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CLEVELAND (WJW) – Local public health leaders said the rising number of COVID-19 cases and hospitalizations paints an increasingly concerning picture of another surge heading into winter.

“Here at the Board of Health, we still have the red flags up,” said Cuyahoga County Board of Health Communications Officer Kevin Brennan.

The case rate per 100,000 residents in the last two weeks has soared in counties across the region to numbers last seen last winter, with the county average standing at about 600 statewide.

The Ohio Department of Health reports the highest local case rates are at 919 in Lake County and 908 in Ashtabula County. The rate is 776 in Summit County and 690 in Cuyahoga County.

“We are almost back to where we were a year ago, despite the fact that we have vaccinations,” Brennan said.

Hospitals are filling up, prompting limits on elective procedures announced Friday.

The Ohio Hospital Association reports 3,997 patients were hospitalized with COVID-19 Friday. That marks an increase of 59% over the last three weeks, matching the level seen about two weeks earlier in 2020 at the start of the long winter surge.

“When we see numbers like this, we get worried that we will overwhelm our hospital systems,” Summit County Health Commissioner Donna Skoda said.

About 53% of Ohioans are fully vaccinated and most protected from serious illness.

The unvaccinated have made up nearly 95% of hospitalizations since January, according to ODH.

“This really is becoming a very defined division in terms of who’s vaccinated, who’s not, who’s becoming ill, who’s not,” Brennan said.

While vaccination is a new defense, Ohio’s required mitigation efforts that were in place last year have ended. The state legislature banned the governor and ODH from implementing public health orders, including for masking, social distancing and capacity caps in businesses.

Last year at this time, a statewide curfew was in place until COVID-19 hospitalizations dropped below 2,500, far lower than the current number.

With restrictions gone — and less masking — health officials said influenza cases are also outpacing last year, adding additional stress on hospitals.

They reiterated the importance of taking personal precautions such as masking and getting vaccinated or boosted to offer additional protection and prevent COVID-19 from further mutating into dangerous new variants.

“The only way to get out of this is if we all work together, and that’s protecting all of us,” Skoda said.