summit county covid-19 activity summary, mmwr week 52 (12 ... · summit county 2020 covid-19 weekly...

Summit County COVID-19 Activity Summary, MMWR Week 52 (12/20 – 12/26/2020)

Note: There should be a sustained decrease in most OPHAS indicators for 4-6 weeks to be considered a substantial decrease in community COVID-19 activity

Other Indicators 12/6 - 12/12/2020 12/13 - 12/19/2020 12/20 - 12/26/2020 Current Status School-associated (including sports) COVID-19 cases 179 136 29 Decreasing ↓ Pediatric testing capacity at Summit County Public Health (available to symptomatic students who cannot locate testing through other COVID-19 testing providers) 30 tests / day 30 tests / day 30 tests / day No change Pediatric case rate (per 100,000 residents aged 17 and under) 242.2 171.5 130.8 Decreasing ↓ Source: Ohio Disease Reporting System (ODRS)

Full report (including Summit County COVID-19 indicator data and definitions) can be obtained here: https://www.scph.org/covid/maps-data Data is provisional and subject to change

Date prepared: December 30, 2020 Prepared by: Summit County Public Health Communicable

Disease Unit ([email protected])

OPHAS Indicators (from Ohio Dept. of Health) Three weeks ago

(12/2 – 12/8) Two weeks ago (12/9 – 12/15)

Previous week (12/16 – 12/22) Current Status

1) Population Case Rate (previous 14 days) 886.5 (High) 950.1 (High) 818.3 (High) Above ODH threshold 2) Sustained increase in new COVID-19 cases Sustained increase Sustained increase No Sustained increase No Sustained increase 3) Proportion of cases not in a congregate setting (See also Figure 7 on page 4 of this report) 59.5% 37.8% 12.0%

Above ODH threshold (see page 4)

4) Sustained increase in COVID-19 ED visits Sustained increase Sustained increase Sustained increase Sustained increase 5) Sustained increase in COVID-19 outpatient visits Sustained increase No Sustained increase No Sustained increase No Sustained increase 6) Sustained increase in COVID-19 hospital admissions No Sustained increase No Sustained increase No Sustained increase No Sustained increase 7) ICU bed occupancy (total and COVID-19) Total: ↑, COVID: ↑ Total: ↑, COVID: ↑ Total: NC, COVID: NC Above ODH threshold OPHAS Alert Level Level 4: Purple Level 3: Red Level 3: Red Level 3: Red Source: Ohio Disease Reporting System (ODRS) and Ohio Public Health Alert System (OPHAS): https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

Summit County COVID-19 Case Data by Age, as of 12/26/2020 Cases Hospitalizations Deaths Count 26,552 2,238 572 Range < 1 year to 104 years < 1 year to 103 years 30 to 103 years Mean 45.2 years 65.3 years 79.5 years Source: Ohio Disease Reporting System (ODRS)

https://www.scph.org/covid/maps-datahttps://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

Summit County 2020 COVID-19 Weekly Report, MMWR Week 52 (12/20 – 12/26/2020) Page ii

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Summit County 2020 COVID-19 Weekly Report, MMWR Week 52 (12/20 – 12/26/2020) Page 1

Summit County Public Health COVID-19 Community Surveillance Report

Report #19 Centers for Disease Control and Prevention MMWR Week 52: December 20 to 26, 2020

Summit County Surveillance Data:

COVID-19 Case Data: Data based on the reporting date (Figure 1) indicates that there has been a sustained increase in the 7-day average of COVID-19 cases in Summit County throughout November and early December. During that time period, the 7-day average increased from 272 cases per day on November 15 to 508 cases per day on December 12. Since then, the 7 day average decreased to 306 cases per day by December 26. Even with this decrease, these case rates in Summit County indicate that widespread community transmission is present.

Based on symptom onset date (Figure 2), there was also a sustained increase in the 7-day average of COVID-19 cases in Summit County, from 316 cases per day on November 15 to 495 cases per day on December 6. Data with a case onset after December 12 is considered to be incomplete and trend determinations generally cannot be made at this time, but the elevated case onset counts continue to be extremely concerning and indicates high levels of COVID-19 activity and community spread in Summit County.

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Figure 1. COVID-19 cases reported in Summit County in 2020, based on date reported, 11/15 - 12/26/2020

Source: Ohio Disease Reporting System (ODRS)

COVID-19 Case Data: Public health data can be presented in different ways. For COVID-19 case reporting, Summit County Public Health (SCPH) reports case count data by the date each case is reported. This provides SCPH and community partners a real-time picture of case reporting and public health response, such as case interviews, contract tracing, outbreak investigations and mitigation efforts. Summit County reports confirmed and probable cases that active cases at time of reporting, and does not include cases reported due to positive antibody test results.

