Ohio Valley Health Officials Grappling With Rapid Spread of COVID

WHEELING -- New cases of COVID-19 jumped in the Ohio Valley during November, with public health officials in Ohio and Marshall counties pointing out that new cases seem to be coming through community spread, rather than events that can be easily identified.

COVID cases in Ohio County have risen by more than 1,100 in the last month. On Nov. 1, the Wheeling-Ohio County Health Department reported 638 total cases and, at the time, nine deaths. By Thursday, the county recorded a total of 1,790 cases and 22 deaths. Recent weeks have seen dozens of new cases each day.

It has been much the same in Marshall County.

On Nov. 1, the Marshall County Health Department reported 414 positive cases, 48 probable cases and five COVID-related deaths. On Dec. 1, the department had reported 1,121 confirmed cases, 183 probable cases and 31 associated deaths.

Wheeling-Ohio County Health Administrator Howard Gamble said his department has noticed that many new cases arise from spread within households, rather than attributing the increasing numbers to any major external events.

Gamble had previously said that the trend upward was representative of how the disease typically spreads through a community, rather than "spiking" due to any particular events.

"It spreads rapidly to (others) inside the house, and you have a large increase as a result of spread within the household," Gamble said Friday. "… A lot of it is household-to-household. I don't see large businesses with lots of cases as a result."

On a more optimistic note, Gamble noted that the county no longer sees explosions of cases in long-term care facilities, thanks to better precautions being taken.

"What we don't see is spread within long-term care facilities. ... The long-term care, because it's a closed population, we don't see a big blossom. We did at one time, but don't anymore," he said.

"Once they start looking at control measures, making sure they're not moving patients and staff between floors, or when they're accepting people, they're accepting them in a certain manner — they're tested before they arrive, placed in 14-day quarantine until you go back, make sure that person isn't infectious, or have some sort of barrier system."

Gamble said Wheeling Hospital, which had seen several cases among staff members in recent weeks, doesn't seem to pose a risk of spreading COVID internally; rather, the infected staff members individually seem to have contracted the disease from community spread.

"Wheeling Hospital announced they had so many people sick, but keep in mind, it may not be from the hospital floor. It may be that the employee is sick because, within their own home, another person is sick. What I don't see is an abundance in one floor, at Wheeling Hospital or at any medical center. ... What we see is two or three, that just so happen to have contact outside the facility."

Dr. Clark Milton, Wheeling Hospital's director of Corporate Health Services, said the upward trend in cases is speculated to be linked to the increasingly indoor nature of gatherings. As temperatures dropped in late October and through November, more and more people gathered indoors, and in closer proximity to one another, creating a scenario favorable for transmission of the virus.

"I think the trend we've seen is based on the change of seasons — we're no longer outdoors for our celebrations," Milton said. "Because of the indoor celebrations, that allows this infectious virus to spread easily. ... When we're in close quarters without protection, less than 6 feet apart for a cumulative time of 15 minutes, that's the risk. Watching the football game, sharing and eating meals, that's where our risk, at this point in time, seems to be."

Milton said that in hospitals, staff can anticipate which patients have COVID-19, and take active precautions when around them. In public, however, the average passerby is an unknown risk factor, so people must take more generalized safety measures.

"We know who the positive patients are, that's an advantage to be compulsive in using personal protective equipment," Milton said. "Unfortunately, in the community, we don't know who's positive, and we need to assume that maybe everybody is, and use those social distancing rules and masks."

Since Nov. 1, Belmont County has experienced 1,485 additional cases, 491 recoveries, 978 active cases and 16 deaths. Harrison County has had 235 new cases, 87 recoveries, 147 more active cases and one death. Jefferson has had 1,192 new cases, 383 recoveries, 797 active cases and 12 deaths. Monroe County has had 218 more cases, 138 recoveries, 76 active cases and four deaths.

Belmont County Deputy Health Director Robert Sproul has spoken about the surge, pointing out that recent weeks have seen more than 90 new cases in a single day. Sproul has cited several factors, such as the close-quarters of many households during winter's onset, which has done more to facilitate community spread.

Sproul has also noted issues non-compliance in the public with the state's mandates on mask wearing and social distancing.

Sproul has also pointed out difficulties in contact tracing people who might have been exposed. This is further complicated since Sproul himself and three staffers at the health department learned they were exposed to an infected person and have since had to go into quarantine.

Meanwhile, health department heads in the more rural counties of Harrison and Monroe have pointed out their sparse populations and distance between residents as a factor that has slowed community spread in the past, but they continue to experience the surge as well.

In Marshall County, Threat Preparedness Director Mark Ackermann said his health department is on alert over the next week to see how many new cases arise as a result of last week's Thanksgiving gatherings. As many of the week's new cases were tested over last weekend or early in the week, Ackermann fears that the worst is yet to come.

"We're seeing the higher numbers, we're seeing the death toll, we're afraid, really, of the next 48 to 72 hours, the numbers we'll start to see from after-Thanksgiving testing," Ackermann said Thursday evening. Between Nov. 23 and Thursday, Marshall County's death toll due to COVID more than doubled, going from 16 to 33.

"We could have seen some of that, but looking at the numbers (that have been released) so far, include test results from Monday. ... We're afraid that it is (going to spike)."

Compounding the work of the health department is, as Gamble had previously lamented, a reluctance for some infected individuals to cooperate with the health department, and an inability to act on commonly-known, but not officially confirmed, contacts they may have had.

"Here's what we fight with every day: people don't want to tell us where they've been and who they've been around," Ackermann said. "If I'm positive and have been around you, you have to go into quarantine, and I don't want to tell the health department that, because I don't want to put them into quarantine.

"We ask people on the phone, who are positive, who lives with you? And they say, 'It's just me and my mom.' Okay. A few days later, the aunt comes back positive, and we ask where she lives, and it's with her sister and her daughter. The family didn't bother to tell us the aunt lived with them, because they didn't want her placed in quarantine."

Several barriers, such as workload and medical privacy laws, prevent the health department from cross-referencing residential information with governmental sources, Ackermann said.

"Contact tracing is absolutely only as good as the information the person gives to us. We can't force them — we've had people flat out refuse, 'I'm not telling you anything,'" he said.

"… A minor set of the general public doesn't understand; they feel that they don't have to give us that information because they don't want to affect their friends, going into isolation because of them. 'They're going to hate me after this!' Well, okay, but they'll still be alive, hopefully."

Times-Leader reporter Robert A. DeFrank contributed to this report.