Mahoning ‘Cautiously’ Considers Hotspot Data; Prepares Covelli Centre

YOUNGSTOWN, Ohio — As county and state health departments have been preparing for a surge in positive diagnoses of COVID-19, they have been receiving information requests from residents and the media about providing information on so-called “hotspots” and ZIP code-level data.

Mahoning County Public Health has been in discussions with the Ohio Department of Health about those requests, which the state department has said it is “cautiously considering” providing.

“I stress and the Ohio Department of Health stresses cautiously,” because testing is still limited to those who are severely ill with COVID-19, the disease spread by the coronavirus, as well as health care workers and first responders, says Ryan Tekac, Mahoning County health commissioner.

Breaking down the data to the ZIP code level with such limited testing can create a “false sense of security in areas” where there appears to not be a hotspot, Tekac said during a phone conference with reporters Tuesday morning. There may be individuals who contract the virus but display only moderate symptoms and are not tested, he says. It’s also difficult to know where the virus was originally contracted because of community spread.

“You can work in Austintown, live in Poland and have shopped in Canfield on your way home,” Tekac says. “Where did you contract the virus?”

For someone living in Poland who contracts the virus outside of the township, that number still gets counted for Poland, he added. Thus, Tekac stressed the importance of continuing to adhere to the preventive measures recommended by the Centers for Disease Control and Prevention, including social distancing and proper hygiene.

“This is not a time as we move forward to put our guard down,” Tekac said. “We need to continue to practice those public health measures. Need to make sure we’re getting out in front of it and allowing our first responders and health care providers to continue to provide those services to those who are most sick.”

As of April 6, the county reports 272 confirmed cases of COVID-19 with 117 hospitalizations and 17 deaths. Residents who are 60 to 79 years old comprise the most cases at 42.5%. Those younger than 60 make up 41.8%, and those 80 and older 15.8%. The media age is 56.

Nearly half of hospitalizations are among those aged 60 to 79 (47.9%), followed by those younger than 60 (27.4%) and those 80 years and older (24.9%), with a median age of 68. Deaths are evenly split between the two older age ranges at 47.1% each, with those younger than 60 making up 5.9% of deaths. The median age for those who have died from COVID-19 is 77.

Another reason the state is hesitant to release ZIP code-level data is because it could infringe on an individual’s privacy, noted Melanie Amato, press secretary for the Ohio Department of Health. Although 29% of the Mahoning County’s COVID-19 deaths have been from residents of long-term care facilities, the state isn’t identifying those facilities to maintain the privacy of those residents, Amato said, adding that it’s up to the local jurisdictions and facilities to release that information.

If there is a case in a long-term care facility that has only 10 residents, for example, it can be easy to identify the resident, “and that goes against all the HIPAA and privacy laws that we stand for,” she said.

At the county level, the public health board works with long-term care facilities to identify any cases of positive diagnosis with the center, as well as identifying any close contacts with the individual so they can self-isolate, Tekac added.

In the coming days, the state health department is working with county health departments and long-term care centers to review procedures and will offer guidance and instruction to help them throughout the surge, Amato said. That could mean providing extra epidemiologists on the ground, working with the Ohio Emergency Management Agency to see if they need any additional resources and helping with communications.

For county residents who have a grievance about a long-term facility, they can file a formal complaint with the Ohio Department of Health, Amato noted.

“The Ohio Department of Health investigates all complaints,” Amato said. “We are very transparent of the fact if there are problems with a facility.”

Meantime, Mercy Health-Youngstown has been working closely with the National Guard in preparing to convert the Covelli Centre into a temporary field hospital to treat COVID-19 patients after they’ve passed the peak of their illness.

During the call Tuesday morning, Dr. James Kravec, chief clinical officer for Mercy Health-Youngstown and medical director of Mahoning County Public Health, said the National Guard advised him it would take two weeks to get the center ready. Last weekend, Mercy worked to develop a list of needed supplies, gathered and ordered them, and worked with the National Guard on getting cots ready for the center, Kravec said.

“I don’t see this being used in the next couple of weeks,” he said.

Mercy has also expanded its own capacity by setting up care areas in nontraditional areas of the hospital, including post-anesthesia units, he noted.

Patients transferred to the Covelli Centre will likely not be there for long, since the goal is to get them back home or to an extended care facility, Kravec said. Transfers will be based on the “best scientific judgment” of the doctors by monitoring the patients’ vital signs, lab results and imaging, he said.

Because COVID-19 affects each patient differently, there is no hard and fast idea on how long a person will be in the hospital and how long he would be at the Covelli Centre, if the center is used at all, he said.

“If this all works, our biggest measure of success is there’s never a patient there,” Kravec said. “That’s the goal. To never use these centers.”

Copyright 2022 The Business Journal, Youngstown, Ohio.