Ohio’s six children’s hospitals and many of the state’s adult hospitals are overwhelmed with COVID-19 patients, and that’s largely because roughly half of Ohio’s school districts aren’t requiring masks, Gov. Mike DeWine and leaders from the Ohio Children’s Hospital Association (OCHA) said Tuesday.

“The data are now clear that there is a higher level of COVID-19 in school districts where masks are not required,” DeWine said during a Zoom press conference. “If we want our schools to stay open, the best way to do that is for those 12 and over to get vaccinated. But because those under 12 are still too young to be vaccinated, we need students who come in to school to wear a mask until we get through this.”

DeWine was joined by OCHA President and CEO Nick Lashutka, Dayton Children’s Hospital President and CEO Debbie Feldman, Cincinnati Children’s Hospital Chief of Staff Dr. Patty Manning, Nationwide Children’s Hospital Chief Medical Officer Dr. Rustin Morse and ProMedica Russell J. Ebeid Children’s Hospital Chief Nursing Officer Paula Grieb.

“We are being overrun -- in virtually all of our access points -- by sick children since the resumption of school. Our primary care physicians, our urgent cares and our emergency departments are inundated daily,” Grieb said.

“We had a very significant and very frightening event occur for us last night in Lucas County. At 10:36 p.m. last night, all of our Lucas County emergency departments went on EMS bypass. That includes Ebeid Children’s and all of our adult hospitals,” Grieb continued. “What does that mean? That means that if a rescue squad was called for a 9-1-1 call and needed to pick up a patient and deliver them to a hospital, if that hospital is on bypass, that rescue squad is not allowed to stop at that hospital. Every hospital in Lucas County was on EMS bypass simultaneously last night. … It’s unprecedented for that to occur.”

Grieb then explained how emergency services are provided under a “code red alert.”

“As every EMS call comes in, they are dispatched one at a time throughout the community to our individual emergency departments,” she said. “What does that mean for our folks? That means that you don’t necessarily go to the emergency department that’s closest to your home or most likely suited to take care of your direct patient needs. It might mean that a three-year-old who is in need of an emergency department that’s specifically for pediatrics is delivered to a traditional ED because that’s who’s next in the queue. … That situation lasted for us in Lucas County for over eight hours before we were able to alleviate some of the volume issues in four of the local hospitals, including our very own, to come off of bypass. Again, it’s unprecedented for us to have ever been in that event, and is something that is very concerning for us as we strive to care for the youngest and most precious of our resources.”

DeWine said leaders from OCHA met with school district superintendents across the state on Tuesday, providing the following data showing why all schools should impose mask mandates for all students and staff:

- Since Aug. 15, there have been 29,823Ohio school-aged children aged five to 17with confirmed and probable cases of COVID-19.

- Cases among this age group increased 198 percent from the week of Aug. 15 to the week ending Sept. 4.

- As reported by the American Academy of Pediatrics, COVID-19 cases among children have increased 240 percent nationally since early July when the Delta variant began to surge. During that same period in Ohio, there has been a2,000 percent increase in cases among Ohio children.

- COVID-19 cases are increasing at nearly twice the rate among school-aged children as compared to the rest of the population. This past week, Ohio saw a 44 percent increase among school-aged children and only a 17 percent increase among the rest of the population.

- Over the two-week period ending Sept. 4, there was an average of 909 cases per 100,000 school-aged Ohio children versus 561 cases per 100,000 people comprising the rest of the population.

- The 16 days with the highest number of cases per day throughout the entire pandemic for kids aged five to 17 in Ohio have all been in the last 19 days. This includes every day except the three days of the Labor Day weekend.

- In Ohio school districts where masks are optional, among school-aged kids, there are both higher case rates per 100,000at 945.7 and a greater week-over-week increase in cases. School districts where masks are optional have seen a 54 percent week-over-week increase compared to a 34 percent increase in school districts where masks are either required for all or required for some, usually K-8.

“This is a perfect storm, and it’s impacting kids like it hasn’t before. It’s a combination driven by COVID-19 cases increasing -- primarily driven by the Delta variant -- increasing respiratory illnesses, more mental health challenges, and staffing challenges. Everyone can agree that our number one goal is to keep children in schools five days a week, and that’s what we shared with the state’s superintendents today,” Lashutka said.

“Our inpatient numbers are the highest they’ve been. Our ICUs are caring for more patients than there’s ever been. More children are on ventilators than there has ever been. There are more children than ever entering our emergency departments and our urgent care centers. That impacts the care of all children, not just those that are COVID-19 positive,” Manning said.

Manning pointed to a study of seven school districts in the Greater Cincinnati area that analyzed outcomes for schools with universal K-12 mask mandates and those with mandates that only apply to K-6 school buildings.

“We were able to look at the difference between COVID-positive children -- not quarantined children, but children testing positive for COVID. They were almost twice as likely to test positive for COVID if they were partially masked, versus a fully masked school district. We feel like that, as well as many other examples that you’ve heard, is evidence for the efficacy and usefulness of masks,” Manning said.

