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October 2020

COVID cases, hospitalizations continue to soar in Ohio; DeWine calls for local ‘defense teams’

Ohio once again shattered its daily record for new coronavirus cases on Friday as 3,845 more residents tested positive (Source: “Ohio sets more COVID records with 3,845 new cases and hospitalizations at all-time high,” Columbus Dispatch, Oct. 30).

Friday's new cases were 7.1% higher than the previous record of 3,590 new cases set Thursday, state Department of Health data shows. It marks the second time Ohio's newly reported cases have exceeded 3,000 a day and the 15th day above 2,000 cases. A total 1,629 Ohioans remained hospitalized with COVID-19 as of Friday, which is the highest number since the pandemic began in March. The total hospitalized on Friday represents a 6.1% increase, data shows.

Given the soaring number of cases and hospitalization, Gov. DeWine on Thursday called on leaders of each county and community to create COVID-19 “defense teams” (Source: “Ohio Gov. Mike DeWine calls for local coronavirus ‘defense teams,’ acknowledges there’s no solid data on cause of recent alarming spread,” Cleveland.com, Oct. 29).

DeWine said defense teams would be made up of county commissioners, mayors, local hospital leaders, the local health commissioners and business, religious and other leaders. The teams would look at COVID-19 data, inventory their assets and act.


Ohio Medicaid enrollment spikes amid pandemic

The number of Ohioans enrolled for Medicaid coverage has increased more than 250,000 since the start of the pandemic, according to new state data (Source: “Ohio Medicaid rolls increase during pandemic,” Dayton Daily News, Oct. 29).

The state- and federally funded insurance program as of September covered 3.05 million Ohioans, with the increase primarily from covered families and children, according to the latest data reported by Ohio Department of Medicaid.

The Medicaid rolls have steadily shrunk for years as the economy improved in Ohio. But amid the disruption of the pandemic and related restrictions, many people have lost income and Ohio’s unemployment rate rose to 8.4% in September.


Study finds link between neighborhood noise levels, dementia risk

Long-term exposure to noise may be linked to an increased risk for Alzheimer’s disease and other forms of dementia, a new study found (Source: “Living in Noisy Neighborhoods May Raise Your Dementia Risk,” New York Times, Oct. 28).

After controlling for education, race, smoking, alcohol consumption, neighborhood air pollution levels and other factors, researchers found that each 10 decibel increase in community noise level was associated with a 36% higher likelihood of mild cognitive impairment, and a 29 percent increased risk for Alzheimer’s disease. The associations were strongest in poorer neighborhoods, which also had higher noise levels, according to the study published in the journal Alzheimer’s & Dementia.

The reasons for the connection are unknown, but the lead author, Jennifer Weuve, an associate professor of epidemiology at Boston University, suggested that excessive noise can cause sleep deprivation, hearing loss, increased heart rate, constriction of the blood vessels and elevated blood pressure, all of which are associated with an increased risk for dementia.


HHS finalizes price transparency rules

Health insurers will be required to publicly post, in advance, the price for the most common services and procedures, under a rule finalized by the federal Department of Health and Human Services on Thursday (Source: “New Trump policy will force insurers to disclose prices up front,” The Hill, Oct. 29).

Patients will eventually have access to new information about cost, including an estimate of their cost-sharing liability, through an online self-service tool. Currently, this is information that patients typically receive only after they get those services, through an explanation of benefits form.

Beginning in 2022, insurers will be required to make available data files on the costs of various procedures, to better allow for research studies, and to help developers design tools to let patients compare costs across insurance plans. The requirement will take effect for 500 of the "most shoppable" services beginning in 2023, and then for all services starting in 2024.


Ohio COVID-19 cases continue to rise, top 2,500 on Friday

Ohio broke its record for daily coronavirus cases for the third straight day with 2,518 cases reported Friday (Source: “Coronavirus: Ohio tops 2,500 daily cases, breaks record for third straight day,” Dayton Daily News, Oct. 23).

The previous two records were 2,425 reported Thursday and 2,366 reported Wednesday. In the last two weeks, Ohio broke the state record for daily cases six times.

There have been 192,948 total cases in Ohio throughout the pandemic, according to the state health department.

Ohio reported 184 additional hospitalizations Friday, bringing the total to 17,866. Hospitalization rates have continued to climb the last two weeks in southwest Ohio, with nearly 200 more COVID-19 patients in hospitals. While the state’s hospital beds are not at capacity at this time, health officials are watching to see where hospitalizations will peak. Currently, there’s no indication of where hospitalizations will level off.

Ohio is also reporting the highest number of red counties since the state first announced the Ohio Public Health Advisory System at the end of June. As of Thursday, 74% of Ohioans are living in a level 3, or red, county. Only 1% of Ohioans live in a level 1 county. This is the lowest number of level 1 counties the state has had.


Ohio cigarette tax revenue up as more Ohioans appear to be smoking during the pandemic

Cigarette tax revenue in Ohio has been significantly higher than expected through September, a troubling sign that Ohioans are smoking and using other tobacco products more during the pandemic (Source: “‘Troubling trend’: Ohioans appear to be smoking more amid pandemic stress,” Dayton Daily News, Oct. 20).

