Highland County Health Commissioner Jared Warner is pictured during Thursday's county COVID-19 update.
Highland County Health Commissioner Jared Warner is pictured during Thursday's county COVID-19 update.
Highland County Health Commissioner Jared Warner hosted the county’s weekly COVID-19 update Thursday afternoon, where he reviewed recent changes to state mandates and discussed the health department’s role safely planning the county fair, the reopening of schools and upcoming local events.

As was noted during the May 28 update, the county has seen another increase in COVID-19 cases in the past week. The current totals include 21 confirmed and seven probable cases, for a total of 28 COVID-19 cases; 20 recovered patients; one death; one hospitalization, whom Warner said should be “released shortly;” seven actively sick people; and 24 individuals under quarantine and being monitored by the health department.

One viewer asked if the “probable” patients are put under quarantine. Warner said those patients check in with the department daily, as discussed during the contract tracing portion of the May 28 meeting. He added that the “probable” patients are “treated just as if somebody was a lab-confirmed case.”

“The reason that this probable category exists, and the reason that it’s important, is we still do have some limitations on the level of testing available to us,” Warner said. “There are some circumstances where we’ve got direct contact with a known, lab-confirmed case.

“Let’s say a wife has a lab-confirmed case, and her husband develops symptoms that are consistent with COVID-19. We know they’ve had close contact. Rather than us using some of our limited tests to get a lab confirmation, we can call that person a probable case, put them under the same restrictions and put them in quarantine.”

During Thursday’s conference, Warner gave an overview of some recent changes at the state level, as Ohio Department of Health Dr. Amy Acton signed several health orders over the past weekend.

“A lot of the same 10-person mass gathering rules remain in effect, but one of the big changes is there are no longer any restrictions on gatherings that occur at someone’s place of residence or an adjoining property,” Warner said. “If you are having a graduation party, if you are having people over for s’mores and a fire pit, anything like that — none of these orders restrict any of that sort of activity.”

Another change is that “wedding receptions are allowed to occur for groups up to 300, and they have to meet all the normal restrictions that a restaurant would have to meet,” according to the health commissioner.

“We’re getting to a little bit of a strange place right now with these orders where we’ve got a lot of exemptions and a lot of individual rules, and it’s getting very difficult on our staff to keep track of what’s allowed and what’s not allowed,” Warner said. “We just encourage people to wear your face coverings; keep your distance socially; if you’re sick, stay home; watch yourself for symptoms; and just use some common sense.

“We’re going to come to a point where it doesn’t make a lot of sense, when we have so many exemptions, to keep pushing for some of the stay-at-home, 10-person minimums when you can go to a restaurant and be around 100 people, or you can go to a wedding event and be around 300. It gets a little harder for us to say that you can’t do some of these other events that you’d like to do.”

Another new guideline announced recently by the Ohio Department of Health is on testing priorities. The state was previously focused on testing people in their top-priority categories. Now, ODH is loosening restrictions to allow more people to qualify for COVID-19 tests in the top four priority categories.

As previously reported, the state of Ohio has defined the priority categories as follows:

• Priority 1: Ohioans with symptoms who are hospitalized or who are healthcare workers.

• Priority 2:
— Ohioans with symptoms who are residents of long-term care/congregate living settings; first responders, public health workers or critical infrastructure workers; 65 and older; and/or living with underlying conditions; OR
— Ohioans without symptoms who are residents or staff directly exposed during an outbreak in long-term care/congregate living settings; OR
— Other Ohioans who are designated by public health officials to evaluate/manage community outbreaks such as in workplaces or other large gatherings.

• Priority 3: Ohioans with and without symptoms who are receiving essential surgeries/procedures, including those who were reassessed after a delay; or receiving other medically necessary procedures not requiring an overnight stay/inpatient hospital admission.

• Priority 4: Individuals in the community to decrease community spread, including individuals with symptoms who do not meet any of the above categories.

“The only one that they’re currently not suggesting for is asymptomatic testing, for people who have no symptoms and have no known exposure,” Warner said. “That’s really good news for us. That means that as a community, we’re going to be able to start reaching out to more people and doing more testing.

“It should be easier than ever to do this level of testing and to get testing done in Highland County, if you’re interested in that.”

After last Thursday’s county update, the governor’s office “released guidelines for how county fair boards and agricultural societies can work with county health departments to safely operate junior fairs for kids.” Warner said that he has also been working with the Highland County Fair Board as they make plans for the 2020 Highland County Fair.

“Being so late in the year, we’ve got some time available to kind of see how other fairs go and look at some of those early fairs,” Warner said. “That might help drive some of the decisions. If a fair decides to open up with no restrictions and just be available in general, it may have low attendance rates. That can help drive some of the decisions here in Highland County. It may not make economic sense to all the things at the fair that they normally do, just because attendance may be down.

“We’re continuing to look at that and talk that over with the Fair Board. The governor’s also going to be releasing some orders from the director of Ohio Department of Health that are specific to fairs, so we’ll look to those orders and see if they provide some additional guidelines.”

Governor Mike DeWine’s office also announced June 2 that “as of right now, Ohio intends to reopen schools in the fall, but individual starting dates will be up to each local school board. In the near future, broad reopening guidelines will be issued for schools in regard to protecting the health of students and staff when the school year resumes.”

According to Warner, plans are already underway, as the health department will be attending a meeting with superintendents of all five Highland County districts to discuss “how we find that balance between opening school safely and getting back to as close to normal as we can but still keeping our kids safe and our community safe.”

