What the numbers tell us about COVID-19 in Ohio after 3 years, 40,000-plus deaths and millions of vaccines – cleveland.com

CLEVELAND, Ohio – The impact has been staggering since the first COVID-19 cases were confirmed in Ohio three years ago this week. Tens of thousands of Ohio deaths. More than 100,000 hospitalizations. And 3 million-plus known cases.

So many people have died that if they were all in one place, they would make up one of Ohio’s 15 largest cities.

Have we all had COVID-19 by now? No.

But by some recent research, at least half of us have been infected, probably more and increasing by the day. And 10 to 20 Ohioans still die daily from the virus. Yet, the severity of late is just a fraction of what it once was, thanks largely to highly effective vaccines and what the medical field has learned about treatments.

Here’s what we know and, in some cases still don’t know, about the numbers behind pandemic that became real for Ohio with the first three cases confirmed on March 9, 2020.

Lives lost

By official accounting from the Ohio Department of Health, 41,242 Ohioans died because of the coronavirus during the first three years of the pandemic – 13,621 in the first year, 18,277 in year two, and 9,344 last year.

Yet other data suggests those numbers undercount the real toll by several thousand.

At least 57,540 more Ohioans died from all causes from the start of the pandemic in 2020 through 2022 than had died the previous three years, from 2017 through 2019, according to data from the state health department’s mortality database.

Deaths were on the rise in the decade ahead of the panademic – averaging about 1,700 more a year annually – but the shift was dramatic once the coronavirus arrived.

Total deaths jumped nearly 20,000 – from 123,705 in 2019 to 143,360 in 2020. Then there were 147,583 deaths in 2021, and 137,946 reported so far for last year in preliminary reports.

Deaths from “natural causes” overwhelmingly is the leading reason for the increase – accounting 53,000 of the extra deaths over the last three years, according to the mortality database. Not because of things like homicides (up 610), suicides (down 212) and drugs (up 2,002), though close to 500 cases are still pending a determined cause.

Among the possibilities for the gap between official COVID-19 death numbers and the increase in deaths overall are failure to identify COVID-19 cases, especially early on, patients skipping regular appointments or delaying treatment for other health reasons during the pandemic, and lifestyle changes.

People infected

The Ohio Department of Health reports 3,392,320 cases so far among the 11.8 million Ohioans.

The big year was not year one of the pandemic (740,300 in 2020), but rather the second year (1,357,343 in 2021). Even lately, Ohio continues to report close to 10,000 new cases each week.

But case reports don’t equate to people infected, because some people have been infected multiple times.

And even the number of confirmed cases never should have been considered an accurate reflection – first because tests weren’t available to everyone, then the likely under-reporting of results from now widely available home tests, and the lack of true scientific sampling of the entire population. Some groups, for example, were subject to required testing even without symptoms, such as students returning to college at times, while others were not.

Plus, the question lingers: how many sick people aren’t testing?

One study by a consortium of researchers from five universities released in mid-December said that half of the American adults surveyed reported having COVID-19 at some point, though only a third said they had tested positive. Those shares would be higher now.

Vaccines work, but many continue to skip them

Strong evidence suggests three things about vaccines: (1) they are highly effective in keeping people out of hospitals and from dying, (2) many people continue to refuse to get the shot, and (3) boosters have not fully caught on even among those who got initial doses.

To date, 1-in-4 Ohio adults has not received even one shot.

But even among the 6.8 million adults who have been vaccinated, only 3.8 million returned for a booster at some point, and only 1.7 million have received the latest booster, available since September.

Yet there is ample evidence that the shots work.

Tracking by the state health department for cases starting in 2021 shows that people who received the initial round of vaccines (two Pfizer or Moderna shots, or one Johnson and Johnson) account for just 5.3% of the deaths and 7% of the hospitalizations.

Put another way, those who have not been vaccinated now make up only a small share of Ohioans, but they account for close to 93% of the deaths and hospitalizations.

Including children, 7.6 million Ohioans have received at least one shot.

Surges

Whereas case numbes are dicey, hospitalizations offer a consistent, though not perfect, look at the trends, especially so for severe cases. Efforts were made from the very beginning to identify COVID-19 patients in hospitals and report out that information.

What data from daily surveys by the Ohio Hospital Association shows is that Ohio avoided the feared winter surge this time around, with far lower bed counts than each of the last two winters.

For example, the daily count of patients in Ohio hospitals with COVID-19 this past December and January averaged 1,129, down from 5,211 during the same months in 2021-22 and from 4,253 during those months the first year of the pandemic.

As for just COVID-19 patients in intensive care beds, the daily average was 163 in December and January, down from 1,150 in December-January a year ago, and 1,030 two years ago.

Nursing homes

Nursing home patients are still dying from COVID-19, but nowhere near the frightening levels from early on, according to reporting by the nursing homes to health departments.

There were 4,856 nursing home deaths reported in 2020, dipping to 3,448 in 2021 and then to 1,106 last year. Nursing home patients, starting in December 2020, were among the first to be vaccinated.

To date, there have been 9,543 deaths and 102,743 cases reported among nursing home patients.

The age factor

Early on, COVID-19 deaths disproportionately involved the oldest Ohioans. That no longer is the case, based on historical trends.

Ohioans age 80 and up accounted for more than half the COVID-19 deaths reported in the first 12 months (52%). That has dropped to 42%, which is close to the normal share for this group from all causes. In 2018, people 80 or above accounted for 44% of all Ohio deaths.

The share for deaths among people in their 70s also edged down, but just slightly from 27% over the first year to 26% for all three years.

Factors likely include targeted efforts early on to reduce nursing home deaths and high vaccination rates. Older Ohioans are far more likely to have been vaccinated – close to 90% for everyone over 60.

In pure numbers, however, deaths and hospitalizations for people 60 and older far exceed the numbers for younger people, accounting for 87% of the deaths and 64% of the hospitalizations.

By race, Blacks who make up 14% of Ohio’s population have accounted for 16.5% of the COVID-19 hospitalizations. Whites, 82.8% of Ohio, have accounted for 74% of the hospitalizations, according to the health department.

Geography matters, or is it the vaccine?

A rural/urban divide shows up in the numbers, with people in smaller counties more likely to have died because of the coronavirus. These same rural counties collectively have a notably lower vaccination rate.

There have been 313.1 deaths per 100,000 residents in the 10 largest counties, where the vaccination rate as a group is 66.6%, including in that share anyone who has received at least one shot.

Among the other 78 counties, there have been 399.6 deaths per 100,000. The vaccination rate for those counties is 55.7%.

Taking it a step further, the death rate in the 10 smallest counties is 495.9 per 100,000, and the vaccination rate is 48.8%.

Delaware County north of Columbus has the highest vaccination rate (80.1%) and the lowest death rate (141.5 per 100,000). It’s the 13th largest county in Ohio.

Holmes County in the heart of Amish Country has the lowest vaccination rate (19.8%) and is 43rd for deaths (431.9 per 100,000).

Cuyahoga County ranks third for vaccinations (69.2%) and has the 17th lowest for death rate (326 per 100,000). The state’s largest couinty, Franklin, is second for vaccinations (69.8%) and has the third lowest death rate (213.6 per 100,000).

Vaccines have also become a political issue. The largest counties are Democratic strongholds, while Republicans have wide support in the smaller counties.

Not seeing the county-by-county chart above? Some mobile users may need to use this link instead.

Date used throughout this story was the latest available as of Saturday, March 4, 2023.

Rich Exner has been tracking the COVID-19 numbers daily for cleveland.com since the the beginning of the pandemic.