Ohio Department of Health

At Monday’s press conference concerning the COVID-19 (coronavirus) crisis with Ohio Governor Mike DeWine, Ohio Department of Health (ODH) director Dr. Amy Acton, M.D., MPH, and others, it was stated that people who are 65 years of age or older are urged to stay home for the present.

According to the Pike County General Health District’s summary (on their Facebook page) of Monday’s press conference, the governor stated that people who are 65 years of age or older should stay home, and it was stated at the press conference that those who are 65 years of age or older have a 15 times higher fatality rate, according to earlier studies.

On Monday, the Ohio order against mass gatherings was changed to ban gatherings of 50 or more people, changed from last week’s ban on gatherings of 100 or more people. Also on Monday, President Donald Trump issued guidelines that called, among other things, for Americans to avoid social gatherings of more than 10 people. Fox News reported on Tuesday that Dr. Deborah Birx, M.D., White House coronavirus response coordinator, stated on the network’s morning program “Fox and Friends” on Tuesday that the national guidelines set by the President should be interpreted as rules, noting that they are “’based on all the scientific data’ and that they ‘will make a change on how this epidemic is spread.’”

President Donald Trump issued a set of guidelines entitled “15 Days to Slow the Spread” in an effort to slow the virus’ spread and keep the most high-risk populations safe. The recommendations include the following steps:

1. Listen to and follow the directions of your state and local authorities.

2. If you feel sick, stay home. Do not go to work. Contact your medical provider.

3. If your children are sick, keep them at home. Contact your medical provider.

4. If someone in your household has tested positive for the Coronavirus, keep the entire household at home.

5. If you are an older American, stay home and away from other people.

6. If you are a person with a serious underlying health condition — such as a significant heart or lung problem — stay home and away from other people.

“Today’s guidelines build on the CDC’s general recommendations to help prevent spread of the virus.,” the White House stated. “Americans should continue practicing strict personal hygiene, including washing hands regularly for at least 20 seconds at a time and wiping down surfaces in the home often.

“Even if you are young and otherwise healthy, you are at risk — and your activities can increase the risk of contracting the Coronavirus for others. Everyone can do their part.”

Also from DeWine’s Monday press conference, as summarized by the Pike County General Health District, an order was being issued to close gyms, fitness centers, recreation centers, bowling alleys, indoor water parks, movie theaters, and trampoline parks across the state until further notice, taking effect at the close of business on Monday, March 16.

DeWine’s press conference on Tuesday had a different set-up in response to the President’s rule about not having gatherings of more than 10 people. As a result, the press corps was put into two separate rooms from where the press conference was held.

During the Tuesday press conference, among other issues, DeWine spoke of “one of the challenges that we know is coming”, namely hospital capacity and “making sure that when this hits hard, we are ready for it.”

He and Dr. Acton, as they always do, spoke of slowing the spread of COVID-19 through “flattening the curve.” The curve is often depicted on graphs when coronavirus is discussed. In an article on the news website, thehill.com, Anagha Srikanth explains the curve as representing “the number of people who contract COVID-19 over a period of time.”

“A high curve is created by a steep increase in the number of cases per day followed by a quick decrease,” she reported. “A flatter curve is created by a more gradual increase in the number of cases per day and a more gradual decrease. Over a long period of time, the number of people infected with the novel coronavirus might be about the same, but the difference is in the number of cases each day.”

A more gradual curve is hoped to keep hospitals and healthcare systems from being overwhelmed as they have been in some other countries, causing excruciating life and death decisions to have to be made by medical personnel.

“I’ll go back to the discussion about the curve,” DeWine said. “Again, what we’re trying to do is flatten this (the curve) as much as we can so that we do not have the spike that we see that has occurred in Italy, so we’re not in a situation where we’re overrun, where we don’t have the equipment, (where) we don’t have the personnel.

“These are all things that are very, very significant.”

He said that some of the worries include not having enough beds, ventilators, and personal protective equipment for doctors.

As of Tuesday afternoon, according to ODH, there were 67 confirmed cases of COVID-19 in Ohio in a total of 16 counties, and there were a total of 17 hospitalizations (with many intensive care unit [ICU] hospitalizations included), but Acton has indicated that numbers are coming in very quickly and are changing rapidly. Acton has also indicated that the virus is most likely all over the state, and the actual numbers of people who have the virus are unknown as many people have not yet been tested. Last week, she estimated that at that time there may already have been more than 100,000 cases of people carrying COVID-19 in Ohio.

Dr. Acton said that some of the data for number of counties with cases includes people from other counties who have gone to a more major hospital in another county.

“We’re working on that data as we speak,” she said. “That is the numbers we know. We now have many more in the queue as our testing is going up.”

Ages of the confirmed cases in Ohio range from 14 to 86 (median age of 48). Dr. Acton said that even among 40- and 50-year-olds, the case fatality rate can be 1 in 250. According to the Pike County General Health District, this is .4%.

Illness dates of the currently confirmed cases in Ohio range from Feb. 7 to March 16, according to ODH statistics. Dr. Acton said they know the state had COVID-19 infectivity prior to Feb. 7. Currently-confirmed cases in Ohio include 41 males and 26 females.

In their summary of Tuesday’s press conference, the Pike County General Health District (on their Facebook page) cited an article that was discussed during the press conference about models from the Imperial College in the United Kingdom. Based on the models, if we did nothing to intervene, it is estimated that 2.2 million Americans would die. But with interventions, the hospital surge can reportedly be cut by two-thirds and deaths be decreased by half.

Acton said this is the very same data that President Trump’s team is using to come up with rules like 10 people in a room, social distancing, staying home if you are over 65 years of age, etc.

“What we’ve been saying all along is that we’re saving lives,” she said. “Every one of us who doesn’t spread it to someone else logarithmically with the doubling time of every six days is keeping less of us getting this. It’s so important.”

The full article on the Imperial College modeling is available on the Pike County General Health District Facebook Page.

On Monday, the governor recommended that in-person voting for Ohio’s primary election be postponed from March 17 to June 2, and he filed a lawsuit to do that. On Monday evening, a judge ruled against the governor’s recommendation to delay the election.

Late on Monday evening, Dr. Acton ordered that election polling locations in Ohio be closed on Tuesday in order “to avoid the imminent threat with a high probability of widespread exposure to COVID-19 with a significant risk of substantial harm to a large number of the people in the general population, including the elderly and people with weakened immune systems and chronic medical conditions.” Dr. Acton ordered the polls closed as a health emergency.

On Sunday, DeWine announced that the Ohio Department of Health has issued a director’s order that closes all restaurants and bars in the state to in-house patrons. Restaurants with take-out and delivery options are still allowed to operate these services while closing their dining rooms.

DeWine indicated that he wanted to issue the order ahead of St. Patrick’s Day, March 17, which commonly attracts large groups of people to bars and restaurants, making “social distancing” impossible in many circumstances.

“This is known by healthcare providers to be among the most effective ways to slow the spread of the disease, due to the high rate and speed of transmission in COVID-19,” according to DeWine’s office.

“Our goal is for everyone to get through this,” said DeWine. “Our hope is that next St. Patrick’s Day, everyone will be there and that they’ll have the opportunity to live their life and live their American dream. But, if people are not around, they can’t do that.”

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