized because they are more at risk of hospitalization and death could be key if Ohio has an uptick of infections.
“Even though we’re at risk of seeing an increase in the number of cases, my hope is we are not at risk of seeing a rapid increase in hospitalizations and deaths,” he said.
All of which has the governor speaking optimistically, but with caution.
“It is going to take all of us,” DeWine said. “Everybody in every community to encourage everyone to get vaccinated. We’re going to move pretty quickly from the point where we didn’t have enough vaccine to we do have plenty of vaccine.”