The Ohio Department of Health (ODH) reports data the date that symptoms were first experienced (onset date). All confirmed and probable cases are reported by ODH, including probable cases due to positive antibody tests. The case graph by onset date (also known as an epidemiological curve) provides valuable information on the dynamics of disease transmission and outbreaks. However, the data in the most recent two weeks of the onset date curve will be incomplete, as many of the cases first experiencing symptoms on those dates have not yet been diagnosed and/or reported to the health department.

In this report, graphs for case counts, hospitalizations and deaths include data for the past 6 weeks. Graphs with data for the entire pandemic are included at the end of the report. In the graphs with daily data, 7 day averages are calculated to correct for data variability


Weekly cases by age distribution: Figure 3 and 4 display the weekly age distribution of new cases reported since the beginning of the pandemic, based on date reported. Through Memorial Day, over 90% of reported cases were adults aged 25 and older, and children and young adults represented less than 10% of the cases. Since the early summer, the proportion of children (0 to 17 years) and young adults (18 to 24 years) remained at 18% to 25% of total cases. During the past reporting week, children accounted for 6.9% of the cases reported.

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Figure 2. COVID-19 cases reported in Summit County in 2020, based on symptom onset date, 11/15 - 12/26/2020

Source: Ohio Department of Health (ODH) COVID-19 Dashboard

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Figure 3. Age distribution of COVID-19 cases and weekly totals in Summit County, by MMWR week


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100%Figure 4. Age distribution of COVID-19 cases by percent in Summit County, by MMWR week



Summit County Hospitalization and Death data:

Due to the progression of the COVID-19 illness, hospitalization data in the previous two to four weeks may be incomplete. On November 15, the 7-day average for hospitalizations due to COVID-19 was 19.9 admissions per day (Figure 5), increasing to 27.3 admissions per day on November 30. The admission rate continued to increase through early December, reaching a maximum of 32.9 admissions per day on December 16. This increase in the past six weeks is highly concerning and is a result of the widespread community transmission that is occurring in Summit County.

Eleven COVID-19 deaths were reported in July, and twenty-three deaths were reported in August (Figure 6). Sixteen deaths were reported in September, and twenty-six in October. In November, there were 125 deaths reported due to COVID-19, and 162 deaths from December 1 to 26. COVID-19 deaths can occur up to several weeks following the initial diagnosis and test result.

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Figure 5. COVID-19 hospitalizations reported in Summit County in 2020, based on admission date, 11/15 to 12/26/2020


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Figure 6. COVID-19 deaths reported in Summit County in 2020, based on date of death, 11/15 to 12/26/2020



Ohio Public Health Alert System (OPHAS) Indicators OPHAS Indicator 1: New cases per capita (past 14 days) OPHAS Summary: Flagged if greater than 50 cases per 100,000 residents over the last two weeks. Allows for counties with different population sizes to be appropriately compared. The population case rates reported by OPHAS has exceeded the threshold of 50 cases per 100,000 residents during the three most recent reporting weeks, at 886.5, 950.1 and 818.8 cases per 100,000, respectively.

1) Population Case Rate (previous 14 days) 11/25 to 12/8/2020 12/2 to 12/15/2020 12/9 to 12/22/2020

Number of cases based on date reported: 5599 6394 5963 Population case rate 1034.9 1181.9 1102.2

Number of cases based on symptom onset: 3796 5140 4430

Population case rate 886.5 950.1 818.8 Source: Ohio Disease Reporting System (ODRS) and Ohio Public Health Alert System (OPHAS)

OPHAS Indicator 2: Sustained increased in new cases OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in overall cases by onset date over the last 3 weeks. Reflects disease spread in the population.

New case data are displayed in Figure 1 and Figure 2 (pages 1 and 2), and OPHAS reported no sustained increase in the 7-day case average based on onset date from December 2 to December 22.

OPHAS Indicator 3: Proportion of cases not in a congregate setting OPHAS Summary: Flagged if proportion of cases that are not in a congregate setting goes over 50% in at least one of the last 3 weeks. Used as indicator of greater risk of community spread. Congregate settings are housing situations that may increase the risk of transmission of COVID-19, and include long term care facilities, inpatient rehabilitation facilities, group homes, and prisons or jails. Non-congregate setting calculations on the OPHAS dashboard may be incomplete and is updated each week. Non-congregate setting rates in Figure 7 are calculated by Summit County Public Health and are usually more current. The total percent of COVID-19 cases in a non-congregate setting for all COVID-19 cases in Summit County: 93.8% (3/13 to 12/26/2020), and weekly non-congregate case rates have consistently exceeded 85% since Week 26 (6/21 to 6/27/2020).

