Ohio Health Policy News

Daily COVID-19 cases in Ohio increase to almost 1K

Ohio reported 987 new COVID-19 cases Friday, replacing Thursday as the fourth-highest day of new cases in the state since the outbreak began (Source: “Ohio reports 987 new coronavirus cases Friday,” Columbus Dispatch, June 26, 2020).

Thursday and Friday’s counts marked the highest days of new cases since April, when the state was conducting testing in some of its prisons and new cases were above 1,000 for three days from April 18 through April 20.

The new cases bring Ohio’s total confirmed and probable cases to 48,638, according to the Ohio Department of Health.

Statewide hospitalizations were above the three-week average and up by 68 Friday, bringing the total hospitalizations to 7,570. ICU admissions, meanwhile, grew by seven, bringing the state’s total admissions to 1,904. The seven new ICU admissions were below the three-week average of 13.

The state also reported 16 new coronavirus deaths since Thursday, bringing the total deaths to 2,788 Friday.

Acton steps down as Health Director

Turning down pleas from Gov. Mike DeWine to stay on the job, Dr. Amy Acton surprisingly resigned Thursday as director of the Ohio Department of Health amid the COVID-19 pandemic (Source: “Dr. Amy Acton resigns as state health director; Democrats cite criticism from GOP lawmakers,” Columbus Dispatch, June 11).

Gov. Mike DeWine said Acton’s resignation is effective Thursday, although she now will become his chief health adviser. Lance Himes, Senior Deputy/Chief of Staff for the Ohio Department of Health, will become interim health director, DeWine said.

“It is difficult for me to put in words how grateful I am for Dr. Acton’s service to the state,” he said.

The governor said he has asked Acton, who was appointed health director Feb. 26, 2019, to “take a big-picture look” at improving public health while still working to address the pandemic.

Meanwhile, despite fears of outbreaks as Ohio reopened for business over the past several weeks amid the coronavirus pandemic, cases of the potentially deadly infection have fallen by one-third from early May.

Ohio averaged 605 new cases a day from May 1-10, a figure that fell 33%, to 407 new daily infections, over the first 10 days of June, according to a Columbus Dispatch analysis of state Health Department figures.

DeWine: ‘We should all be outraged’ by racial health disparities in Ohio

Gov. Mike DeWine said Tuesday he plans to increase the state's efforts to improve health and economic racial disparities (“Source: “'We should all be outraged': Gov. DeWine says Ohio will work to improve racial health, economic disparities,” News 5 Cleveland, June 2).

"We should all be outraged that in the year 2020, in Ohio and in this country, there's still inequality of opportunity and there is still racism," DeWine said. "The coronavirus, this global pandemic, has laid bare our vulnerabilities."

DeWine cited a number of different areas in which there are disparities, including lead paint poisoning children, infant and maternal mortality, the drug epidemic, mental health services and implicit bias in law enforcement.

All of this contributes to a disproportionate impact on black and brown Ohioans when it comes to COVID-19 (see HPIO data brief on Ohio COVID-19 disparities by race), and on communities of color when it comes to other health conditions, such as heart disease, diabetes and asthma.

In a statement on racism and health released this week, HPIO asserted that “The data and research evidence are clear that racism is a systemic and ongoing public health crisis with serious consequences for the health of Ohioans. It is also clear that racism is a crisis with profound and pervasive impacts across all the factors that shape our health. This includes our healthcare, education, housing, food, economic, criminal justice and political systems, among others.”

Ohio expands COVID-19 testing criteria

Ohio this week broadly expanded the criteria for determining who is allowed to get a COVID-19 test to include Ohioans who are showing symptoms of the disease (Source: “New state criteria for coronavirus tests could include a broad group of Ohioans,” Cleveland Plain Dealer, May 28, 2020).

Gov. Mike DeWine announced the changes at his Thursday briefing. Tests, which had been in short supply, were previously strictly reserved for people who were hospitalized, worked in health care, were elderly or had underlying medical conditions that made them vulnerable to COVID-19.

The Ohio Department of Health was one of the last states to receive working testing kits from the federal government. Since then, testing capacity has slowly increased, but is still low compared to other states, territories and Washington, D.C.

As of Thursday, just over 357,000 Ohioans had been tested for COVID-19. Ohio was ninth lowest in the country for its testing rate per 100,000 people: Just 2,992, according to Johns Hopkins University’s COVID-19 testing data. Rhode Island leads the nation, with 13,088 tests per 100,000 people, followed by New York at 9,270 and North Dakota at 8,860.

Telemedicine booms during pandemic, expected to stay

With relaxed state and federal rules aimed at enabling distancing during the COVID-19 pandemic, telemedicine use has greatly expanded in Ohio and nationally (Source: “Rebuilding America: Telemedicine use prompted by COVID-19 here to stay, doctors and health care officials say,” Columbus Dispatch, May 28, 2020)

The necessity to isolate led to a sudden relaxation of federal privacy rules that had prohibited some less-secure forms of patient/doctor communication like FaceTime and not allowing doctors to communicate from home, where others might overhear. More importantly, the rules have been relaxed so that Medicaid and private insurers who previously wouldn’t pay for most virtual health-care visits now do so.

Those changes led to an explosion of telemedicine use. And doctors and health care experts say there will be no going back. This, they say, is a seminal moment for medicine.

Telehealth appointments could serve a more important role in the coming weeks as more people come into hospitals for elective surgeries. Gov. Mike DeWine removed restrictions May 1 on elective surgeries in the state. To reduce risk of exposure, patients might be encouraged to do their presurgery appointments from home.

NEW HPIO data brief explores Ohio COVID-19 disparities by race

The Health Policy Institute of Ohio has released a new data brief, "Ohio COVID-19 disparities by race."