“We have two paths forward. One of those paths to end this pandemic is … why don’t we just let everybody get sick? To some degree, that’s what we’re doing right now, which is why we’re struggling. We could just let everybody get sick, including children -- and for whatever reason, we put children out in front of us, and let them get sick -- some of them will get very sick, and some of them might die. They will overwhelm our health care systems and that will affect the care of all children in Ohio. That’s one path forward,” Manning said. “The other path forward is to use tools that are safe, effective and in many cases they are benign. Wearing a mask is not dangerous to your health. These tools minimize people getting sick, minimize children getting ill and having long COVID, minimize the strain and burden on our health care system and allow kids to stay in school. I choose that path. … Please do this small, small thing, and allow children to be masked in schools throughout all grades, and please get vaccinated. It means everything right now.”

Asked why he hasn’t issued a statewide mask mandate for K-12 schools, DeWine said he would issue such an order if the General Assembly (GA) would allow it to stand.

“If I could put on a statewide mandate, if the health department could do it, we would do it. What the Legislature has made very clear is that if we put on a statewide mandate, they will take it off. They have the ability to do that. There is no 30-day waiting period. They can do it right away, and the Legislature has made very clear that if we put on a mandate for kids in school to wear masks, that they will take it off,” DeWine said, referring to provisions in SB22 (McColley-Johnson), which was enacted after the Legislature overrode the governor’s veto. The governor can issue a new state of emergency that would last at least 30 days, but any rules associated with the state of emergency -- such as a mask mandate -- can be revoked by the General Assembly immediately by concurrent resolution.

“People say, ‘Mike, why don’t you do that? It could be on for a couple days or whatever.’ The problem with that is … we would cause, it seems to me, a lot of confusion. We might go backwards,” DeWine continued. “We are slightly over 50 percent of our kids in public schools who are under a mask order by the school. We’ve made some progress. We’ve come a long way from the days that school started. We need to go further. I believe that we will go further.”

DeWine said he’s hopeful that members of the General Assembly will change their opinions on the issue if the situation continues to deteriorate.

“I am happy to put this order on. I will take the responsibility for it. I did not hesitate last year to take responsibility, and I’m not going to hesitate again. But that’s not where we are today,” DeWine said. “There is new information. … When we have talked about this for the last 18 months, people who don’t want masks or sometimes are skeptical about the data -- one thing that they have said is, ‘Well, when hospitals fill up, I know that’s a problem, and we will act.’ What you’re hearing today is that hospitals are filling up. It’s a threat not just to your child if that child has COVID. It’s a threat to your child if that child is in an auto accident or has any other problem.”

DeWine told Hannah News that the administration could possibly implement a mask mandate, wait for the Legislature to act, and then take them to court and obtain a restraining order if they revoke it. However, he said he doubts that is the best approach to increase the use of masks in schools.

“I don’t have the hesitancy -- you’ve watched me -- of doing that, but I have to weigh the damage that would be done by that, and the turmoil that would be created, and the fact that it’s very likely that we will roll backwards,” DeWine said.

Asked whether the General Assembly is responsible for the number of children currently hospitalized with COVID-19 across the state, DeWine said, “I am an optimistic person. … It was interesting today that on the call, there were questions or comments about whether or not this information has been shared with the state Legislature. We were encouraged to share that information, and that was the attitude of some of the superintendents and school officials on the call. Look, we’re going to continue to do that.”

Lashutka said his organization will continue to contact members of the General Assembly to discuss the issue.

“All of our children’s hospitals are in regular communication with the 132 members of the Ohio General Assembly, in both the House and Senate. As we speak, we are reaching back out to them as these data that you’ve heard today and last week continue to evolve, so that they’re not only hearing firsthand the information that we’re sharing with you, but importantly have the opportunity to ask questions of our clinical leaders. What we’re finding is there’s just a tremendous amount of misinformation out there in the public, and I think as we have these conversations … we are finding that people are responding to that,” DeWine said.

The governor said the Legislature has worked with the administration to enact policies that help children in the past, so he’s hopeful they will come around on this issue as well.

“This is a state Legislature that, in two straight budgets, at our request, has overwhelmingly added significant money for children’s health issues,” DeWine said. “They have focused a lot on children. So I still have hope.”

Dayton Mayor and Democratic gubernatorial candidate Nan Whaley on Tuesday once again urged DeWine to issue a statewide mask mandate for schools, reiterating comments she made about a month ago. (See The Hannah Report, 8/19/21.)

“Gov. DeWine has the power to mandate masks in schools statewide. Enough is enough. Stop passing the buck. It’s time to take action to keep our kids safe and in school learning,” Whaley said.

According to the Ohio Department of Health (ODH), there were 7,325 COVID-19 cases reported in the last 24 hours, which is higher than the 21-day average of 5,888. There were 344 hospitalizations reported in the last 24 hours, higher than the 21-day average of 197. There were 23 new admissions to the intensive care unit (ICU) in the last 24 hours, higher than the 21-day average of 19.

The Southern Ohio Medical Center in Portsmouth posted on Facebook that its hospital’s ICU is currently at capacity.

“We are implementing alternate care plans for critical patients and preparing to open our fourth COVID unit to address this ongoing surge. Still, let’s be clear – the level of resources we have been forced to dedicate to this single diagnosis is unsustainable. Like many hospitals, including others in our region, we are being stretched to the breaking point,” the hospital said, urging all Ohioans to get vaccinated, wear masks and practice physical distancing.