MOUNT VERNON – Through the first four-and-a-half months of the COVID-19 pandemic, just two Knox County residents had died from virus-related complications.
Knox Public Health reported Tuesday that five have died in the last six days.
Two residents – a 92-year-old female and a 73-year-old male – died July 29. A 93-year-old female died July 31. And two females, ages 78 and 90, passed away from coronavirus complications on Monday.
KPH did not disclose the identities of the newly deceased individuals in its email to media Tuesday night, and could not be reached for comment later. It's also unclear how many of the individuals were hospitalized at the time of their death, or if any fatalities stemmed from the recent outbreak at Country Court Skilled Nursing Center in Mount Vernon.
KPH Communications Coordinator Alayna Mowry said the health department was "saddened" to learn of the newly confirmed coronavirus deaths on Tuesday, and added that Knox County saw 15 new cases in the last 24 hours, bringing its pandemic total up to 187. Seven residents are currently hospitalized, down from 14 Monday.
There are currently 76 active cases in Knox County, with 104 having recovered. Of the county's 187 total cases, 102 have come from Mount Vernon. There have been 20 from Howard, 15 each from Centerburg and Fredericktown, 12 from Danville, nine from Utica and six from Gambier. Outlying municipalities such as Butler (4), Martinsburg (2), Frazeysburg (1) and Walhonding (1) have also recorded cases.
Four of the seven Knox County residents who have died from COVID-19 have been 90 or older. The other three victims were 73, 74 and 78.
Knox County's age range for confirmed coronavirus cases has widened over the past week. A seven-month-old female tested positive on July 31, and a 100-year-old female did the same on Monday.
While most of those hospitalized locally due to COVID-19 have been older, men ages 18 and 32 were hospitalized last Thursday. Both were still listed as hospitalized on Tuesday.
SUMMERTIME SURGE: Knox County has seen a dramatic rise in coronavirus cases, hospitalizations, and now deaths over the last month. The county has recorded 148 of its 187 cases since July 2. It has recorded 15 of its 24 hospitalizations, and six of its seven deaths, in that time.
Knox County Health Commissioner Julie Miller said last month that she was not surprised to see a surge in cases locally, four months into the pandemic.
"It does not surprise me that this rural population in the middle of Ohio has had to wait until the middle of July to see a surge. That is how communicable diseases work," Miller said during a health board meeting July 22.
Communicable diseases will typically "start on the coasts," she explained, and work inwards.
"It’ll come to the east or west coast, or it might come to both at about the same time, and you can see maps of it moving across the United States," Miller said.
"And then what it does is they hit the metropolitan areas, which makes sense. It’s where [there are] tons of people living closely together, working closely together – on the streets, in subways, in public transportation – whereas all the rural communities, those of us are spread out more, and we might not live on top of each other or have public transportation like subways."
Places like Seattle and New York City were hit particularly hard by the novel coronavirus early on. When it reached Ohio, the state's largest cities initially accounted for the vast majority of cases. On Tuesday, new data from the Ohio Department of Health revealed that many rural counties have seen spikes since mid-July.
Mercer County, in northwest Ohio (population 40,806), had the most positive cases per 100,000 residents in the state from July 21 to Aug. 3. Wyandot County, just north of Marion (population 22,107), had the state's third-highest per-capita rate during that time. Of the 25 counties with the highest per-capita rates during that period, 15 had populations of fewer than 100,000 residents.
Knox County had the highest number of positive cases per 100,000 residents in north central Ohio during that period, with 73.5. The county's per-capita rate ranked 35th in the state, higher than all of its neighbors except Licking County.
Knox County's surge in July came despite efforts to limit large gatherings, such as the cancelation of all public Independence Day celebrations (Apple Valley still held its private fireworks show). The Knox County Fair, held last week, was reduced to Junior Fair events only.
Many of the county's largest stores, including Kroger and Wal-Mart, began mandating masks in mid-July. Gov. Mike DeWine implemented a statewide mask mandate on July 23.
Miller said recently that most positive cases have come from small, private events, such as weddings, funerals, religious services, athletic contests, and gatherings at residences.
“We are seeing it associated with private residence gatherings, because that's where you can have more people than 10..." Miller explained. "Whether it’s a big reunion or just a friendly get-together, we are seeing positive, confirmed cases come out of those types of things."
Knox County also saw its first outbreak at a long-term care facility in July, when patients and staff members at Country Court Skilled Nursing Center began testing positive. The health department reported last Monday that 35 individuals at the facility had tested positive for COVID-19, including 27 patients and eight staff members. Four patients were hospitalized at the time.
MOUNT VERNON – The COVID-19 outbreak at Country Court Skilled Nursing Center has expanded, a…
As of Tuesday, 25 patients were isolated at Country Court (up from 23 last week). It's unclear how many are currently hospitalized and how many have recovered. The status of the facility's infected staff members is also unknown.
Two other Mount Vernon long-term facilities have reported positive cases in the past week.