Cigarette excise tax revenue was $16.1 million (21.8%) above what the state had anticipated for September and $23.5 million (13.6%) above estimate for the first quarter of the state fiscal year.

The Ohio Office of Budget and Management said in its monthly budget report that the "substantial overage is likely related to heightened consumption during the continuing pandemic.”

“It’s a very troubling trend because Ohio already has very high rates of tobacco use and it’s a major cause of our poor health outcomes in Ohio,” said Amy Bush Stevens, vice president of Health Policy Institute of Ohio.

Smoking is the No. 1 cause of preventable deaths. About 20.5% of adults smoked cigarettes in Ohio in 2018, according to the Centers for Disease Control and Prevention, placing the state as the 11th highest smoking rate in the country.

The coronavirus pandemic is a higher risk time for smokers. Smoking impairs lung function, making it harder for the body to fight off coronaviruses and other respiratory diseases. The CDC states being a current or former cigarette smoker increases risk of severe illness from COVID-19.


Ohio releases draft plan for distribution of future COVID-19 vaccination

Ohio plans to roll out a coronavirus vaccine in four phases and give the first doses to high-risk health care workers and first responders, according to a draft plan released by the state’s health department (Source: “Ohio’s four-phase plan to distribute coronavirus vaccine prioritizes health care workers and first responders,” Cleveland.com, Oct. 21).

The first phase of the plan also prioritizes patients in long-term care facilities and those at significantly higher risk for developing severe COVID-19 complications due to preexisting conditions, according to the draft plan dated Oct. 16. The state submitted the 61-page plan to the U.S. Centers for Disease Control and Prevention for approval.

The U.S. Food and Drug Administration has yet to issue emergency use authorization for any COVID-19 vaccine candidate, although public health experts say one could be approved later this fall. But the CDC has cautioned a vaccine could be in short supply after it’s approved because it takes time to manufacture, ship and distribute enough doses.

The second phase of the draft plan calls for the vaccine to be given to health care workers and other essential services workers who are at high risk for exposure. It also includes teachers and school staff members; older Ohioans; and residents with preexisting conditions. People of color, who have been disproportionately harmed by the virus, could also be prioritized during phase two.

The third phase includes young adults; children; and workers in unspecified industries that are critical to the functioning of society. The fourth phase allows all Ohioans to be vaccinated. The plan does not include a timeline for each phase.


CDC expands definition of COVID-19 ‘close contact’

The Centers for Disease Control and Prevention on Wednesday expanded how it defines a “close contact” of someone with Covid-19 as it released new evidence showing the coronavirus can be passed during relatively brief interactions (Source: “CDC expands definition of ‘close contacts,’ after study suggests Covid-19 can be passed in brief interactions,” Stat News, Oct. 21).

Previously, the CDC described a close contact as someone who spent 15 minutes or more within six feet of someone who was infectious. Now, the agency says it’s someone who spent a cumulative 15 minutes or more within six feet of someone who was infectious over 24 hours, even if the time isn’t consecutive, according to an agency spokesperson.

Close contacts are those who are tracked down during contact tracing and are recommended to quarantine.

The announcement from the CDC comes as scientists described in a new study how a correctional officer in Vermont appears to have contracted the coronavirus during “multiple brief encounters” with six incarcerated people who had Covid-19. The infected people were awaiting the results of their Covid-19 tests while the interactions happened.


HPIO online forum to explore health policy implications of the November election

The Health Policy Institute of Ohio is hosting an online forum Nov. 17 on “Politics, perceptions and the pandemic."

In November, voters will elect a president and members of the Ohio General Assembly. What do the results of those elections mean for the next steps in the pandemic response? The forum will explore what's on the horizon as a result of the 2020 election and the likely impacts on health value, equity and the future of public health.

Keynote speaker at the forum will be Dr. Melinda Buntin, Mike Curb Professor and Chair, Department of Health Policy, Vanderbilt School of Medicine.


COVID-19 cases in Ohio top 2,000 for third straight day

In less than a week, Ohio set three one-day records for new COVID-19 cases, topping out at 2,178 Thursday (Source: “As daily COVID-19 cases top 2,000 for third day, experts say Ohio at crucial crossroads,” Columbus Dispatch, Oct. 16).

New cases remained high Friday, though not record-setting, with the state reporting that 2,148 more Ohioans tested positive.

Capacity in critical care units at central Ohio hospitals, meanwhile, is around 79%, which is typical for this time of year, said Dr. Andrew Thomas, chief clinical officer at Ohio State's Wexner Medical Center. Thomas oversees the region's COVID-19 hospital surge plans in partnership with other area hospitals and the Ohio Department of Health. Leaders from Ohio State, OhioHealth and Mount Carmel Health System all said that while they're seeing more COVID-19 patients than they have in the past few weeks, they have room to take more.

Gov. Mike DeWine announced on Thursday that a record 29 counties are now at a red Level 3 COVID-19 advisory. Franklin County was one of the counties elevated from an orange Level 2 advisory to Level 3.

The updated advisories mean more than 65% of Ohioans now live in a red county, DeWine said. In recent weeks, DeWine and other medical leaders have also warned that the virus is spreading more in rural Ohio counties.