YOUNGSTOWN — Mahoning County Health Commissioner Ryan Tekac has not been able to provide many answers as to why Mahoning County leads the state in COVID-19 deaths, but he said Friday he believes area nursing homes have followed government guidelines successfully.

Dr. Amy Acton, Ohio Department of Health director, earlier this week revealed during a televised briefing in Columbus that nursing homes in the Youngstown area have produced “hot spots” for COVID-19, and she told a reporter the high percentage of older adults in the county may be a factor.

Tekac said Friday during a teleconference that area nursing homes appear to be following U.S. Centers for Disease Control and Prevention guidelines.

This includes isolating patients who become ill, restricting visitors and ensuring that employees are wearing appropriate protective equipment.

“We’re in constant contact each day with them,” he said of the nursing homes, then mentioned that the Ohio Department of Health has put together a “strike team to work with local health departments who are having these flare ups.”

When asked whether any of the area nursing homes have made serious “missteps,” he said: “No, there is none I am aware of. Like I said, as they get these (COVID-19) cases, we put a whole team together here with the Ohio Department of Health.”

He said his agency has been in contact with all of the long-term care facilities, but “more specifically those that have the flare-ups.”

The newest Mahoning County statistics Friday were that 31 people had died from the virus, 45 percent of those associated with nursing homes, which would work out to 14 people. All but one of the 31 people who died had an underlying health condition. Fifty-two percent of those who died are at least 80 years old.

“We’re not surprised by this number,” Tekac said of the age of those who have died. “We knew this virus was impacting the elderly and medically fragile. We’re also aware that within our area, we have a lot of underlying health conditions that are prevalent.” His agency’s Community Improvement Plan addresses underlying health conditions, he noted.

He also said the danger to the lives of people with underlying health conditions is the reason county and state officials continue to urge the public to stay vigilant with social distancing during this Easter weekend and not add extra people to the supper table.

“Social distancing only works if everyone stays within their immediate household circle. Exposing yourself to even one more person increases the risk of transmission of this virus,” he said.

Mahoning County’s population of people 65 and older is 21 percent, which is above the state average of 17 percent but below Trumbull County’s 21.5 percent, according to U.S. Census data. Trumbull County’s most recent death total from COVID-19 is well below Mahoning County’s.

John Saulitis, director of the long-term care ombudsman program for the nonprofit Direction Home of Eastern Ohio, which provides services to residents and family members of residents in long-term care facilities, said news from across the country indicates that COVID-19 has been common in such places.

Because government officials are not identifying facilities with COVID-19 cases, “It’s not surprising that many family members and residents themselves have elevated levels of concern because without the more specific information, people are naturally, I think, going to think that the reports are talking about their nursing home.”

Nursing homes cannot even tell other residents the reasons a resident left the facility, for example for a trip to the hospital. That would violate privacy rules.

As for his agency’s role in helping people with complaints about nursing homes, he said calls have not varied much in recent months, but the agency has had more calls from family members frustrated by the limitations on visiting their loved ones that have gone into effect since the COVID-19 outbreak.

When Tekac was asked Friday whether he is still comfortable with the COVID-19 testing the company Quick Med Urgent Care did this week in Campbell and is now planning Tuesday and Wednesday in Austintown, Tekac said he is.

“So far, from my understanding, everything has been flowing fine with the drive-thru clinic,” Tekac said. “The guidelines will still stay the same. They are going to have to register online. They are going to have to be seen by one of their physicians prior to to determine whether they have symptoms prior to being tested.”