Ohio Eastern Star Home reported two positive cases among staff members, although CEO Michele Engelbach told Knox Pages last Thursday that the individuals had already completed their 14-day quarantine and were scheduled to return to work soon.
The two staff members were roommates, Engelbach said, and were quarantined immediately after displaying symptoms – well before test results came back on July 26. The facility conducted contact tracing and isolated those who had come in close contact with the individuals. No other patients or staff members at the facility have tested positive since.
Country Club Rehabilitation Campus has also reported two positive cases among staff members. The facility did not return requests for comment last week. KPH spokeswoman Pam Palm said the infected individuals were not Knox County residents, and were therefore not counted among the county's cases.
While testing has increased in Knox County over the last month, so has the county's positivity rate, which indicates growing community spread.
Through July 2, 40 of the 1,683 coronavirus tests conducted in Knox County had come back positive (2.4 percent). By Aug. 4, the county's positivity rate had jumped to 7 percent, with 187 of 2,660 tests having returned as confirmed (45 test results are still pending).
This reveals an alarming spike in Knox County's positivity rate between July 2 and Aug. 4. Of the 997 individuals tested during that time, 147 were found to have had COVID-19. The county's positivity rate was 15 percent – nearly three times the state average – during that time period.
Knox County now has a higher positivity rate (7 percent) than the state average (5.7 percent) for the first time since the pandemic began.
THE ROAD AHEAD: While Knox County remained "orange" last week in the state's Public Health Advisory System, Miller warned that could change if the caseload continues to grow. Knox County triggered three of the system's seven indicators last week, and counties with four or more are deemed "red."
If Knox County were to turn "red," Miller said more stringent shutdowns would be implemented to prevent the spread of the virus.
“A move to red puts us right back at the beginning," Miller said last week. “Activities will be limited. People will have to work from home. Public access at different facilities will be affected.”
Here are the indicators Knox County triggered last week:
- New cases per capita: Flagged if a county records more than 50 cases per 100,000 residents over the last two weeks. This allows for counties with different population sizes to be appropriately compared. Knox County recorded 89.86 cases per 100,000 residents.
- Sustained increase in new cases: Flagged if a county sees an increase in new positive cases (by onset date) for at least five consecutive days over the last three weeks. This reflects disease spread in the population. Knox County saw an increase every day from July 16 to July 21.
- Proportion of cases not in a congregate setting: Flagged if the proportion of a county's cases that are not in a congregate setting (i.e. long-term care facility, jail, etc.) goes over 50 percent in at least one of the last three weeks. This is used as indicator of greater risk of community spread. Knox County's non-congregate case rate was 80 percent for the week of July 10-16.
Here are the state's four other indicators:
- Sustained increase in emergency department (ED) visits for COVID-like illness: Flagged if a county sees an increase in the number of emergency-room visits for COVID-like illnesses or diagnoses for at least five consecutive days over the last three weeks. This provides information on the health-care-seeking behavior of the population and a gives a sense of how concerned residents are about their current health status and the virus.
- Sustained increase in outpatient visits for COVID-like illness: Flagged if a county sees an increase for five consecutive days, over the last three weeks, in the number of people going to a health care provider with COVID-19 symptoms who then receive a confirmed or suspected COVID-19 diagnosis. This 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.
- Sustained increase in new COVID-19 hospital admissions: Flagged if a county sees an increase in the number of new hospitalizations due to COVID-19 for at least five consecutive days over the last three weeks. This is an important indicator of hospital burden and disease severity.
- 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. This provides an indication of the capacity available to manage a possible surge of severely ill patients.
Knox County met three of the state's indicators last week after spending the first three weeks of July at level one. DeWine will update the map once again this Thursday during his 2 p.m. press conference.
The key to preventing the virus from spreading further in Knox County, Miller said, is for residents to take individual responsibility. This includes wearing masks in public and practicing social distancing. Given the number of complaints the health department receives about these matters on a daily basis, Miller believes the county has a long way to go in its efforts to slow the spread.
“We continue to receive phone calls and emails from residents upset that others are not doing their part to slow the spread of the virus," Miller said.
“Everyone needs to step up and help prevent this virus from spreading. Too many people are refusing to wear a mask when they should wear one. They are not observing social distancing when a little bit of space between you and the next person could make the difference between avoiding the virus and passing it on to someone.”
Other prevention measures include frequent hand-washing and cleaning frequently-touched surfaces, Miller noted.
“If we want to get out of this pandemic situation sooner than later," she said, "everyone – and I mean everyone – needs to do their part.”
Knox Public Health will hold its next drive-thru testing clinic on Saturday at the fairgrounds (601 Fairgrounds Rd. in Mount Vernon). The Ohio National Guard will be on-hand to assist in the clinic, which will last from 8 a.m. to noon.
No appointment is required to participate Saturday. Tests will be administered free-of-charge. For more information on how to receive a test, click here.