The Delaware General Health District on April 7 said 75 people in its operation area tested positive for the COVID-19 coronavirus, and the district was in daily contact with each still at home.
As of that day, seven people in the health district remained hospitalized and one had died.
The patient contacts are part of what Shelia Hiddleson, health district commissioner, called the district's 100% response to the pandemic.
"We are getting a lot of comments on why our numbers (of coronavirus patients) are different than what the Ohio Department of Health is putting out (for Delaware County)," said Traci Whittaker, the health district's public information officer.
The health district doesn't include those areas of the county in Westerville, Dublin or Columbus, so those cases are not included in the health district total.
Those areas are covered by Franklin County Public Health or Columbus Public Health.
Coronavirus tests are conducted only on a doctor's orders, Hiddleson said.
She said those displaying symptoms -- including fever, dry cough or shortness of breath -- and haven't been tested should stay home.
Most people with coronavirus will have mild symptoms, Hiddleson said, adding that because it is similar to having a mild cold or headache, there is no need to call a doctor.
Even those working in an essential business should stay home if displaying symptoms, she said.
If symptoms go beyond mild, such as coughing so hard that a person is having trouble breathing, a doctor should be contacted, she said.
Hiddleson said no one should visit an emergency room without calling a doctor or 911.
Hospitals don't want people with coronavirus in their emergency rooms if something else can be done first, she said.
Hiddleson said anyone with life-threatening symptoms should call 911 immediately. Such symptoms can include trouble breathing, pain or pressure in the chest, blue lips or a slightly blue face, confusion or if a family member had trouble waking up a person, she said.
Patrick Brandt, Delaware County 911 director, said the 911 center can't give medical advice or give exemptions to the stay-at-home order.
"Those who believe they have a medical emergency should call 911 and (an ambulance) will be dispatched," he said.
Brandt referred any general questions to the ODH COVID-19 call center, open seven days a week from 9 a.m. to 8 p.m., at 1-833-4-ASK-ODH (1-833-427-5634).
Hiddleson said tests are growing more readily available with results returned in 24 to 48 hours.
The most susceptible to coronavirus are those with underlying health conditions or over age 60, she said.
"Definitely those age 70 and over (with coronavirus) are getting sick very quickly," she said.
The health district interviews each person who tests positive, asking questions such as where they have been and who they have been in contact with, who also will be interviewed, Hiddleson said.
Once interviewed, patients will get daily calls from the health district for updates on conditions and possible needs.
On April 7, Hiddleson said, Delaware County and Ohio still were waiting for a clear beginning of the coronavirus "surge" -- a rising increase in the daily number of new positive coronavirus cases.
"In a lot of ways the surge won't change what we do, but we'll be doing more of it," she said.
Ohio Health Director Dr. Amy Acton has predicted the number of new daily cases in Ohio could reach 10,000 at the peak.
Ohio's stay-at-home order and other precautions, Acton has said, are designed to prevent the peak of the surge from exceeding the state's health care system's capability of treating patients.
Hiddleson said different models for predicting the surge haven't agreed, so the beginning of the surge can't be forecast with accuracy.
Depending on the volume of cases during the surge, Hiddleson said, local health districts across the state might not have the capability to make daily calls to all those testing positive for coronavirus. Some who aren't in a high-risk category might be asked to phone the health district if issues arise.
Almost all general health district personnel are working on the response to coronavirus, Hiddleson said. Before the pandemic, about five health district employees were working on disease and response control. That number has increased to 25.
Some of the health district's routine activities -- such as inspections for plumbing and residences -- continue as part of the district's essential services, and immunizations are continuing by appointment, she said.
The health district has been getting calls from health-care providers and is supplying them with information, Hiddleson said.
The health district urges families to send only one person on a grocery trip, to shop at one store and buy enough for two weeks in an effort to minimize trips, Whittaker said. Those at high-risk should avoid shopping and use curbside pickup or home delivery if necessary, she said.
A Facebook video from the health district suggests sanitizing a counter space, and if possible, sanitizing the outside of food packages before placing them on the counter.
The Centers for Disease Control and Prevention said cloth face masks are better than nothing, but masks can't take the place of social distancing, Hiddleson said.
Delaware County Emergency Management is playing a support role for the health district by working collaboratively with others on long-term planning for supplies and resources, said Sean Miller, emergency management director.
A particular focus is protection equipment for health-care workers, he said.
Hiddleson said the health district has received three shipments of protection gear from the CDC, but that might not be enough if the county gets a large number of cases.
Miller said Ohio has an emergency stockpile of N95 face masks, gloves and gowns, and DCEM is working to prioritize requests for the equipment.
Jeff Fishel, Delaware County EMS director, said the county has made arrangements with Battelle -- a Columbus-based nonprofit research company -- to have medical-grade face masks decontaminated once a week.
Battelle has said it received federal authorization to decontaminate up to 160,000 of the masks daily.
That step will ensure enough masks for Delaware County EMS and any local fire department that needs them, Fishel said.