COVID-19 County Metrics and Requirements
Eric Holcomb
Governor of Indiana
Good afternoon.
Over the last 9 months, we have asked a lot from Hoosiers.
Back in March, when the pandemic began to take hold in Indiana and with all the growing cases, and hospitalizations, and deaths, we asked you to hunker down and you did. And it made a difference.
Then, in early May, when the number of hospitalized COVID patients had decreased for 14 days, when we were convinced that we had the capacity for critical care beds and ventilators, when we began to build up our stockpile up of PPE, and when we reached a point that we could test symptomatic persons and initiate contact tracing, we methodically began to lift restrictions accordingly.
And as you’ll recall throughout the spring and summer, we continued our progress, gaining more confidence in our ability to take needed health precautions while various sectors of our economy started bouncing back, and we gradually and safely saw more and more businesses, and camps, and entertainment venues, and restaurant options bring employees back as their market demand returned.
Then, in July we paused and we added a requirement to wear face coverings when our case positivity rate again began to climb, when counties that previously had experienced many positive tests began to report more and more cases, and when hospitalizations increased because of COVID-19.
We wanted to be in a position for our schools to safely reopen to in-person classes as much as possible, and we took actions to support that cause and that approach.
We recovered nicely, schools began to reopen and that led us to move to Stage 5 on Sept. 26. The day we announced Stage 5, and please remember this, our positivity rate was 3.9 percent, we were testing an average of 15,000 Hoosiers a day, and our healthcare resources, including ICU beds and ventilators, were in a good place, a manageable place. But I also said at that time, very deliberately, that we could not let our guard down or change our good habits because we know how and how fast COVID-19 spreads.
Unfortunately, too many of us, and around the country, have let our guards down and either assumed we won’t get it, or if we do, so be it, we’ll get through it, without any more universal consideration to what these multiplying numbers have on others and our system of care for them.
Stage 5 has been viewed by some as a reason to return to the days before we ever heard of the words “COVID-19†or “pandemicâ€Â in a modern-day sense.
Rather than doing the things that we had been doing that allowed us to open our restaurants and shops and museums and attractions to full capacity – while maintaining social distancing and wearing mask coverings –  too many have said, “we’ll just ride it out and if I get it, so be it.â€
And that brings us to where we are today. We continue to increase our testing, we have solidified our supplies of PPE, and we have contact tracing programs that are fighting to reach as many Hoosiers who test positive as possible and with as many who will work with us.
But several of the other critical drivers that we’ve tracked since the outset of this pandemic—that has been taking lives—are reaching or have already reached critical points. Let me just name a few:
- The number of hospitalized COVID patients is at an all-time high – 2,544 to be exact –  and hospital officials tell us that in some instances, their patient numbers may double over the next several weeks. You can look back at the last several weeks and you can project out to the next several.
- And, we’re now averaging more than 210 new COVIDpatients a day in our hospitals!
- Our 7-day positivity rate stands at 10.3percent, up a full 6 percent from the day we announced Stage 5.
- Hospitals and other health care providers are experiencing staff shortages and increasingly more staff themselves are having to call in sick.
- Because our frontline medical personnel, our nurses, and assistants, and doctors — they’re exhausted and overwhelmed and need us all to do the things that we can, on the outside, that will slow the number of patients that need hospitalization and their treatment inside.
That’s where we individually all come in.
We must do all we can to protect our hospital’s capacity –  so they can protect patients and care for them. Not only for those who have the COVID, but for the cancer patient, and the heart patient, and the other Hoosier patients who need care in our urban, rural, suburban hospitals all across the state of Indiana, but their beds are filling up. They’re being taken up.
So, beginning this weekend, there will be no more Stage 5. The Back on the Track plan, with stages, was for sure helpful for us to help regain our footing and our economy. But now we must focus on how we’ll get to the light at the end of this tunnel, and there is light at the end of this tunnel.
We’ve seen widespread therapeutics like the one Lilly received emergency approval for earlier this week, made right here in Indiana. So proud. And we’ve seen reports of effective vaccines that will help protect us for the longer term.
So, we know what game-changers they will be when they are widely available, but we gotta get there. And our 4-color coded maps will help us do just that.
In September, we introduced these “metrics maps†that show the prevalence of the virus by county and provide guidance designed to help communities, local communities, make decisions about actions they could take to slow the spread of this virus. Some communities have done just that, they’ve taken various actions; and you guessed it, others have not.
Blue on the map means there is a minimal community spread in a county. The colors progress or worsen to yellow, orange, and then finally, red when there is very high positivity and community spread. You can see that in September a large majority of counties were blue in the state of Indiana, with low case counts and spread of the virus. This week, no county is blue. In fact, only 5 counties are yellow, most are orange and 9 are now red. You remember last week I was talking about 3.