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Figure 7. Non-congregate COVID-19 cases reported by week (% of all cases)


OPHAS Indicator 4: Sustained increase in Emergency Department (ED) visits for COVID-like illness OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus.

OPHAS Indicator 5: Sustained increase in outpatient visits for COVID-like illness OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of people going to a health care provider with COVID symptoms who then receive a COVID confirmed or suspected diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus. Data from the OPHAS dashboard indicates that there were sustained increases in the 7 day averages for ED visits from December 2 to 9. There was no sustained increase in outpatient visits reported in the past three weeks.

OPHAS Indicator 6: Sustained increase in new COVID hospital admissions OPHAS Summary: Flagged if increasing trend of at least 5 consecutive days in the number of new hospitalizations due to COVID over the last 3 weeks. Important indicator of hospital burden and disease severity.

For this report, data from three sources were compared: Summit County Public Health data directly from the Ohio Disease Reporting System (ODRS), ODH dashboard data (also from ODRS), and data from the OPHAS dashboard. The SCPH and ODH data are generally consistent, and these sources indicate that hospitalizations due to COVID-19 increased in October, and that the hospitalization data were entered in the time following the latest OPHAS dashboard update on December 24. There was no sustained increase over 5 days in hospital admissions from December 2 to 22.

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Figure 8. COVID-19 Emergency Department (ED) and Outpatient visits (7-day averages), 11/25 to 12/22/2020

Source: Ohio Public Health Alert System (OPHAS)

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Figure 9. Four week trend in hospitalizations (7-day averages), Summit County COVID-19 cases. 11/25 - 12/22/2020


OPHAS Indicator 7: Intensive Care Unit (ICU) bed occupancy

OPHAS Summary: Flagged if percentage of the occupied ICU beds in each region goes above 80% for at least three days in the last week, AND more than 20% of ICU beds are being used for COVID-19 positive patients for at least three days in the last week. Provides an indication of the capacity available to manage a possible surge of severely ill patients.

Based on data downloaded from the OPHAS dashboard (Figure 10), neither total ICU nor did COVID-19 ICU occupancy rates reported at Summit County facilities indicate an increasing trend from November 25 to December 22. In the past four weeks, total ICU occupancy rates ranged from 77.6% to 87.9% and the range for COVID-19 ICU occupancy was 24.4% to 29.4%. Both Total and COVID-19 ICU occupancy exceeded the 80% and 20% thresholds in the latest OPHAS reporting week, respectively.

About this report: Data used in the report was obtained from three sources:

1) ODH COVID-19 Data Dashboard: The State of Ohio COVID-19 Dashboard displays the most recent preliminary data reported to the Ohio Department of Health (ODH) about cases, hospitalizations and deaths in Ohio by selected demographics and county of residence. Data is reported to ODH via the Ohio Disease Reporting System (ODRS): The ODH data dashboard may be accessed here: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/overview

2) Ohio Public Health Alert System (OPHAS) Data Dashboard: The Public Health Advisory Alert System is a color-coded system designed to supplement existing statewide orders through a data-driven framework to assess the degree of the virus’ spread and to engage and empower individuals, businesses, communities, local governments, and others in their response and actions. The OPHAS dashboard is updated every Thursday afternoon and is available here: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/

3) Summit County Public Health: Data reported by Summit County Public Health is acquired from the Ohio Disease Reporting

System (ODRS). In addition to this report, a COVID-19 data dashboard is available at: https://www.scph.org/covid/maps-data This dashboard is updated daily (Monday-Friday by 4:00 pm).

Numbers may change as updated reports are received. For questions, please contact Joan Hall at the Summit County Public Health Communicable Disease Unit ([email protected]). Report was issued on December 30, 2020.

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Figure 10. ICU Occupancy in Summit County health care facilities: 11/25 - 12/22/2020

Source: Ohio Public Health Alert System (OPHAS)

https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/Ohio-Disease-Reporting-System/welcome/https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/overviewhttps://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system/https://www.scph.org/covid/maps-datahttps://www.scph.org/covid/maps-data


APPENDIX. Daily COVID-19 case counts (by report date and symptom onset date), hospitalizations and deaths since the start of the pandemic

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COVID-19 cases reported in Summit County based on date reported, 3/13 to 12/26/2020


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COVID-19 cases reported in Summit County based on symptom onset date, 3/10 - 12/26/2020

Source: Ohio Department of Health (ODH) COVID-19 Dashboard


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COVID-19 hospitalizations reported in Summit County in 2020, based on admission date, 3/11 to 12/26/2020


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COVID-19 deaths reported in Summit County in 2020, based on date of death, 3/11 to 12/26/2020


summit county covid-19 activity summary, mmwr week 52 (12 ... · summit county 2020 covid-19 weekly...

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