I am not against wearing a mask but it is at the bottom of my COVID-19 priority list. My first three priorities I think we can all agree are important. Wearing a mask is my fourth priority and it has problems. To prevent the spread of COVID-19 here is what I consider to be important.

My first priority is to keep a safe distance from other people. When I first heard about social distance, my first thought was that I have been doing that for years. Over the years most of my communications are brief and we are typically 6 to 10 feet apart. My interactions with people from the world’s infection hot spots are almost non-existent. An area I can improve upon is maintaining a good social distance while standing in grocery store lines. This is not hard and there are little crosses on the floor to remind you.

My second priority is to wash my hands more often and avoid touching my face. This is something I have improved upon.

My third priority is to give my immune system a fighting chance. This generally involves eating well, sleeping well, doing something outdoors, exercising daily, and minimizing stress. This disease is a great reason to start living a healthier lifestyle.

My fourth priority is to wear a mask and clean it daily. Although many people think this is a ‘slam dunk’ policy, I remain skeptical about wearing a mask. It sounds like a good idea but so did finding WMDs in Iraq. I hate to be picky but has anyone done a scientific study showing that wearing a mask will prevent the spread of COVID-19? Wasn’t it a month ago our experts were arguing against this policy? It does look like this policy is based on anecdotal information and not on scientific studies. Does a dirty mask make it more likely you will get sick? How do you clean a mask to prevent diseases? When it comes to wearing a mask, I am willing to let someone else be the guinea pig.

A few days ago I complained that a web page discussing COVID-19 cases at Long-Term Care Facilities had disappeared. I found it by going to the Ohio COVID-19 Dashboard. It has been several days and the page has not re-appeared. I can see where a Long-Term Care Facility would not want to talk with residents or family members about this subject at this time. When I viewed the page it had COVID-19 statistics for every Long-Term Care Facility that had a least one confirmed case. Courtesy of the Wayback Machine here is what the summary page said:

Long-Term Care Facilities

The case counts here reflect cases of COVID-19 among facility staff and residents during the calendar year 2020. This week’s numbers ?are cumulative and may include individuals who have been discharged from area hospitals and are in recovery, as well as past cases when an individual has fully recovered and returned to their prior place of residence. Moving forward, this number will be updated as they are reported to the Ohio Department of Health by local health departments weekly. Numbers will be updated at 2pm on Wednesday every week.

This information does not replace a thoughtful conversation with facility staff about their current infection control practices and mitigation strategies. Questions that families might ask a care facility include:

• What are you doing currently to protect residents from COVID-19?
• What precautions do you take when you do identify a person who is symptomatic of COVID-19?
• How are families kept apprised of changes related to your infection control policies?

In addition, residents and family members should understand that the presence of COVID-19 at a facility is no way an indicator of a facility that isn’t following proper procedures. Families should always feel free to ask questions of the facility where their loved one resides, and if not satisfied, contact their local ombudsman.

On Thursday, April 17, I went to a page off of the Ohio COVID-19 Dashboard called Long Term Care. It listed confirmed cases at long term care facilities. Today I cannot find the page. From a purely scientific viewpoint, this is important information. On Thursday after visiting the page, I was quizzing my wife whether she remembered the long term care facility her grandmother was in. It was a few years ago and she did not remember the facility. One of the long term care facilities sounded vaguely familiar. Our situation has changed over the years. Her mom is now 84 years old. She is a pain in the butt but I think it is highly unlikely we will ever transfer her to a long term care facility. Like most people caring for the elderly, long term care is on our mind. So what is the plan with long term care facilities? Obscuring the obvious is not a winning plan. If we are planning to let the state get back to work, it is important that we have the most vulnerable portion of the population taken care of. So what is the plan?

I was curious whether population density mattered in the spread of COVID-19. To answer this question I calculated the population density for every Ohio county and did a scatter plot of the March 26^th Confirmed Cases. The three points on the right side of the plot are Cuyahoga(Cleveland), Franklin(Columbus), and Hamilton(Cincinnati) Counties. The exponential trend line looks like a pretty good match to the data.

This graph is created using the numbers on the dashboard at the Corona Virus Case for Ohio page using R. This will be my last edition of this graph. The dashboard displays a similar graph and has more functionality to subset the data. Important things to notice:

• So while the number of counties with at least one confirmed case of coronavirus increased to 60, the number of cases, hospitalizations, and deaths are dominated by the Cleveland-Akron, Columbus, and Cincinnati metropolitan areas. When these areas slow down, hospitalizations and potential deaths will have peaked for the state. The rest of the state’s counties continue to participate at a much slower rate.

This graph is created using the numbers at the Corona Virus Case for Ohio page using R. Important things to notice:

• The Cleveland-Akron and Columbus metropolitan areas continue to dominate the number of confirmed cases and the growth rate compared to the rest of the state.
• Cleveland-Akron area grew by 62 cases to 326.
• Columbus area grew by 21 cases to 114.
• Cincinnati area grew by 11 cases to 79.

This graph is created using the numbers at the Corona Virus Case for Ohio page using R. Important things to notice:

• This continues to be a big city disease right now. 75% of the confirmed cases are in either the Cleveland-Akron area(47%), Columbus area(16%), or the Cincinnati area(12%). By far the largest contributor to the Cincinnati increase was Hamilton county. The suburbs, Butler, Warren, and Clermont counties, were static.
• Good News. The Cleveland-Akron area increased by only 38 new cases. Cincinnati increase by only 15 cases. These numbers imply a slowing rate of increase.
• Bad News. Columbus increased by 39 new cases. These numbers imply an increasing rate of increase. The suburbs are part of this increase.
• 44% of Ohio counties have no confirmed cases.

This graph is created using the numbers at the Corona Virus Case for Ohio page using R

This graph is created using the numbers at the Corona Virus Case for Ohio page using R. Important things to notice:

• Like yesterday this is a big city disease right now. Cleveland, Columbus, and Cincinnati leads this list.
• The counties with existing confirmed cases are showing the greatest growth. The sick counties are getting sicker
• There are large swaths of Ohio without a single confirmed case of Corona Virus. 40 of Ohio’s 88 counties have at least one confirmed case.
• The counties that do not have a confirmed case probably have been socially distancing long before it was recommended.

This graph is created using the numbers at the Corona Virus Case for Ohio page using R. Important things to notice:

• This is a big city disease right now. Cleveland, Columbus, and Cincinnati leads this list.
• The counties with existing confirmed cases are showing the greatest growth.
• There is large swaths of Ohio without a single confirmed case of Corona Virus.