CLEVELAND — Once manufacturing powerhouses that had to re-invent themselves, the cities of Cleveland and Detroit share a lot of similarities. However, in terms of the impact of COVID-19, the two cities couldn't be any further apart. Despite being 30% more populous, Detroit's Wayne County has had more than 20 times the number of coronavirus deaths compared to Cuyahoga County. While variables certainly exist, experts believe quick decision making by Ohio Gov. Mike DeWine and state health director Dr. Amy Acton certainly played a role.

"Compared to other states our health director and governor intervened aggressively early in the epidemiological curve," said Dr. Keith Armitage, an infectious disease specialist at University Hospitals Roe Green Center for Travel Medicine.

"They have gotten a lot of criticism. I think people that are protesting their press conferences should just look at Detroit. Just look at some of the cities in the Greater New York area. Look at New Orleans. We are so fortunate that they acted when they did," he said.

As of Thursday, Wayne County, Michigan had more than 12,000 positive coronavirus cases and nearly 900 deaths. Those statistics greatly dwarf those in Cuyahoga County, which had nearly 1300 cases and 39 deaths as of last Thursday. Although Detroit and Cleveland both share similarities, there are likely variables that factored into Wayne County's higher COVID numbers.

For one, Detroit's airport is a hub for international travel, which likely intensified the spread of asymptomatic COVID transmission, experts said. Michigan also has an international border. Additionally, Michigan's primary elections were held on March 10, which some experts believe may have intensified the spread even more. Ohio's primary elections, originally scheduled for March 17, were postponed.

Although the top medical minds at the major hospital systems in Northeast Ohio have anticipated a surge of positive COVID patients, the surge has not been as pronounced as once feared.

"The planning from the top down and the cooperation to prepare for a surge and how people have stepped up, that has been very positive. So far we haven't had a surge and that's even more positive," Dr. Armitage said.

"Cleveland's blessed to have three great hospitals: UH, Cleveland Clinic and Metro. All three insitutions were preparing for massive surges. We're ready but it looks like if we keep this up -- I don't want to jinx it -- if we keep it up, even with a little bit of loosening of restrictions, we can avoid that big surge. That would be extraordinary," he said.

When it comes to executive action, Gov. DeWine also slightly outpaced his Michigan counterpart, Gov. Gretchen Whitmer. Gov. DeWine was one of the first governors to ban mass gatherings, close restaurant dining rooms and issue stay-at-home orders. In many cases, Gov. Whitmer issued similar orders the day following Gov. DeWine's orders. Experts also believe that Ohioans by in large have heeded the medical community's warnings about social distancing.

"People understand the message around social distancing. We've seen evidence of it," said Terry Allan, the Cuyahoga County Board of Health Commissioner. "That's very heartening to see that people have adopted the Ohio plan."

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