Heads of the health boards in Trumbull and Mahoning counties say COVID-19 statistics on deaths, hospitalizations and new cases have not helped them determine whether the reopening of Ohio last month has made the virus worse.

Frank Migliozzi, health commissioner for the Trumbull County Combined Health District, said he has seen no indication that the reopening of restaurants, bars and other businesses has been detrimental.

But even if the number of cases were increasing, Migliozzi said, it would be impossible to know whether that was because of people coming in closer contact with others — or the result of the increased testing that has taken place in recent weeks.

An increase in testing reveals more cases of the virus, even among people who have no symptoms, Migliozzi and other experts say.

Ryan Tekac, health commissioner for Mahoning County, likewise said COVID-19 data on cases, hospitalizations and deaths doesn’t provide clear answers. He also mentioned increased testing has an impact on the number of cases recorded.

Tekac said when the Ohio National Guard carries out increased testing at Ohio long-term care facilities such as nursing homes in the coming weeks, that again will affect the statistics.

He’s has seen an increase in the number of cases in recent weeks but only in long-term care facilities, not among the general public, and those are the result of increased testing there, he said.

“In my opinion, it’s going to be very hard to pinpoint (whether) are we seeing an increase in cases because of testing or if are we seeing an increase in cases because of things being opened up,” Migliozzi said. “But honestly, the number of cases we are getting is remaining level.”

TRUMBULL’S FOCUS

Migiozzi said he does not know why Trumbull County has had so many fewer coronavirus cases and deaths than Mahoning County, but he believes Trumbull’s early focus on long-term care facilities such as nursing homes helped keep Trumbull’s numbers down.

As of Sunday, Trumbull County has had 612 confirmed coronavirus cases, compared to 1,511 for Mahoning County. Trumbull County has had 164 hospitalizations, compared to 323 for Mahoning Countyr.

And Trumbull County has had 53 deaths compared to 194 for Mahoning County.

The overall populations and elderly populations in each county are similar. According to U.S. Census data released in December, Trumbull County has 201,794 residents and Mahoning County has 231,064.

The percentage of Trumbull County residents age 70 and over is 13.9 percent, compared to 13.7 percent in Mahoning County. Statewide, the percentage is 10.8 percent.

One difference between the two counties is the number of long-term care facilities (such as nursing homes) each county has and the number of patients those facilities can accommodate. Trumbull County has 31 facilities that can accommodate 2,538 people, but Mahoning County has 52 facilities that can accommodate 3,805 people.

The Ohio Long Term Ombudsman Program, which is part of the Ohio Department of Aging, states Trumbull County has 18 nursing homes that have 1,620 beds. Mahoning County has 28 nursing homes with 2,632 beds.

Trumbull County has 13 assisted-living facilities that can accommodate 918 people. Mahoning County has 24 assisted living facilities that can accommodate 1,173 people.

LONG-TERM FACILITIES

Migliozzi said officials from the Trumbull County Combined Health District and its partners in fighting the virus, such as fire chiefs and emergency management, focused heavily on long-term care facilities early — right after Ohio started getting cases.

Having a case early may have alerted Trumbull County officials a bit sooner than other counties to take action, Migliozzi said.

“We were the third county in the state to have a case,” Migliozzi said of Kevin Harris, 55, of Warren, who was treated at St. Joseph Warren Hospital after being diagnosed March 11. At the time, Ohio had only five virus cases — three in Cuyahoga County, one in Trumbull and one in Stark.

“We went into full emergency mode right after that,” Migliozzi said of establishing the county’s Emergency Operations Center, which involves appointing health and other officials to map out a response to an emergency.

“We had a partial opening of our emergency operations center when Cuyahoga County had a case. Then we went into full emergency operations after (Trumbull got its first case) and really just started to get information out, seeing the trends that were happening elsewhere.”

Mahoning County had its first case around March 17.

Migliozzi said Trumbull County learned early from Cuyahoga County that a lot of cases were in long-term care facilities.

“As we started to pull our emergency operations team together … we just started reaching out to our (long-term care facilities) and saying: ‘Listen, this will be devastating if this comes through your door,'” he said.

Migliozzi said another message to such facilities was, “watch your employees. The governor had shut down guests coming into (long-term care facilities) right away, so the main way for it to come into a facility was the workers,” Migliozzi said.

The Trumbull County Combined Health District and its partners set up teleconference meetings with long-term care facilities to make them understand their employees could be a key to keeping the virus out.

They were told to start taking employees’ temperature, watch for symptoms such as coughing or shortness of breath and fever — and “don’t let them in your place” if they do, Migliozzi said.

“That rapid response to get the message out — I think they listened, and it made a difference,” Migliozzi said.

It also matters how many employees such facilities are sharing, Migliozzi said.

“We said, ‘Try to eliminate people bouncing in and out of these different facilities,'” he said, reasoning an employee may have the virus without knowing it. “And they’re walking out of one facility and coming into your facility and they could spread the virus that way. Those are some of the things we told our facilities early on.

“The other thing we really pushed for our facilities to do is implement separation rooms,” Migliozzi said. “If you know you have someone who is showing signs and symptoms of (the virus), don’t keep them around other people. Get them isolated. We did that every early. I think that made a difference.”

DO YOUR PART

Tekac said health departments all over Ohio were busy in January learning about the virus and receiving documents from the Ohio Department of Health and Centers for Disease Control and Prevention to pass on to long-term care facilities.

Mahoning County public health officials also met with long-term care facilities and hospitals in January, he said. He also discussed the work his agency, the Ohio Department of Health and other state agencies did around Easter, April 12, to help long-term care facilities in Mahoning County with their outbreaks of the virus.

Migliozzi said he tries to avoid going into stores, but when he does, he doesn’t like seeing people not wearing a mask and talking loud on their cellphones. Because such places are noisy and crowded, people sometimes feel the need to talk loudly.

“They are talking away with no mask on, and they are trying to be loud about it,” he said. “They can project that out. Those droplets (from a person’s mouth) are going to travel. They are going to settle on a surface. And if you touch that surface right away, you put your hands up to your face, you are putting yourself at risk,” Migliozzi said.

Everyone has to do his or her part, such as wearing a mask because masks do help prevent the spread of the virus, Migliozzi said.

“There is a Centers for Disease Control and Prevention study that came out that says cloth masks knock down 75 percent … of droplets traveling out and settling on surfaces,” he said.