WARREN — Several counties on the watchlist to move to purple did so Thursday, but Trumbull County was not one of them.

Trumbull County was placed on the purple watchlist with Adams, Clermont, Hamilton, Medina, Portage, Richland, Stark, Summit, Warren and Wood counties.

When the Ohio Public Health Advisory System updated data Thursday, Medina, Portage, Richland, Stark and Summit turned purple, joining Lake, Lorain and Montgomery counties. Franklin County went down to the red level.

INDICATORS

Trumbull, Mahoning and Columbiana counties are at the red Level 3, meaning there is “very high spread and exposure,” according to the advisory system. Level 4 purple indicates “severe spread and exposure.”

Trumbull County did not meet the indicators for sustained increase of outpatient visits or hospital admissions. The county has seen an average of two hospital admissions per day, and 16 outpatient visits per day, according to the seven-day average calculated on Tuesday.

But, the county did hit the indicator requirements for cases per capita, new cases, the percentage of cases not in a congregate setting, emergency room visits and intensive care unit bed occupancy availability.

There are 712.72 cases per 100,000 people in Trumbull County. And, 70 percent of the cases are in a noncongregate setting. The seven-day average for emergency room visits in the county is 18, as of Tuesday.

The ICU occupancy figures in Trumbull, Mahoning and Columbiana counties are the same, so that indicator was met in all three counties. The ICU beds in the counties are 85 percent full, with 26 percent of the beds being used by COVID-19 patients, as of Tuesday, according to the advisory system.

Mahoning County did not meet the indicators for sustained increase of outpatient visits, hospital admissions or for the number of cases not in a congregate setting. The county has seen an average of two hospital admissions per day, and 23 outpatient visits per day, according to the seven-day average calculated on Tuesday.

But, the county did hit the indicator requirements for cases per capita, new cases, emergency room visits and intensive care unit bed occupancy availability.

There are 868.45 cases per 100,000 people in Mahoning County. The seven-day average for emergency room visits in the county is 26, as of Tuesday.

Columbiana County did not meet the indicators for sustained increase of outpatient visits or hospital admissions. The county has seen an average of two hospital admissions per day, and five outpatient visits per day, according to the seven-day average calculated on Tuesday.

But, the county did hit the indicator requirements for cases per capita, new cases, the percentage of cases not in a congregate setting, emergency room visits and intensive care unit bed occupancy availability.

There are 758.71 cases per 100,000 people in Columbiana County. The seven-day average for emergency room visits in the county is nine, as of Tuesday.

On Thursday, the state added 8,921 new cases, Trumbull County added 255 new cases, Mahoning County added 271 new cases and Columbiana County added 119 new cases.

Deaths increased by one each in Trumbull and Columbiana counties, bringing the total to 154 and 102, respectively, but remained at 303 in Mahoning County. The state reported 82 deaths, bringing the total to 6,753.

CORONAVIRUS ADDRESS

Gov. Mike DeWine today is expected to discuss vaccine distribution and priorities in a rare Friday briefing. DeWine said he is in touch with the federal government about the logistics and said he has been in touch with CVS and Walgreens — companies selected by the federal government to handle nursing home distribution.

DeWine said Thursday there is a “crisis” in Ohio hospitals, and it is getting worse.

There are 5,142 people being treated in hospitals for COVID-19, and 1,204 of those patients are in the ICU, DeWine said.

The numbers of cases, deaths and hospitalizations are “grim,” DeWine said.

“We lose people every single day. Each of these lives matter. Whether it is your friend or my friend, no matter who it is. Each life matters a lot. And I think all Ohioans deserve, your families deserve for us to be guided by the facts and to do everything we can to battle this virus,” DeWine said.

Even the counties with the lowest amount of spread are facing triple the amount the CDC sets as high incidence of spread.

Dr. Andy Thomas, chief clinical officer at The Ohio State University Wexner Medical Center, warned that Ohio is not yet seeing the impact of gatherings that took place over Thanksgiving because hospitalizations are a lagging indicator. Symptoms generally develop within 10 days of transmission, and hospitalizations typically occur a week after diagnosis.

“This is not the beginning of the end or even the end of the beginning,” said Dr. Thomas. “Hospitals are in a very difficult spot here, and we’re just now heading into the most challenging three months of the pandemic. ICU beds are an area of capacity where we have the biggest strain across the state, especially in rural areas.”

The uptick in hospitalizations doesn’t only stress space, but the health care workers who care for them, and COVID-19 treatment relies heavily on staff availability to get patients medications, respiratory therapy and to turn patients over to improve lung functions.

Hospitals don’t have an unending supply of staff or space, Thomas said.

One out of three patients in ICUs across the state are there for COVID-19 treatment, Thomas said.

“That is not sustainable,” Thomas said.

Hospitals are already pushing back regular care and nonemergency care, Thomas said.

“No one wants to see that,” Thomas said.

“Hospitals around the state are delaying nonemergency procedures, which will impact routine health care. The bottom line is that non-COVID patients are being crowded out of the system and won’t be able to get the care they need to stay healthy. We all must do our part to stop the spread of the virus,” said Dr. Nora Colburn, associate medical director for clinical epidemiology at The Ohio State University Wexner Medical Center.

DeWine said numbers still haven’t plateaued, but he believes the 10 p.m. to 5 a.m. curfew, more compliance with mask orders and other measures have prevented an even more aggressive increase rate in cases. Still, the state has surpassed a 15 percent positivity rate, which is one of the guidelines the state has been using for its own out-of-state travel restriction guidelines, DeWine said.