Like many states across the country, we are in the midst of a second surge.
So, beginning November 15th and for the next month, I’ll sign an executive order that will implement pandemic requirements for all Hoosiers, and targeted restrictions for counties that are in the Orange and Red status.
We’re taking these steps again to try to reduce the number of people who contract the virus, to quarantine those who are close contacts and isolate those who test positive, to protect our hospital capacity and to give some measure of relief to our stressed and strained health care workforce and system.
I know—I’ve mentioned this before, I sound like a skipping record, but the best way we can help, it may be inconvenient but it’s also, turns out, happens to be the most inexpensive way to help as well—that means face coverings are still required to be worn by all Hoosiers. And do the right thing by not going to work or other locations when you’re sick or symptomatic.
All Hoosiers are required to maintain social distancing of at least 6 feet in public spaces, whether inside or outside, and especially when you are with others who are not members of your immediate household. All general requirements according to the conditions we’ve already outlined in previous executive orders.
Also, the Indiana Department of Homeland Security and the Alcohol and Tobacco Commission, together with local partners and citizen input, will continue to check businesses for occupancy, social distancing, face-covering use, and other executive order components to assure compliance.
We will now make $20 million available to local governments to support these type of COVID efforts. Local governments, including cities and towns and counties, may request funds for such items as local event plan review and public awareness and education and compliance. We’ll finalize this program and all the details in the next couple of days.
Businesses are required to place signage at their public and employee entrances notifying all that face coverings are required. Businesses should admit only those who wear face coverings, practice social distancing, and follow requirements when counties are Orange and Red.
And remember, all customers in restaurants and bars, and nightclubs are required to be seated when receiving service, 6 feet of distancing between non-household parties is required, including tables and bar seating.
We have to do these things that work, that are proven to work, so our schools can remain open when safe to do so by following the recommendations of our State Department of Health.
And on the other end of the age spectrum, Hoosiers 65 and older and those with other known high-risk medical conditions should remain vigilant about protecting their exposure to COVID.
That means Hoosiers in contact with individuals 65 and older and those with known high-risk medical conditions should consider suspending in-person visits, as hard as that is, as this surge continues to crest. And, obviously, it should go without being said, but please do not visit in person if you are symptomatic or have received a positive COVID test, and wear a face-covering at all times around seniors and the more vulnerable.
This will be, I know, extra difficult during the holiday season that’s upon us for so many. Please keep your holiday gatherings in 2020 small, keep ‘em shorter maybe than normal, and wear face coverings. Consider limiting your gatherings to immediate household members only or your identified small social pod. Maybe even gather outside, weather permitting.
You’ve heard me say so many times that the virus is often spread when family members or friends let their guards down in social situations and take off their face-coverings, or don’t socially distance and stay in close quarters inside for long periods of time.
The holiday season is a time that reminds us to be thankful and to have hope. My hope is maybe this year it’s our actions that can be the best gift we can give to one another.
And, lastly let me just say – let me repeat myself, get tested!  There are more than 250 COVID test sites available throughout the entire state, many of which are operating free of charge by the state. Testing helps us know the local spread rate, trace it, and isolate it. Slow that spread.
Dr. Box will go into more detail about new requirements for counties that have metrics that put them in Orange and/or Red status, but the bottom line is social gatherings will be limited to 50 people in counties with orange metrics and 25 people for those in the red states.
We will require that special, seasonal or commercial indoor events seeking higher attendance submit those plans and receive approval from your local health officials.
While high school basketball and other extracurricular sports and activities are among our most sacred events, it’s our heritage by gosh, but we will need to limit attendance at winter K-12 activities in counties with orange and red metrics.
If anything, this should provide everyone with the incentive to do your part, our part: wear a mask, keep yourself socially distanced, don’t attend events or visit others if you’re sick, limit social gatherings, maintain self-hygiene.
Let me turn it over to Dr. Box now, but first just repeat: in February and in March, the world didn’t know a lot about how COVID-19 was transmitted. We’re in a different time now. We all know now. And we know what we can do to protect ourselves and one another.
As I mentioned, there is good news on the horizon. Lilly’s antibody treatment for COVID received emergency FDA approval and distribution is getting underway this week. There appears to be a positive movement about the prospects for a COVID vaccine and distribution plans are being put in place come that day.
As I said, we’ve asked a lot of you, and we’re asking you to do even more through these next weeks and months as COVID is taking an even greater toll on us.
With your help, we can and we will get through this.