ELKHART — The Elkhart County Health Department will not reintroduce COVID-19 restrictions at least until after Election Day. Not because the outbreak is not serious enough but because of the potential political consequences.
That is according to ECHD spokesperson Melanie Sizemore, who said officials in Elkhart County, and in the state as a whole, have concerns about imposing restrictions ahead of Nov. 3. One of the concerns, she said, is how it would affect reelection chances of incumbents.
Locally, Elkhart County Health Officer Dr. Lydia Mertz is retiring at the end of the year and does not need to worry about keeping her job, but the ECHD still has to consider the public’s response to new restrictions so close to Election Day, Sizemore said.
“There is still political support at play. While Dr. Mertz, yes, could put out a public health measure or intervention, there’d still need to be support behind it in order for it to be effective within the community,” she said. “It’s a sticky situation for us to be in right now.”
She hopes people will see new restrictions in a less political light after Nov. 3. And since some conspiracy theorists have suggested that the coronavirus is merely a tool to make President Donald Trump look bad, and that it will go away come Nov. 4, Sizemore thinks there may be more support for restrictions when the outbreak continues after the election.
“It allows people to understand that Nov. 4 does not stop the virus,” she said.
But what if people die while the Elkhart County Health Department withholds restrictions until the election is over?
“There is no good answer to that,” Sizemore said.
She said people should follow the rules already in place, including a statewide mask mandate. People know they should wear a mask, social distance and wash their hands, she said, but some choose not to follow that advice. But as the local outbreak has now worsened for over a month, the ECHD has repeatedly said that, instead of reintroducing restrictions, its focus would be on educating the public on the importance of following the advice and the mask mandate. By Sizemore’s admission, that campaign is not working.
“I don’t think we’re changing anybody’s minds,” Sizemore said.
It is the job of the ECDH to educate the public on health, she said, but the department cannot control what people do with the information they are given, and the worsening outbreak shows that some are not listening, she added. She did not say the county will necessarily reintroduce restrictions after Election Day.
County remains orange
Despite warnings from the ECHD last week that the county’s alert level was likely to move from orange to red this Wednesday, Elkhart County remains orange.
While Elkhart County continues to have more than enough weekly cases per 100,000 residents (the criterion to move to red is 200 or more and Elkhart County had 441 this week), the reason the county remained orange is that the positive test rate counting all tests grew from 10.13 percent in the previous week to 11.13 percent this week. For the county to move to red, the rate would have had to surpass 15 percent.
The color codes, ranging from blue to red, are used to indicate the severity of the outbreak in a county and to compare with the rest of the state. Each color comes with a set of recommendations for actions but does not require a county to reintroduce restrictions. The vast majority of Indiana counties are yellow and orange, while three are blue and three are red.
Though the local alert level stays the same, Indiana State Department of Health data continue to show a more severe COVID-19 outbreak locally, as well as in much of the state. On an almost daily basis, the seven-day average for new cases in the county sets a new record. With the data reported Wednesday, the average is 146 new cases per day. The record set during the first wave in June was an average of 78 per day.
Testing, after being down for months, has now just about caught up to June levels, with slightly more than 400 individuals tested per day. The uptick in testing, however, does not explain the uptick in cases, as the number of people getting tested has roughly doubled since the spike in cases began around Sept. 10. The number of new cases per day is now five times higher than at that time, when the average was 28 new cases per day.
It appears from ISDH data that the positive test rate in the county has found a plateau of just above 20 percent for unique individuals and 11 percent for all tests. Both rates have roughly doubled since Sept. 10.
1 death per day
There were three more Elkhart County deaths reported by ISDH on Wednesday, bringing the county’s COVID-19 death tally to 145 since March. Thirty-two of those deaths occurred in the last 30 days, meaning that the county is slightly above the previous high average of one death per day, which was recorded in July. Since deaths tend to occur weeks after a person is infected, local health experts anticipate a continued rise in deaths over the coming weeks.
According to local hospitals and the ECDH, a significant part of the 145 county residents who have died from COVID-19 had underlying medical conditions. ISDH data show that 95.3 percent of county residents who have died from the virus were 60 or older. Those who were 80 or older account for 56.6 percent of COVID-19 deaths.
Meanwhile, those 60 or older account for 19.8 percent of confirmed infections, and 4.3 percent of cases in the county are in people who are 80 or older.
The age group with the highest percentage of infections is 20-29, which makes up 17.7 percent of cases. About 80.2 percent of cases in the county are among people who are 59 or younger.
Elkhart General Hospital and Goshen Hospital have 51 and 31 COVID-19 inpatients, respectively. The total of 82 hospitalizations is another record for the county and is about four times more than what the hospitals were experiencing in August and much of September. Elkhart General is rescheduling elective procedures that require patients to stay at the hospital, as there are not enough staff members to care for more patients.
Most have recovered
Indianapolis-based Regenstrief Institute estimates that 6,529 Elkhart County residents have recovered from COVID-19. The total number of confirmed cases in the county is 9,549.
Regenstrief Institute estimated the number of recovered patients by calculating the number of individuals who tested positive more than 21 days ago and have not been hospitalized, plus individuals who tested positive more than 21 days ago and were hospitalized and have been discharged for a least seven days, minus the number of deaths reported by ISDH.
Regenstrief Institute is used by the Elkhart County Health Department to show which local ZIP codes have the most cases. Those data show that ZIP codes with the largest current growth in cases are 46507 (Bristol), 46573 (Wakarusa) and 46514 and 46517 (both Elkhart), but the number of cases is growing in all ZIP codes. In the county as a whole, the 2,887 cases reported in the last 30 days make up 29.6 percent of cases reported since March.
No clear source
It is not clear from ISDH data that Elkhart County’s surge is due to outbreaks within specific communities such as nursing homes, schools or manufacturing plants.
“It’s a combination of everything,” Sizemore said. “There is no one particular thing that stands out.”
But contact tracing shows social gatherings, such as parties, are behind a growing number of new infections, she said. The ECHD advises that people who go to social gatherings should wear masks and stay socially distanced, even among family and friends.