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Cuyahoga County is approaching a Level 4 public health emergency under  , which would indicate 鈥渟evere exposure and spread鈥� of COVID-19.

Under a Level 4 advisory, residents would be asked to only leave home for supplies and essential services.

鈥淲e鈥檝e got real trouble,鈥� said County Executive Armond Budish in a news briefing Friday. 鈥淭he (national) surge is catastrophic, and we鈥檙e right in the thick of it here.鈥�

The state鈥檚 color-coded system ranks the level of virus spread in each county using seven different indicators:

1.  new cases per capita
2.  increase in new cases
3.  increase in non-congregate cases (meaning cases outside of areas such as nursing homes and jails)
4.  increase in emergency room visits
5.  outpatient visits
6.  hospital admissions
7.  intensive care unit bed occupancy

Cuyahoga County has already met six of the seven indicators that would move it from the current Level 3 to Level 4, according to the Ohio Department of Health (ODH).

The only indicator that the county has not triggered is ICU bed occupancy, but officials warned ICU bed use is inching up and crossed over the 80 percent use threshold on Friday.

Cuyahoga County reached a Level 3 advisory on Tuesday, which is when state and local officials issued a .

Two other Ohio counties, Butler and Hamilton, are also approaching Level 4, officials said.

Who Will Enforce The Mask Mandate?

Questions remain regarding which agencies have the authority to enforce mask mandate.

Gov. Mike DeWine has pointed to local agencies, like county and city health departments, to handle enforcement but also said local police may need to step in.

A violation of the state鈥檚 order is a second-degree misdemeanor, punishable by up to 90 days in jail and a $750 fine, Budish said.

Cuyahoga County officials will rely primarily on citizens filing complaints via an  or through a new hotline at 216-698-5050, Budish said.

鈥淎s these comments come in, especially the ones that are most egregious, then we will take steps to enforce,鈥� he said.

The goal is not to penalize people for not wearing masks, he said, but if a business or other institution is reported repeatedly, the county sheriff鈥檚 office has the authority to investigate, as does local law enforcement.

鈥淚t's our hope that this kind of action won鈥檛 be necessary,鈥� Budish said. 鈥淲e hope that informing the business owner or relevant party will correct any compliance issues that exist.鈥�

People can also call their local city hall or police departments, he said.

Two police departments in the county, Bedford, and Berea, recently asking residents not to call the police to report mask mandate violations.

鈥淲e didn鈥檛 want our dispatch center to get tied up with mask complaints when it鈥檚 not us that enforces that,鈥� said Rick Suts, deputy chief of the Bedford Police Department. 鈥淚t is our hope that everyone can find common ground and not require any police involvement.鈥�

Both agencies wrote on the social media site they can, however, enforce trespassing violations if a resident not wearing a mask refuses to leave a business.

The  City of Cleveland issued its own mask mandate July 6, separate from the county. City officials said in an email they plan to decide 鈥減unitive actions for noncompliance鈥� in a meeting next week. They also said the city鈥檚 health department and police are tasked with enforcing Cleveland鈥檚 mandate.

Cases Increasing For Younger Residents, After Social Gatherings

Cuyahoga County has seen a spike in cases in younger people, said Terry Allan, Cuyahoga County health commissioner.  Allan is concerned the spike will be followed by an increase in hospitalizations as younger people, who may be asymptomatic or unaware they have COVID-19, come in contact with older, more vulnerable populations.

鈥淲e need to remember that our young people are not invincible and that their actions have consequences,鈥� he said.

Romona Brazile, who heads the board of health's prevention and wellness department, said younger people now make up the largest group of confirmed cases in the county.

鈥淥ne out of five people who have been diagnosed with COVID-19 are between the ages of 20 and 29,鈥� Brazile said.

Contact tracers have noticed an increase in people becoming infected after traveling out of state, she said. 

People are also going to work or engaging in other activities, such as birthday and graduation parties while feeling sick, or while waiting for COVID-19 test results.

鈥淲e understand that people have that desire to see their loved ones, again, but it is posing a risk to everyone that attends that gathering if somebody just so happens to be sick,鈥� Brazile said.

There is widespread infection in the community, said Dr. Heidi Gullett, the county's medical director.

The increase in case counts, however, is not the result of an increase in testing; testing has actually decreased, while the percentage of positive tests has risen, Gullett said.

Gullett encouraged healthcare workers to wear masks in public to set an example for others, while Allan recommended businesses post signs indicating masks are required.