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After six straight weeks of declines, Ohio had its second consecutive week of increases in the number of COVID-19 cases per 100,000 residents.
The 496.3 COVID-19 cases per 100,000 residents for the period between Nov. 4 and Wednesday is up from 410.5 cases per 100,000 last week, according to Ohio Department of Health data provided Thursday. It's an increase of 20.9 percent since last week.
Two weeks ago, it was 354.3 cases per 100,000.
It was 359.1 COVID-19 cases per 100,000 three weeks ago, 419.2 COVID-19 cases per 100,000 four weeks ago and 507.4 COVID-19 cases per 100,000 five weeks ago.
The state's COVID-19 cases per 100,000 residents had declined in each of the previous six weeks until last week.
"The rising cases and the rising hospitalizations that we are again seeing (makes it obvious) we have more work to do," Dr. Bruce Vanderhoff, ODH director, said.
He added the "delta variant seems to have gotten a second" wave and 1 in every 7 Ohioans hospitalized has COVID-19.
COVID-19 case numbers "are trending in the wrong direction," Vanderhoff said.
The state's cases are nearly five times what the U.S. Centers for Disease Control and Prevention consider to be high-transmission areas for COVID-19.
The CDC number for high transmission is 100 cases per 100,000. It recommends face masks while indoors at public places in those areas, but it's not a mandate.
For the first time in four weeks, the state had counties with more than 1,000 cases per 100,000 residents.
The highest was Williams with 1,092.9, followed by 1,092.8. The lowest was Athens with 199 cases per 100,000 residents.
Eight weeks ago, 30 counties posted rates higher than 1,000 cases per 100,000 residents.
Mahoning, Trumbull and Columbiana had higher rates of COVID-19 cases per 100,000 residents than the state.
Mahoning is 25th in the state this week with 686.1 COVID-19 cases per 100,000 residents.
Last week, it was 28th with 533.1 COVID-19 cases per 100,000 residents.
It was 38th two weeks ago with 431.2 COVID-19 cases per 100,000 residents, 43rd three weeks ago with 439.9 COVID-19 cases per 100,000 residents, 39th four weeks ago with 538.7 cases per 100,000 residents and 40th five weeks ago with 652 cases per 100,000.
Trumbull is 39th this week with 577.9 cases per 100,000 residents.
It was 32nd last week with 507.4 cases per 100,000 residents, 30th two weeks ago with 463.2 cases per 100,000 residents, 54th three weeks ago with 382.4 cases per 100,000, 59th four weeks ago with 425.3 cases per 100,000, and also 59th five weeks ago with 541 COVID-19 cases per 100,000.
Columbiana is 14th this week with 753.8 COVID-19 cases per 100,000 residents.
It was 17th last week with 677.2 COVID-19 cases per 100,000 residents.
It was ninth two weeks ago with 620.3 COVID-19 cases per 100,000 residents, 12th three weeks ago with 586 cases per 100,000, fifth four weeks ago with 750.9 cases and ninth five weeks ago with 839.2 cases per 100,000.
The ODH measures cases per 100,000 residents among counties to get a fair comparison because total cases would result in more-populous counties ranking higher.