COLUMBUS (WCMH) — Gov. Mike DeWine provided updates on COVID-19 and vaccination efforts in Ohio on Thursday, when Franklin County returned to purple on the state’s Public Health Advisory System.

As of April 15, a total of 1,048,109 (+2,164) cases have been reported since the pandemic began, leading to 54,636 (+181) hospitalizations and 7,604 (+31) ICU admissions. A total of 4,254,389 people, or 36.4% of the population, have started the vaccination process in Ohio, an increase of 49,075 from the previous day.

DeWine reported that Franklin County was returning to purple, or level 4, the highest level of disease spread in the community as determined by seven indicators by the Department of Health. It had been at level 3, or red, since December, the last time it was purple.

The designation is another sign of a new wave in the pandemic. In addition, the daily increase in hospitalizations and ICU admissions represented three-week highs. And DeWine spoke from Toledo, where he attended a vaccination clinic at the University of Toledo. That part of Ohio has seen an increase in cases based on its proximity to Michigan, where COVID-19 variants are causing a surge.

The state’s rate of cases per 100,000 residents over a two-week period has climbed to 200.0. Weeks ago, DeWine set a benchmark of 50 for lifting the pandemic health orders in the state. After case numbers initially declined, they have gone up the last three weeks.

In its most recent update, the Department of Health reported an additional 90 deaths, bringing the state total to 18,917. The state is updating the total number of deaths only after death certificates have been processed, usually twice a week.

Vaccination in Ohio is open to those 16 and older.