When the Ohio governor, Mike DeWine, was told earlier this month that a diner in Trumbull County, Ohio, had posted a sign letting customers know that using masks indoors was optional, he simply shook his head.
“I don't know why anybody would ... I just shake my head, that’s all. Let me just shake my head and I won't have to say anything,” Mr DeWine said.
The governor’s response could be read as exhaustion; he had just finished discussing the recent spikes in coronavirus cases in the state – which he attributed largely to people letting their guards down by forgoing masks and attending social gatherings – when he learned of the Top Notch Diner’s flippant policy.
Since then, the situation in Ohio has only worsened.
Over the last two weeks, Ohio has repeatedly broken daily records in numbers of new coronavirus cases. On Tuesday, the state reported 2,509 new cases, a 27 per cent increase on the daily average of the last three weeks.
There were 22 deaths reported – compared to a three-week daily average of 14 – and hospitalisations were also far beyond the daily average, with 198 reported over 117 in the last three weeks.
In total, Ohio has had 202,740 cases and 5,239 deaths since the start of the pandemic.
“We're seeing in Ohio a huge increase in cases - much more than we saw in the spring and summer,” Governor DeWine tweeted on Monday. “These seem like innocent events, but we're seeing a lot of spread in small gatherings like retirement and birthday parties, bonfires, indoor movie nights, sleepovers, bridal showers, and family get-togethers. What's so dangerous is that some people are carriers but don't know it.”
There is no peak in sight as the caseload continues to rise and to make matters worse, another large scale gathering is just around the corner – Election Day.
As Ohio's demographics have trended older – in 2020 it’s expected that over-60s will outnumber under-20s – the state has become more conservative. Ohio has long been a reliable battleground state but in recent years political experts have debated whether that designation is still accurate.
Donald Trump carried the state in 2016 and even saw significant increases in Republican voters in counties that he lost. During the 2018 midterms, the much heralded "blue wave” was a dud in Ohio. In fact, the state's Republicans became more powerful during that election.
The latest polling averages from FiveThirtyEight show Mr Trump leading Democratic challenger Joe Biden by 2.3 points.
While Democratic Senator Sherrod Brown has predicted that Mr Biden will win Ohio in a landslide, the polling is too close to safely bet one way or the other.
On 20 October, Ohio Secretary of State, Frank LaRose, announced that 1.1 million Ohioans had already cast a ballot – whether voting by mail or through in-person early voting. That's nearly triple the number of those who cast a ballot in-person four years ago.
Nearly 5.5 million votes were cast in 2016 but Ohio voter turnout is expected to break records for the 2020 US election. It’s expected that at least 4 to 5 million people will vote – likely in person – between now and 3 November.
That means waiting – and long lines have been reported at polling places around the state, even for early voting – likely in cold weather. It means that poll workers, untested for such an unprecedented voting year, will have to enforce indoor mask usage and proper sanitizing procedures to mitigate contagion risks.
Ohio's primaries took place on 28 April after being delayed from March. A little more than a week later, on 8 May, the state reported its second-highest spike in new cases that spring.
While it’s far from conclusive that the spike was caused by voters going to the polls, the timing of the increase is likely to cause concern heading into the November election.
State representative Tavia Galonski, whose constituents live in Summit County where the city of Akron is located, said that she has concerns that the state's lack of a mask mandate and overall absence of health expertise at the highest levels of leadership may leave voters vulnerable when they head to the polls on Election Day.
“All the precautions they used in Summit County were excellent. But I don't know whats happening around the state, and if the long lines I'm seeing continue as weather gets colder - its kind of natural when you're in a line to try to stay warm,” she told The Independent.
“What happens if it rains, snows … people have a tendency to stay closer together to keep warm. It's harder to maintain social distancing.”
The state's leadership on coronavirus has been muddled. Mr DeWine emerged as a champion of the “right way” to handle the virus in the early days of the pandemic's spread throughout the US. With guidance from his then-director of the Ohio Department of Health, Dr Amy Acton, the governor was quick to issue lockdowns and advise social distancing guidelines.
But Ohio’s pandemic response – praised by many liberals despite Mr DeWine being a Republican – quickly generated backlash, both from conservative Ohioans as well as within the state's Republican-supermajority state legislature.
In May, the Ohio House moved to pass legislation that would limit orders given by the health department to only 14-day periods, effectively stripping Dr Acton of her power. Republicans were angry that Dr Acton's orders were shuttering businesses.
Groups of bars, restaurants, child care providers and music venues launched lawsuits against Dr Acton, and protesters – some of them armed with firearms – protested outside her house.
In June, protesters – organised largely through far-right Facebook groups – launched demonstrations outside the state capitol, and at least one person carried a sign with antisemitic messaging on it. Republican state representative, Nino Vitale, referred to Dr Acton as a “globalist”, which is considered an antisemitic slur. Dr Acton is Jewish.
Dr Acton resigned from her position in June.
Since then, Mr DeWine has had little success finding a replacement to lead the Ohio Department of Health. In September, Dr Joan Duwve was appointed to replace Dr Acton but withdrew her name from consideration hours later after learning of the abuse that Dr Acton suffered at the hands of both the protesters and the state legislature.
The current interim director, Lance Himes, was the long-time legal counsel for the Ohio Department of Health, but – as he's an attorney – has no background in medicine.
Dan Tierney, Mr DeWine's press secretary, said the governor was still in the process of conducting a nationwide search to find an appropriate permanent replacement for Dr Acton.
