The 2020 pandemic has landed on Ohio with numbers that are only getting bigger.

The state’s chief public health doctor says she estimates that right now, today, more than 100,000 Ohioans could be infected with the novel coronavirus, a pathogen that emerged in humans barely four months ago and nearly 7,500 miles away in Hubei province, China.

Humans have no immunity to the new virus, which spreads through droplets from sneezes and coughs. Right now, everyone is susceptible to infection, and the new virus has proven itself ferociously contagious, even among the young and healthy. The number of new cases appears to be doubling every six days.

Estimates from the World Health Organization and other public health bodies have found that every infected person spreads the novel coronavirus to at least two to three people. A person can be infectious for five or six days before developing symptoms of illness, which makes hand-washing and covering sneezes with throw-away tissues important preventions.

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“It’s concerning,” said Philip Smith, an assistant professor in the department of kinesiology and health at Miami University, who has produced a video on this math. “The replication rate, or the R-naught factor, is more for the novel coronavirus than we typically see for the flu, but less for other things, like measles.”

The lack of immunity plus the rapid spread generates a dizzying curve of increasing numbers of infections and then illness. Last week, Ohio learned the virus has been moving unimpeded through “community spread,” no longer strictly through travel to affected countries or contact with an already infected person

Dr. Amy Acton, director of the Ohio Department of Health, said last week the virus math is like seeing a star and knowing that light is a moment from the deep past. The problem is that the present can only be made out as a vague blob because the nation still does not have enough tests to sample people or laboratories to process the tests.

But the numbers that the state government did have spoke loudly enough. Unless officials exercised controls over the movement of Ohio’s citizens for weeks and even months, catastrophe is a matter of when, not if.

“We have the opportunity to avoid this thing or minimize this thing if we act now,” said Dr. Steve Feagins, medical director for Hamilton County Public Health. “If we do this now, we could potentially avoid some significant cases. That’s a real number.”

Without state action to control infection, The Enquirer estimates that by the end of March, nearly 1 million new infections would occur in Ohio. For about 80% of Ohioans, if the experience in China and other countries fighting the infection holds true, the novel coronavirus will deliver mild cold symptoms with full recovery in 10 days.

But 20% of those infected, or about 200,000, will need more medical or hospital care to treat COVID-19, an upper-respiratory illness that can become so serious, especially for the already sick, that a patient requires mechanical breathing assistance.

An epidemic-driven demand for advanced medical care inside a month or six weeks would overwhelm Ohio’s hospital systems. Patients will wait for care in tents like the one just erected at the University of Cincinnati Medical Center.

Only the very sickest of the sick would be admitted. A USA TODAY study last week found that if the novel coronavirus makes a path in Ohio as in other countries, there will be more than 14 patients for every hospital bed.

Doctors, nurses and other health care workers would inevitably get sick, too, and hospital systems are scrambling to grasp the impact of a mountainous spike in demand with a depleted workforce. At least two doctors in the country have been diagnosed so far with COVID-19.

Last week, hospital executives said facility staffs have drilled for a pandemic for years and can adapt. But no one offered stout prediction of how the systems could care for sick Ohioans by the hundreds of thousands.

The purpose of shutting down much of public life – schools, universities, offices, sporting events – is to put the brake on the momentum of the novel coronavirus, DeWine and Acton said. If people stay away from each other, the virus loses opportunities to spread by human contact. Fewer people get infected, the viral curve rises more gently, and the pressures on the medical system would still be intense but below tolerances.

For that policy to work best, though, there’s more math to consider. People need to stay isolated long enough for experts and researchers to measure whether the curve of infections has peaked and now heads downhill. Acton said that time could be six to eight weeks, maybe longer.

But Acton said the math won’t or change until thousands more results from virus testing can offer more information on trends and directions. Even though more private labs are trying to answer the demand, scaling up testing to a level that can offer real answers won’t happen before at least the end of the week.

Nothing has ever tested the resilience and endurance of health care in Ohio like the novel coronavirus. In making decisions, state officials confront one more big number. At least 2% of Ohioans who get the virus and become ill with COVID-19, about 2,000 people, could die before the pandemic ends.

That number would rank COVID-19 as one of the 10 major causes of death in the state this year.