MANSFIELD -- Richland County turned "purple" for the first time on Thursday, the most severe category in Ohio's color-coded COVID-19 rating system, reporting more than 1,000 new virus cases in the last two weeks.
For a second straight week, Richland County triggered all seven of the Ohio Public Health Advisory System indicators, becoming one of eight "purple," or level four, counties in the state.
Other counties turning "purple" this week were Summit, Portage, Medina and Stark counties. They join Montgomery, Lorain and Lake counties, which turned purple last week.
Franklin County, which had been purple, improved to "red," or level three, this week.
Ashland, Crawford and Knox counties all remained "red," or level three, on Thursday.
Richland County was "red," or level three, for the past several weeks and was placed on the state's "watch list" a week ago, meaning it would go purple if the local situation didn't improve.
Richland Public Health educator Reed Richmond said the "purple" level indicates severe exposure and spread of coronavirus and it carries the recommendation people should only leave home for supplies and services.
"It does not curtail businesses or the need to report to work," Richmond said.
All Ohio counties remain listed for high incidence of COVID-19 spread. All counties had active cases of coronavirus at or over 100 cases per 100,000 population.
Below is a breakdown of Richland County's indicators this week:
New cases per capita -- Flagged if greater than 50 cases per 100,000 residents over the last two weeks. In Richland County, there have been 1,097 new cases over the past two weeks, or 905.46 per capita. In the last two weeks of October, the county had 237 cases, rising rapidly during November and into December.
Sustained increase in new cases -- Flagged if increasing trend of at least five consecutive days in overall cases by onset date over the last three weeks. Richland County had five such days between Nov. 20-24, rising from 85.43 to 102.57 on a seven-day average. It has declined since then, dropping to 54.14 on Dec. 1.
Proportion of cases not in a congregate setting -- Flagged if proportion of cases that are not in a congregate setting goes over 50 percent in at least one of the last three weeks. Richland County was at 84.56 percent between Nov. 25 and Dec. 1.
Sustained increase in Emergency Department (ED) visits for COVID-like illness -- Flagged if increasing trend of at least five consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last three weeks. Richland County had two such five-day periods from Nov. 21-25 and Nov. 13-17. It has dipped slightly since then.
Sustained increase in outpatient visits for COVID-like illness -- Flagged if increasing trend of at least five 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 three weeks. Richland County triggered this Nov. 12-16, rising from 50.14 to 50.86 on a seven-day average.
Sustained increase in hospital admissions -- Flagged if increasing trend of at least five consecutive days in the number of new hospitalizations due to COVID over the last three weeks. Richland County met this indicator with five days of growth between Nov. 13-17, rising from 2.43 to 4.86. It has declined since then and was at 1.14 on Dec. 1.
Intensive Care Unit (ICU) bed occupancy -- Flagged if the percentage of occupied ICU beds in each region goes above 80 percent for at least three days in the last week AND more than 20 percent of ICU beds are being used for COVID-19 positive patients for at least three days in the last week. The region in which Richland County operates had five such days between Nov. 25 and Dec. 1.
The "purple" designation was announced Thursday by Ohio Gov. Mike DeWine during his bi-weekly press briefing. The governor said it seemed clear vaccines were on the way, but said the continued spike in numbers was overwhelming the state's hospitals and medical staffs.
Dr. Andy Thomas, chief clinical officer with The Ohio State University Wexner Medical Center, said the rise in cases and hospitalizations do net yet reflect the impact of the Thanksgiving holiday, during which people may have traveled and gathered despite government recommendations.
"Usually, people are admitted a week after they're diagnosed. This is not the beginning of the end. This is not even the end of the beginning," Thomas said during the briefing.
"We're in a really difficult spot here, and we're just now heading into the most challenging three months of this pandemic. ICU beds are the area of capacity where we have the biggest strain across the state - especially in rural areas," Thomas said.
Dr. Nora Colburn, associate medical director for clinical epidemiology at the Wexner Medical Center, said the state was in a crisis.
"Healthcare workers are burned out and stretched thin. Our hospitals are stressed to the extreme and we haven't even seen the infections resulting from Thanksgiving," she said.
"We will be overwhelmed if things don't change. Hospitals around the state are delaying non-emergency procedures. This will impact routine healthcare. People need their diagnostic screening procedures," Colburn said.