Warner added that the health department staff has already begun considering plans in the event of a spike “or if a particular school starts to see a number of COVID-19 cases.”

“We may do something similar to what we do during the flu season, where we shut down for a few days,” Warner said. “We may shut down for a week and try to get a handle on things before bringing students back.”

Several viewers expressed concerns about social distancing at planned upcoming outdoor activities, including a planned protest in Hillsboro this weekend and Paint Creek’s annual “water days” for children. However, Warner assured the community that the health department is also assisting with these local events.

“We’re in a stage right now in Highland County with COVID-19 where we’re trying to find that balance between getting closer to being back to normal and doing some of these events and still being safe,” Warner said. “We’ve reached out to Paint Creek and talked to them about following the same guidelines that we have in place for public swimming pools.”

For the protest, Warner said that the department has “pulled out 100 cloth masks that we’ll be providing to the event organizers so that we can encourage people at that protest to wear those face coverings, and if anybody is sick there, to prevent COVID-19 from spreading.”

“We have seen some reports of some cases that have occurred in the Columbus area, where they’ve had COVID-19-positive protestors that have showed up,” Warner added. “It is an issue of concern, and we’re taking some common-sense steps to try to keep people safe.”

He advised the protestors to “space yourselves out, wear some face coverings and if you’re sick, stay home” to prevent the spread of illness.

In a similar question, one viewer asked Warner to discuss his take on Black Lives Matter. Warner spoke about the movement “from the public health side of things.”

“There’s long been a significant discrepancy between the health outcomes of individuals who are in poverty, who are different races and different ethnic backgrounds,” Warner said. “There are several issues involved with this, and I don’t know that this forum is the best place to get into it.

“It is an important issues, and there are a lot of really specific things that we talk about, even before the current protests, in Highland County, on how we deal with some of the diverse health outcomes we see out there.”

As an example, Warner said, infant mortality rates are an issue across the state, as the Ohio Department of Health reported in February. At that time, ODH wrote: “The number of black infant deaths declined almost 12 percent from 2017 to 2018, the first year-to-year decline in five years. However, disparities continued to persist with black infants dying at more than two-and-a-half times the rate of white infants.”

“We’ve done some work with some of our community partners to target that in particular,” Warner said. “Racial issues have a big impact on health, and we’ll keep looking at those from a health lens.”

Also during Thursday’s conference, Warner spoke about how citizens have succeeded thus far in “flattening the curve.”

“I do think the overall epidemiological curve for COVID-19 continues to be very flat,” Warner said. “There are parts of the state where it’s increased. We’ve seen some increases locally, and some increases in southwest Ohio, but nothing to date that really gets to the level where we can so ‘oh, we’ve had a spike’ or ‘we’ve had a second surge.’ I think if we continue to operate things safely and encourage people to do the social distancing and some common-sense protective measures, we won’t see that second spike. That’s our hope, and we’ll continue to watch things as we move forward.”

Warner said that the messaging needs to change to help inspire people to continue to take steps to prevent the spread of the virus.

“I’ve been giving a lot of thought to this idea of what now? What happens next?” Warner said. “At the beginning of this, we had this message, this ‘flatten the curve’ message, and it made sense.

“People got behind it. It was a call to action that people could support, even if you didn’t necessarily agree with all the science. There’ve been naysayers from the beginning, and that’s fine. The ‘flatten the curve’ message was one that resonated, and it drove people to make changes.”

As the “Responsible RestartOhio” plan continues to be implemented and more businesses reopen across the state, there is no longer a “key message” or “strategy” for people to follow, he added.

“We’re missing that big overarching message to drive why we think this is worth doing and why it matters,” Warner said. “We’re going to talk through this internally and we’re going to be reaching out to the public to see what’s the message we need to be focusing on now to explain the purpose behind all these continuing closures and doing things a little different.”

Warner suggested that a phrase he used several times throughout the conference — “find the balance” — should be citizens’ new focus as testing and PPE supplies continue to improve and all planning for the pandemic has been implemented or completed.

“We’ve done everything that we need to do to prepare for a surge,” Warner said. “I think right now we need to find the balance. Let’s open up as much as we can to still protect those high-risk people, to still protect our health care system, but to know we’ve got resources ready to respond if we need to.”

Warner added that “the better we do at practicing social distancing, wearing our face coverings, washing our hands and being kind to each other, the easier it is to quickly find that balance.”

A viewer asked if the virus was likely to continue spreading throughout the summer.

“One of the reasons we want to do antibody testing is we want to get a better idea of what the disease prevalence is in Ohio,” Warner said. “There’s a lot of indication right now that because we acted so quickly and so early that we have not seen a high level of disease and have not had a lot of people who have contracted COVID-19, which means we haven’t got a lot of people who have developed any sort of immunity.

“As we open up more things and people do more things, there’s still a lot of additional risk for exposure. I would expect things to be pretty close to what they are now, if not higher rates of COVID-19 cases, for the next several months. I just think likely we’re going to be somewhere between the five- and seven-percent prevalence rate in Ohio, so we’ve got a lot of people who’ve still not come into contact with this disease and a lot of people who could potentially get sick.”

Contact tracing is the health department’s method of working to “find that balance between opening things up and still being able to stop any of those major, serious disease spikes from occurring,” he added.

Other topics discussed at previous conferences include wearing masks at businesses; reopening certain businesses and related guidelines; statewide COVID-19 testing in long-term care facilities, which will be conducted by the Ohio National Guard; a statewide “randomized,” voluntary antibody testing project; local testing options; contact tracing; limits to testing; and how cases are reported based on the county of residence for each patient.