Ohio's COVID-19 case reports are spiking, but all aren't being counted

Reported COVID-19 cases are up in recent weeks across Ohio, but experts say the counts still underestimate the actual spread of virus cases.

The winter time, as people gather indoors more to get away from the cold weather, increases the spread of respiratory viruses, said Dr. Joe Gastaldo, an infectious disease specialist and vice president of clinical affairs at OhioHealth’s Dublin Methodist Hospital and Grady Memorial Hospital.

In addition to COVID-19, the flu and RSV (respiratory syncytial virus) are also on the rise during this time of year.

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Summit County clocked 432 cases at the end of November, the most since February, according to the county's dashboard.

There were 13,215 cases of COVID in Ohio during the week ending Dec. 7, according to the state’s dashboard, which is updated every Thursday.

The week before, there were 12,835, and before that, just 8,700.

Still, that’s likely an undercount, said Gastaldo, due to positive at-home tests that should be reported but often aren't and people who have symptoms but aren’t testing.

“It is a gross underestimation of what’s happening activity-wise,” Gastaldo said of the official count.

Instead, Gastaldo relies on more reliable reports, such as the viral load found in wastewater testing, emergency department visits, and hospitalizations for respiratory illness.

He expects the cases of COVID and other flu-like illnesses, including the flu, to go up.

“We’re seeing a small rise in people being admitted with COVID,” Gastaldo said. “It’s typically people who are elderly, very frail and with weakened immune systems.”

Overall this year, there were 279,172 cases in Ohio, 11,046 hospitalizations and 1,772 deaths. This past week, 47 people died in the state, according to the state dashboard. The week before, there were 36 deaths and the week before that, 48.

Flu cases rising in Summit County

Influenza cases are also up in Summit County, with the county public health office recording 60 positive tests as of the first week of December. That number is up from 47 the previous week.

Flu-related hospitalizations across Ohio increased by 50 in the same week to 106 total hospitalizations since the start of the flu season in mid-November, according to ODH flu dashboard.

How are cases counted?

Testing individuals for viral infections is the best way to track flu and coronavirus outbreaks, but when testing is not widely available or a popular option, more indirect measures are used.

Summit County Public Health Chief Epidemiologist Richard Marountas explained that officials will track lab reports, hospitalizations, flu and pneumonia deaths, school absenteeism, emergency room visits for influenza-like illness and thermometer sales to determine if an outbreak is occurring.

"The purpose of looking at several different sources is that each of the above is an imperfect measure of influenza on its own but can provide evidence of a widespread outbreak when looked at together," Marountas said.

If all indicators rise at the same time, it is likely that an outbreak has started or is accelerating through the local population as people try to fight or test for a respiratory illness.

Lab reports from infected individuals show the strain while hospitalizations and deaths indicate the severity of the strain, he explained.

To determine how widespread respiratory illnesses are in the community, Marountas said local health departments often measure emergency room visits and school absenteeism.

How to protect yourself and others

Gastaldo encouraged people to get vaccinated against the flu and get updated vaccines for COVID-19, as well as for RSV, a virus that causes inflammation of the small airways in the lungs and can lead to pneumonia, if eligible.

The vaccines don't stop all transmission, but they lower it. They don't stop people from getting ill, but lessen the illness.

“The reason to get them is that they defang the virus, meaning that if you do get an infection, you’re very likely to only have mild symptoms and you’re significantly less likely to die or be hospitalized for these viruses,” he said.

If people are unsure or skeptical about vaccines, he encouraged them to speak to a trusted health care provider about them.

And, if people aren’t feeling well, they should stay home to protect vulnerable people in the community.

Gastaldo also encouraged people to get tested for COVID. People can get free tests sent to their homes via www.covid.gov.

There is also testing for the flu and the benefit to getting tested for both is the possibility to qualify for antiviral treatment, he said.

Masks are no longer mandated, but they do serve a purpose, Gastaldo said.

“It’s good advice to wear a mask if you have an at-risk condition or are immunocompromised,” he said. And, if you have symptoms or are indoors with a lot of people.

Otherwise, wash your hands, practice good coughing etiquette by covering your cough, and stock up on over-the-counter treatments like painkillers.

This article originally appeared on The Columbus Dispatch: Summit County COVID-19, flu cases on the rise heading into holidays