CLEVELAND, Ohio – The rate of new coronavirus cases in Ohio is now worse than it was a month ago when Gov. Mike DeWine announced his plans to eventually lift his health orders amid what was then a fast shrinking number of cases.

The Ohio Department of Health on Thursday reported a rate of 183.7 cases per 100,000 people with an onset of symptoms over the last two weeks, up from 167.1 a week ago.

This is far from the rate of 50 cases per 100,000 the governor set on March 4 as the number he wants to see before he will lift all his health orders, ranging from mandated masks in public to limits on patrons in restaurants and entertainment venues.

At the time, the rate had been going down for months to near 179 cases per 100,000, and it continued to sink for the next two weeks, dropping to a low for the year of 143.8 per 100,000 with the March 18 update. But it has gone up each of the last three weeks.

The rate was last below 50 in June, and as high as 845.5 per 100,000 in mid-December.

“We’re moving now in the wrong direction.,” DeWine said during Thursday’s coronavirus briefing. “We’re not seeing the runaway case growth we saw during the fall, certainly not yet. We can still turn this around if more people continue to get vaccinated. This is a race. We are in a race. It’s a life and death race.”

About 1-in-3 Ohioans has received at least one vaccination, with vaccinations complete for about a fifth the state’s population, the health department reported.

The case rate is based on when people reported becoming sick, not when the cases were reported by the state. And it excludes incarcerated individuals in an effort to focus on community spread issues.

Not only have reported cases increased, so have hospitalizations. The 1,193 coronavirus patients hospitalized each of the last two days were the highest patient counts since Feb. 27, according to daily surveys by the Ohio Hospital Association.

The number was as low as 823 on March, and was below 1,000 every day from March 5 through March 31.

Ohio coronavirus case rate

Ohio’s coronavirus rate has been increasing the last few weeks. The rate is based on cases with an onset of symptoms in the two weeks prior to the date listed in the chart.Rich Exner, cleveland.com

Variants drive increase

“It’s clear that Ohio and the nation are enduring yet another wave of COVID-19. This time it is being driven by the new variants of the original virus,” said Dr. Bruce Vanderhoff, the state’s chief medical officer.

Vanderhoff said the B.1.1.7 variant, first identified in the United Kingdom, “accounts for the lion’s share of our total” for cases tied to variants. Vanderhoff said B.1.1.7 “is not only more contagious; it’s also more deadly.” Yet he said the vaccinations appear to be doing the job against the new variants.

Fatal numbers related to the variant were not provided. However, it often is weeks or months before deaths are confirmed to be related to the coronavirus by the state.

Alert county update

Meanwhile, on Thursday the state updated its coronavirus alert map, with 52 counties now listed on red alert over concern of spread of the virus. This includes Cuyahoga County and each of the six neighboring counties in Greater Cleveland.

A week ago 51 counties were listed on red alert in the state’s coronavirus advisory system. This compared with 55, 66, 76, 80 and 84 red alert counties in previous weeks.

Putnam was upgraded from orange to the higher level of red, DeWine said. Carroll, Mercer and Morgan went from the lowest concern level of yellow to orange.

Level 3 red alert, according to the health department, means there remains a public emergency for increased exposure and spread, and that people should “exercise a high degree of caution.” The alert system takes into account more than just new case rates, but also trends in hospitalizations, doctor visits and emergency room visits related to COVID-19.

Case rates by county range from 25 per 100,000 in Holmes County to highs of 336.5 in Hancock County, 300 in Lucas County and 291.1 in Summit County.

Greater Cleveland case rates

* Cuyahoga: 237.2 per 100,000 this week versus 194.3, 167, 162 and 190.6 in the updates each of the previous four weeks.

* Geauga: 128.1 versus 123.9, 106.8, 122.8 and 147.4 the last four weeks.

* Lake: 192.9 versus 136.9, 126, 149.5 and 160.8.

* Lorain: 204.6 versus 198.8, 148.5, 143 and 159.1.

* Medina County: 178 versus 178, 190.8, 206.4 and 189.7.

* Portage County: 213 versus 211.1, 186.5, 164.3 and 155.7.

* Summit County: 291.1 versus 267.3, 219, 203.7 and 184.3.

The advisory system

Here’s a closer look at the advisory system introduced in early July. Alert levels are determined by the number of warning benchmarks met. But once a county reaches red alert, it does not drop unless its rate of new cases also drops below 100 per 100,000 over two weeks.

* 1. New cases – Alert triggered when there are 50 new cases per cases 100,000 residents over the last two weeks.

* 2. Increase in new cases – Alert triggered by an increase in cases for five straight days at any point over the last three weeks. This is based on the date of onset of symptoms, not when the cases are reported.

* 3. Non-congregate living cases – Alert triggered when at least 50% of the new cases in one of the last three weeks have occurred in outside congregate living spaces such as nursing homes and prisons.

* 4. Emergency rooms – Alert triggered when there is an increase in visits for COVID-like symptoms or a diagnosis for five straight days at any point in the last three weeks.

* 5. Doctor visits – Alert triggered when there is an increase in out-patient visits resulting in confirmed cases or suspected diagnosis for COVID-19 for five straight days at any point in the last three weeks.

* 6. Hospitalizations – Alert triggered when there is an increase in new COVID-19 patients for five straight days at any point over the last three weeks. This is based on the county or residence, not the location of the hospital.

* 7. Intensive Care Unit occupancy – Alert triggered when ICU occupancy in a region exceeds 80% of total ICU beds and at least 20% of the beds are being used for coronavirus patients for at least three days in the last week.

Rich Exner, data analysis editor for cleveland.com, writes about numbers on a variety of topics. Follow on Twitter @RichExner. See other data-related stories at cleveland.com/datacentral.

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