Montgomery County has weathered the coronavirus pandemic better than the state’s other large counties and many with smaller populations. But as businesses begin to reopen, a new study suggests the county is poised to emerge a coronavirus hotspot in coming weeks.
County health officials neither condoned nor condemned a recent Dataminr study, but said they are bracing for more infections as restrictions begin to loosen.
People with existing health conditions and unhealthy habits have been protected so far by good compliance with social distancing measures – as well as a dose of good luck – which may not last indefinitely, said Dr. Michael Dohn, Public Health – Dayton & Montgomery County medical director.
“We’re in a position where we would expect that things are going to start to look more like the rest of the state,” he said.
An analysis of social media clusters by the technology firm Dataminr suggests an impending case spike in three Ohio counties, including Montgomery, and in 21 other small metropolitan and rural counties in seven other states currently reporting a fewer number of confirmed COVID-19 cases. Lucas and Summit are the other Ohio counties.
“While it may be the case that the outbreak is ‘peaking’ in major cities, it is also likely the case that new virus waves are on the brink of emerging in other small metro and rural areas,” Dataminr CEO Ted Bailey told Fortune.
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Dataminr said its software in March succeeded in predicting an upswing in cases in 14 states after observing exponential growth in on-the-ground, first-hand public social media posts related to the coronavirus in regions that had yet to experience an exponential rise of positive cases.
Social media data as of April 21 predicted virus outbreaks within six to 13 days from that date in the 22 counties including Montgomery County, according to the analysis.
The clusters represent posts from people who indicated they tested positive for COVID-19, were experiencing symptoms of the disease or that they have been exposed but not tested. The posts also included first-hand accounts of confirmed COVID-19 cases from relatives, friends, and colleagues as well as posts about shortages of supplies and business closures, according to the study.
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Dohn said the health department doesn’t monitor social media posts but has studied cell phone data that showed little movement among Montgomery County residents, indicating a high degree of voluntary compliance with the state health department’s stay-at-home order.
“All of Ohio went quiet, but Montgomery County, in particular, was very, very low,” he said. “We’ve had excellent compliance with the stay at home order and the distancing. We’ve had really good response from the businesses … Nobody’s happy about this, but people have done what they need to do.”
As of Monday, Montgomery County’s rate of 60.1 cases per 100,000 population is currently lower than 51 of Ohio’s 88 counties. The fifth most populous county, Montgomery County ranks 13th in the total number of confirmed or suspected cases and 23rd in number of deaths.
Ohio Gov. Mike DeWine gave Ohio manufacturers, distributors, general offices and construction companies the greenlight to reopen on Monday. Other consumer and retail operations will get the go-ahead next week.
While Montgomery County has been “fortunate to this point.” The next phase is likely to bring the specter of additional cases and deaths to Montgomery County as human interactions increase, Dohn said.
“This can’t go on forever. We hope it does,” he said. “But we’ve got to plan for the fact that that it’s going to get a little more intense in terms of the number of cases.”
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People returning to jobs in Montgomery County are likely to bring the virus to work, Dohn said.
As many as 80,000 people work in or will return to work in Montgomery County from surrounding counties, most of which have a higher infection rates. Of the seven counties sharing borders with Montgomery County, five currently have higher infection rates. Only Greene and Clark counties have lower rates.
“As those people come back, they’re coming from a higher prevalence area. And so they may also begin to bring it back into Montgomery County,” Dohn said. “The travel was so low that it’s just as likely that people coming in are more apt to have the virus or been exposed to it recently than people in the county because our rates are so low.”
The highest neighboring case rate is in Miami County, with 135.6 cases per 100,000 people, primarily due to clusters of cases at care facilities. Outbreaks at similar facilities have occurred in Butler, Darke and Warren counties, something Montgomery County has avoided.
“We are especially concerned about congregate care and congregate living facilities, our long-term care facilities like nursing homes, skilled nursing facilities, the jail as well as homeless shelters, said Jeff Cooper, Public Health – Dayton & Montgomery County health commissioner.
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Expanded testing will also drive up the numbers of confirmed cases in Montgomery County, Cooper said.
“One of the qualifiers regarding all of those data, however, are that there may be less testing to date that has happened within Montgomery County,” he said.
As the state boosts testing between now and the end of May, capacity will increase 200% across Ohio. Within an eight-county area including Montgomery County, about 1,000 more tests will be administered daily.
“No question, we should anticipate to start to see an increase in the number of cases being reported for Montgomery County,” Cooper said. “We have to be very careful as we move forward reopening the economy. We need to make sure that we understand that the virus is still circulating.”
The county’s demographics, chronic disease rates and other health risks also leave officials ill-at-ease about what comes next.
African Americans have been affected disproportionately by the disease caused by coronavirus, according to John Hopkins University research and the Centers for Disease Control and Prevention. Of 26 states that reported coronavirus deaths by race, black people account for nearly 34% of the fatalities, according to Johns Hopkins.
As of Monday, blacks accounted for 26% of Ohio’s 20,474 cases and whites 52%, though 12% were not known. Of the, 1,056 dead, blacks were 17%.
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In Montgomery County, blacks make up 20.4% of the population compared to 13% in the state and 13.4% throughout the country, according to U.S. Census data.
“We know that they’re likely to be more affected somehow,” Dohn said. “That’s a concern.”
As rules are relaxed, the prevalence of respiratory disease along with the number of people smoking and vaping in the county have the potential to increase infections, the health officials said.
More Montgomery County adults smoke, 23%, than the U.S. rate of 17%. Dohn said 25% of Montgomery County adults have vaped and 40% of high school students have experimented with vaping with 22% of the cohort reporting they are current users.
“Smoking just predisposes people to respiratory illness,” Dohn said. “If you are exposed to something, whether it’s a bacteria, or pneumonia or this virus, you’re more likely to actually catch it and get infected.”
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Long-term exposure to a type of air pollution pervasive in Montgomery County may also put people with pre-existing conditions like lung disease more at risk of dying from COVID-19, according to a Harvard University study released in April.
Researchers at the T.H. Chan School of Public Health cited Butler, Hamilton and Montgomery counties in Ohio as among those across the country with high pollution levels and current death rates from Covid-19 lower than the U.S. average.
Authors of the study found that someone who lives for decades in a county with high levels of fine particulate pollution is 8% more likely to die from COVID-19 than someone who lives in a region that has just one microgram per cubic meter less of the pollution.
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The study, which has not yet been peer reviewed, examined the link between long-term exposure to fine particulate air pollution generated largely from fuel combustion from cars, refineries, and power plants.
Whether the number of cases or deaths skyrocket in Montgomery County won’t be due to the amount of testing, the availability of N95 masks or how good hospitals operate, Dohn said.
“It depends on how people behave,” he said. “We expect that there might be some bumps if people start to circulate a little bit again. It really depends on how people see their part in this.”
A study based on social media posts suggest COVID-19 cases to spike soon in the following counties:
St. Joseph County