The COVID-19 pandemic’s impact on the healthcare system, both locally and statewide, were among the topics discussed in the Highland County Health Department’s Friday, Nov. 20 update, as the county surpassed 900 cumulative cases and 800 cumulative recoveries this week.

The county ended the week with 158 currently sick patients, an increase of 39 in the past two days and up 38 from last Friday.

The county also surpassed 900 cumulative cases, with 986 total combined cases reported. That is an increase of 102 in the past two days and an increase of 169 in seven days.

“Current per-capita rates for Highland County are 417.04 per 100,000,” Highland County Health Commissioner Jared Warner said. “Our new survey-based contact tracing process is helping our nursing staff keep pace with our cases, but we are definitely not able to talk on the phone with every case and every close contact.

“To put some numbers to it, in the last three days we have made over 300 phone calls and sent over 200 letters. The State of Ohio is having similar capacity issues and are now showing a disclaimer on their state reporting system about reporting delays.”

As mentioned, recoveries also surpassed the 800 mark, with 809 patients marked as recovered as of Friday. This is an increase of 73 in the past two days and an increase of 130 since last Friday’s update.

There was a decrease in quarantines Friday, with 380 individuals being monitored for symptoms. This is down from 411 reported Wednesday and 474 last Friday.

“As a reminder, if you are confirmed as a COVID-19 case, you should be isolated at home for at least 10 days, and you can get back to normal once 24 hours without a fever and after a great improvement of symptoms,” Warner said. “Don’t wait on the health department to tell you this.”

Hospitalization rates are comparable to the previous update, with 59 total hospitalizations (an increase of one) and five current hospitalizations (the same number as Wednesday) reported. Warner addressed hospitalizations in answering the following question from a citizen: “Are the hospitals really in as bad a shape as our infamous governor says? Or is this an exaggeration to curb future problems?”

According to Warner, “the short answer is yes, and yes.” He issued the following explanation:

“The long answer to this is complicated, so let’s break it down into a few parts. The healthcare system has a few constraining factors that can limit their ability to keep patients and staff safe and provide the standard of care that we expect.

• Staffing – Healthcare staffing can be a significant limitation for healthcare response to pandemics. Hospitals often run at 80-90-percent capacity in a normal year, and they have staff on payroll to meet this normal need. This includes elective surgeries, short term stays, recovery for minor procedures, etc. Being 80-percent full on a normal year may not be the same as 80-percent full if a majority of cases are infectious diseases. Percentages only tell part of the story here.

“Additionally, when we start increasing our overall hospital usage, it can be difficult to find staff to support increased bed usage. Combine this with staff who are often getting sick themselves, and we can run into staff shortages pretty quickly. Hospitals run on people, not beds, so this is something that we are really concerned about.

“Personal Protective Equipment (PPE) – PPE supplies are much better than they were early on in this pandemic. When we have increased COVID-19 cases, healthcare staff use significantly more PPE supplies than with non-COVID-19 patients. This can begin to cause a strain on supply issues over the long term. I have heard reports of inventory shortages and order delays already occurring. Lack of available PPE leads to less well protected healthcare workers, which can reduce the number of beds that can be staffed for COVID-19 patients.

“Beds – Bed availability is a something that can fluctuate greatly depending on several factors and decisions made by the hospital. Hospitals can postpone elective surgeries in order to free up beds and staff, but this is not a long-term solution. Eventually these postponed procedures will need to be done. Alternative areas in the hospital can be developed in order to provide additional bed capacity, but this can reduce the level of care available to patients. In short, hospitals can flex their capacity quite a bit, but there are tradeoffs.

“Current Situation - Current hospitalization trends are all headed up sharply. This is creating strain on staffing resources and PPE currently, and can lead to general hospital capacity issues down the road. Several hospitals in our urban centers have reached very high levels of bed use. One hospital has added an outdoor tent for ED overflow. Others have already started to limit elective procedures that require an overnight stay.

“Things are not great currently in our healthcare systems. Governor DeWine is calling attention to this problem because it already is an issue. We have to remember a couple of important things. First, hospitalizations are a lagging indicator. Hospitalizations will rise a week or two after any large surges in cases, which means that any policy changes that we make today will take several weeks to make an impact on our numbers.

“It reminds me of my short career driving a water truck for the City of Lebanon. I learned the hard way that you have to start braking early in order to slow big heavy things down. We have to raise the alarm now because our current COVID-19 trends show us where we are headed.”

In other local COVID-19 updates of interest, the State of Ohio reporting system updated the schools dashboard Thursday. The following numbers were reported:

• Bright Local: seven new student cases (eight cumulative);

• Fairfield Local: two new student cases (five cumulative) and five cumulative staff cases;

• Greenfield Exempted Village: 12 cumulative student cases and three new staff cases (eight cumulative);

• Hillsboro Christian Academy: One cumulative student case and four cumulative staff cases;

• Hillsboro City: One new student case (seven cumulative) and seven cumulative staff cases; and

• Lynchburg-Clay Local: One new student case (eight cumulative) and four cumulative staff cases).

There have also been 19 COVID-19-related deaths since the start of the pandemic.