Trumbull County has returned to Level 3 as a high-risk area for COVID-19.

Gov. Mike DeWine said Thursday the county is back at Level 3 (red) in the Ohio Public Health Advisory System. He said the county had a couple of large COVID-19 outbreaks at long-term care facilities.

Ohio Department of Health data show big increases in cases — 21 each — at two nursing homes: Community Skilled Health Care Centre in Warren and Continuing Healthcare at the Ridge in Mineral Ridge.

Only nine of the state’s 88 counties are at Level 3, the least since the system began July 2.

The system was important during its second and third weeks when those in Level 3 counties were required to wear face masks, starting July 8. But after DeWine imposed a statewide face-mask mandate, with some exceptions, effective July 23, it primarily serves as a guide for counties that are hot spots for COVID-19.

Those in Level 3 counties don’t have any additional restrictions compared to other counties.

Having zero to one of the seven indicators puts a county at Level 1, two to three at Level 2, four to five at Level 3 and six to seven at Level 4 (purple). No county has reached Level 4 since the system was put in place.

Trumbull met four of the seven indicators that returned it to Level 3. Mahoning met three indicators and Columbiana has two, with both counties remaining at Level 2 (orange).

Trumbull was at Level 3 for the first two weeks of the system in July, then dropped to Level 2 for four straight weeks before returning to Level 3 Thursday.

Mahoning has been at Level 2 since the system began. Columbiana was at Level 1 (yellow) when the system was put in place July 2, went to Level 2 on July 30 and back down to Level 1 last week, and then returned Thursday to Level 2.

INDICATORS

The four indicators Trumbull met to return it to Level 3 are:

• Having greater than 50 cases per 100,000 residents over the last two weeks. Trumbull had 51.52 cases.

• An increase in new cases of at least five consecutive days during the past three weeks. Trumbull saw its new case numbers increase for five days from 9.14 on Aug. 7 to 13 on Aug. 12. It since has had a drop, hitting 5.14 Tuesday. The cases are a rolling seven-day average.

• Cases in noncongregate settings being more than 50 percent at least once in the last three weeks. Trumbull was well over that in all three weeks with a high of 91.51 percent during the week of July 24 to 30. Noncongregate means in the general population, not in a closed location such as a nursing home or assisted-living facility.

• At least five consecutive days during the past three weeks with an increase in number of people going to a health care provider with COVID-19 symptoms. That happened Aug. 7-11 and since has declined.

While two of the indicators have gone down, Trumbull is expected to remain at Level 3 next week as the high points still will be within the measured three-week time period.

Mahoning County’s three indicators were greater than 50 cases per 100,000 residents, cases in non-congregate settings being more than 50 percent and five straight days with an increase in people going to health care providers with symptoms. The latter happened Aug. 8-12 and since has dropped.

COVID DATA

The number of newly reported COVID-19 cases in Ohio increased for the fourth straight day and exceeded 1,000 for the first time since Saturday.

The state recorded 1,122 new cases Thursday. There have been 4,329 cases during the first five days of this week for a daily average of 866.

The ODH reported 112,003 total COVID-19 cases Thursday with 91,656 presumed recovered and 3,929 deaths.

Of the 22 newly reported deaths in Ohio on Thursday, one each occurred in Trumbull, Mahoning and Columbiana counties.

Mahoning County reported 2,729 total cases Thursday with 2,178 presumed recovered and 262 fatalities.

Trumbull County listed 1,675 total cases Thursday with 1,360 presumed recovered and 114 deaths.

CARE CENTERS

DeWine announced adult day centers and senior centers may reopen at a reduced capacity beginning Sept. 21.

They’ve been closed since March 23 with senior citizens making up a majority of the state’s COVID-19 deaths.

The centers will be able to reopen if they meet certain safety standards, DeWine said, such as reduced capacity, limited entry sites, daily screenings, required face coverings and thorough cleanings.

Also, DeWine said an order will be put in place for a statewide testing initiative at the state’s more than 765 assisted-living facilities. Baseline saliva testing will be offered to all staff and residents at no cost to the facilities.

“Our focus has been and remains on protecting Ohioans while navigating this pandemic,” he said. “To achieve this, we must have 100 percent participation of all assisted living facilities.”

DeWine also said he expects an order today for the reopening of performing arts facilities. If it’s like the state’s order on sporting events, seating will be reduced significantly.

The sports order for outdoor venues allows 1,500 people or 15 percent of a venue’s capacity, whichever is lower. For indoor facilities, it is 300 or 15 percent capacity, whichever is lower.

The order also calls for seating assigned to provide at least 6 feet of space between groups in all directions and that groups can be no more than four people with face masks required.