State representative Michele Lepore-Hagan, who represents constituents in and around Youngstown in northeast Ohio, said the state legislature's undermining of Mr DeWine is an example of the pitfalls of one-party rule. She pointed to an exemption to mask mandates within state buildings, noting that masks are not required within the Ohio legislative chambers. She said that individuals have been afraid to come and testify on behalf of legislation over fears they'll be exposed to the coronavirus while doing so.
“Coronavirus has broken out in the state house – staff, legislatures, senators – there's no creative plan to deal with this. The most glaring message is that we don't have a person in place for the health director for the state of Ohio during a global pandemic,” Rep. Lepore-Hagan, a Democrat, told The Independent.
She also pointed to the state's $2.7bn “rainy day fund” established under DeWine's predecessor, John Kasich, which has still not been tapped by the governor.
“If this isn't a rainy day, what is?” Rep. Lepore-Hagan asked.
Mr DeWine announced last week that more than $419.5m in Cares Act funding will soon be on its way to Ohioans, though Rep. Lepore-Hagan pointed out that the state legislature passed the package allowing that funding in September. She accused the governor of sitting on signing the package until it was politically advantageous.
Mr Tierney denied the allegation and said the governor's decision to wait to sign the bill was done to give the US Congress time to determine whether or not they would be offering expanded or extended benefits to US citizens.
In recent weeks, Mr DeWine has been the focus of ire for more than just Democratic lawmakers. Last week, a woman who met with a state lawmaker asking about Mr DeWine's home address admitted she made a call to someone to discuss putting the governor under house arrest. She has since walked back those claims but not before declaring herself governor of Ohio and telling DeWine to “pack his stuff” and “go home”.
The woman, Renea Turner, blames the governor for passing legislation that protected hospitals, schools and businesses from lawsuits related to coronavirus contraction. Her mother died in hospital of Covid-19, though she claims that the hospital allowed her to die. She is a critic of coronavirus prevention policies passed by the state.
The Republican lawmaker she met with, state representative John Becker, said he did not get the impression Ms Turner was dangerous or planning to arrest the governor. In August, he drafted 10 articles of impeachment against DeWine, which was co-sponsored by two other Republican lawmakers.
Ohio has been under a mask mandate since July but critics say there is little enforcement of the rule. Governor DeWine exempted political rallies and church gatherings from the mandate.
He has continued to urge Ohioans to follow coronavirus mitigation guidelines, especially ahead of the election.
Mr Tierney said the state has engaged in messaging for months, advising older Ohioans or those with co-morbidities to vote by mail. He said he believes that Ohioans have taken that message to heart, and that in doing so it will ease the strain on polling places come Election Day and reduce the risk of coronavirus transmission.
With regard to conservative Ohioans’ seeming open rebellion against Mr DeWine’s efforts to stop Covid-19's spread, Mr Tierney said that the governor was in regular discussion with lawmakers and that personal experiences with the virus have helped to sway people's perceptions of mitigation efforts.
“You'll hear more and more that people are getting the message and that risk is within their community. Part of this is that we know there are people who are skeptical of the risk, and unfortunately we're seeing it spread right now,” he told The Independent.
“One of the good things is we're hearing more and more anecdotes about those who've had it affect them or someone they know, and then when they have that experience they decide to follow the guidelines a little bit more.”
Donna Skoda, Summit County public health commissioner, said that despite the risks, her department views voting as a safe activity, as long as the guidelines are followed. Summit County offers curbside voting for the elderly to prevent them from having to stand in lines or inclement weather.
She echoed Mr DeWine's assertion that the recent spikes in the state were due to people attending social events and forgoing masks and social distancing. She said that reopening of the state – which she agreed was necessary – also may have lulled people into a false sense of normalcy.
“What I'd like to see more of are less activities. [Ohioans] really should restrict their visits to businesses and activities, and please don't have people into your home,” she said.
She praised businesses that have taken the virus – and the governor's message – seriously and chosen to follow the state's mandates, even when it costs them business.
Nathan Offerdahl owns Westside Bowl, a music venue, bar and bowling alley in Youngstown, Ohio. He has taken the state's guidelines for businesses seriously in order to protect his staff and customers. He offered complimentary face-masks to patrons picking up carry-out food, and removed the bar's stools to protect his bartenders.
While he fully supports the safety measures, they have come at a cost. Mr Offerdahl has had to build new outdoor seating and barriers and increase daily staff numbers to ensure proper sanitation and guideline enforcement is carried out. Meanwhile the main driver of his business – live music – has been hobbled by the pandemic. The state only allows venues to have up to 15 per cent of their total capacity inside to see shows.
“I fully support the guidelines in place, but it makes it financially untenable to do live music. At 15 per cent capacity, no one makes money, not the bands or the venues,” Mr Offerdahl told The Independent.
He was one of many businesses that received Paycheck Protection Programme (PPP) funding but added that it was the only government relief he and other business owners had received, and that it was long gone. He isn't holding out hope for more anytime soon.
“If [Congress] doesn’t get it done before Election Day, it’s not gonna happen in the lame duck, regardless of the winner,” he said.
Mr Offerdahl said the only silver lining to the current situation has been the city and community’s support for his business. He said Westside Bowl may not have survived if not for the surrounding community in Youngstown rallying around to keep him afloat.
He was less enthusiastic of the state and country’s leadership, saying the lack of empathy among some politicians has left him angry.
“Frustrating isn't anywhere near a strong enough wort to describe how I feel towards some of the people at that level of power,” he said. “I get the sense that their attitude is 'yeah, a bunch of businesses might close but someone else will buy them’. I'm at a loss for how to describe that.”