The U.S. Centers for Disease Control and Prevention reports that COVID-19 is disproportionately impacting communities of color in the U.S. As of May 16, 2020, 265 black/African-American, 23 Hispanic/Latino and 11 Asian-American Ohioans died with COVID-19. 

Current data suggests that the impact of COVID-19 on black/African-American Ohioans is far reaching. This brief provides data on:

• COVID-19 cases, hospitalizations and deaths among black/African-American and white Ohioans relative to their proportions of the state population 
• All-cause mortality in 2018 (most recently-available year) compared to COVID-19 mortality in 2020 among black/African-American Ohioans
• COVID-19 deaths in 2020 compared to leading causes of death in 2018 among black/African-American Ohioans

At today’s COVID-19 press conference, Gov. Mike DeWine highlighted the COVID-19 racial disparities in Ohio (source: “DeWine shares Minority Health Strike Force recommendations,” Cleveland Jewish News, May 21) and announced that the state has added a new interactive tool to its coronavirus dashboard to sort data by race and ethnicity and also added an Ohio Opportunity Index map that displays local information on seven factors (transportation, education, employment, housing, health, access and crime) that impact health and wellbeing.

The Governor’s Minority Health Taskforce is expected to release recommendations soon to address long-term disparities in health, DeWine said. He also announced that the state will hire a deputy director of Social Determinants of Health and Opportunity within the Ohio Department of Health.

To learn more about health disparities in Ohio, see the Health Policy Institute of Ohio’s 2019 Health Value Dashboard, which includes equity profiles for Ohioans based on race/ethnicity, disability status, education and income.

Ohio Medicaid rolls increase amid pandemic

With increased joblessness accompanying the coronavirus pandemic, more Ohioans are turning to Medicaid for health coverage (Source: “Ohio Medicaid rolls now increasing, a reverse from the downward trend,” Cleveland.com, May 12, 2020).

About 3 million people are now on Medicaid, Ohio Medicaid Director Maureen Corcoran said Tuesday.

“We had an increase in the number of people by about 140,000 from the end of March until the end of April,” she said.

In July 2017, there were nearly 3.1 million people receiving health care through the joint state and federal program, which targets Ohioans with lower incomes and those with disabilities. Month-by-month since then, the number went down, hitting a low of just over 2.7 million in November 2019.

At the time of the decrease, state officials and social welfare experts had attributed the decrease to an improved economy providing more jobs, a decrease in advertising from the White House under President Donald Trump and problems with Ohio’s benefits system.

DeWine announces plans for more business openings, expects COVID-19 cases to increase

As Ohio reopens businesses, Gov. Mike DeWine said Thursday that coronavirus cases will increase (Source: “Gov. Mike DeWine on reopening Ohio: Coronavirus cases will increase,” Cleveland.com, May 7, 2020).

“As we open up the economy, let me just state the obvious,” DeWine said at his Thursday statehouse news briefing in which he announced plans to open restaurants, hair salons and other business in the coming weeks. “The risk is up. The more contacts we have, the more that we do, the more risk there is.”

Currently, the transmission rate between people is one-to-one. Someone with coronavirus will likely give it to one other person. As businesses open, DeWine said, the rate will increase.

“This is a gamble," DeWine said. "This is a new part of the journey. We are on a road that’s never been traveled before, certainly never been traveled before in Ohio. It is a road that has danger signs on it. And we need to fully understand that. And what is the danger? The danger is that we relax. The danger is that we pull back. The danger is that we say, ‘OK, well things are better. We don’t have to do this.’”

Caution urged as more Ohio businesses begin to reopen

With more Ohio businesses planning to reopen in the coming weeks, experts warn that employers should be cautious in their plans to bring employees back on site (Source: “Caution urged as first businesses open today in Ohio,” Dayton Daily News, May 1, 2020).

Dental, veterinarian and medical offices will reopen today, the first businesses considered non-essential to open under Ohio’s new health orders. Non-essential manufacturing, distribution, construction and general office businesses to reopen Monday and retail opening in mid-May with conditions like increased sanitation and social distancing.

Dr. Dawn Wooley, virologist and Wright State University professor, said the pace of reopening shared by the DeWine administration is fairly conservative, but she cautioned that it’s important to remember the virus is going to be with the community even when cases decline to a lower level. “Therefore people still need to be cautious. We do not want a resurgence, but if we’re not careful we’re going to negate everything we’ve done, all of this pain and suffering with the shutdowns will be for nothing,” Wooley said.

The Ohio reopening plans include important layers of protective measures such as social distancing and symptom assessment, face coverings and disinfecting commonly used services.

The Health Policy Institute of Ohio recently developed evidence-informed policies and guidelines for reopening its office, which may be used as a starting point for other organizations still in the process of planning for their eventual reopening.

Latest HPIO addiction resource page explores impact on children, youth and families

The Health Policy Institute of Ohio has released the latest tool from its Addiction Evidence Project: An online evidence resource page on the impact of addiction on children, youth and families. The resource page includes expert guidance and evidence-informed programs to ease the impact of the addiction crisis on young people and their families, including resources that address the foster care system, kinship caregiving and prenatal drug exposure.

While progress is being made across the country and in Ohio, more can be done to identify and implement effective strategies to address the addiction epidemic. A key component of the Addiction Evidence Project, HPIO evidence resource pages bring together the best evidence on how to combat addiction and serve as the foundational resource for stakeholders engaged in this work.    

HPIO has previously released evidence resource pages on:

• Prevention, treatment and recovery
• Overdose reversal and other forms of harm reduction
• Law enforcement and the criminal justice system