With coronavirus cases growing in Summit County, the state of Ohio placed the county at Level 3 on its new risk rankings, triggering mandatory face coverings while in public.


Summit County Public Health was alerted Thursday afternoon that the county had moved from level two (orange) to level three (red) in the Ohio Public Health Advisory System.


Stark County remains at level two (orange).


The level 3 designation means there is very high exposure and spread of COVID-19 in the county. Summit County residents are encouraged to limit activities as much as possible and to follow all current health orders.


The order goes into effect at 6 p.m. Friday and will remain effective until Summit County is no longer designated at Level 3 in the Public Health Advisory System.


Level 3 mandates facial coverings be worn at any indoor location that is not a residence.


It also applies outdoors when at least 6-foot distance can’t be maintained from non-household members, as well as when waiting for, riding, driving or operating public transportation, a taxi, a private car service or ride-sharing vehicle.


It doesn’t apply to people driving through the county.


Facial coverings are not required for children under 10 years old and people with a medical condition preventing mask use.


The penalty for violating an Ohio health order is a second-degree misdemeanor punishable by up to 90-day jail term or a fine up to $750.


Summit County Public Health will enforce the mask mandate. To report violations, call 330-926-5795.


But Summit County Public Health Commissioner Donna Skoda said the focus will be on education and compliance, not punishment, as is the case with business violations.


"It's trying to help people come into compliance because that's really what will allow individuals to have some semblance of a normal life by being able to go somewhere but yet keep people protected and that's what we're after," she said. "Nobody wants to lock you in your basement, but we really want you to be responsible."


According to the state, Summit County’s COVID-19 cases have increased in the past three weeks. The county currently has faith-based, workplace and long-term care facility outbreaks.


Seven indicators are analyzed to assess risk for each county. Level 3 is reached when a county triggers four to five of seven indicators. The indicators triggered in Summit County include:


• New cases per capita of more than 50 cases per 100,000 residents over the last two weeks.


In the past two weeks, Summit County had a total of 59 cases per 100,000 residents. From June 16 to June 30, the average new cases per day nearly tripled from 11 to 30; the numbers could continue to grow for the period due to clinical and reporting lags.


• Sustained increase in new cases of at least five days in overall cases by onset date.


• Proportion of cases not from nursing homes or other congregate-living cases is more than 50%.


• Sustained increase in outpatient visits of at least five days in the number of people going to a health care provider with COVID symptoms who then receive a COVID confirmed or suspected diagnosis.


From June 16 to June 30, ER visits by Summit County residents for COVID-19 symptoms increased from an average of 5.5 per day to 8.5.


More people also are visiting their doctors and being diagnosed with COVID-19 in Summit County, according to the state. Between June 16 and July 2, the average outpatient visits nearly tripled from 11 to 29 visits per day.


Other Ohio counties at Level 3 include Butler, Clermont, Cuyahoga, Fairfield, Franklin, Hamilton, Lorain, Montgomery, Pickaway, Trumbull and Wood.


Three of those counties are on the watch list, meaning they are close to reaching Level 4, with severe exposure and spread: Butler, Cuyahoga and Hamilton. Franklin County remains at Level 3 but was dropped off the watch list.


Huron County was previously at Level 3 but dropped down to Level 2.


"Our concern has been with the reopening and travel and individuals leaving the state," Skoda said.


"When that happened — when we started to see our lives change, we were no longer shut down, people were going back to their offices to work — we were fearful that we would see a spike. It's summertime, people wanted to get outside, they may have gone to more bars or partying or restaurants," where it’s hard to maintain distance from other people, she said.


Skoda said young people should think about the people who could get seriously sick, like older family members or strangers in a store, calling it "reckless" behavior.


"Out of respect for everyone, you need to take precautions," she said. "You are younger, you may survive, you may do well. But you have a really good chance of giving it to somebody who's not as young and as healthy as you are."