Michigan is now averaging six deaths a day from coronavirus -- a long way from April when the average was more than 100 deaths a day.
The state currently has 438 people hospitalized with the virus, roughly a tenth of the nearly 4,000 in-patients at the state’s peak.
And while the coronavirus caseload is now hitting levels not seen since early May, the 715 new cases reported Thursday was the lowest number in the Upper Midwest and a fraction of the 9,985 cases reported in Florida, the 8,843 cases in Texas, the 8,174 in California.
So why is most of Michigan still in Stage 4 of a six-phase reopening plan?
It’s a question asked by many Michigan residents, who see big improvement in various metrics. They are perplexed that Gov. Gretchen Whitmer has not only paused the reopening of the economy but has rolled back some aspects, including an executive order this week that put new restrictions on the Upper Peninsula and northern Lower Peninsula.
Whitmer order tightens restrictions on northern Michigan parties, bars
“I just continue to believe we’re going way too slow,” said Sen. Ed McBroom, R-Vulcan.
“At this point in the Upper Peninsula, you have zero people in the hospital with COVID, and yet we’re increasing constraints on people and businesses,” he said. “It’s a little bit hard to figure out why.”
But talk to public-health experts, and a much different perspective emerges. They’re nervous about the state’s current trajectory. They look at what’s happening in other states such as Florida and Texas and California, and they see a cautionary tale. People are asking them about the reopening of schools, and the health experts worry some more.
“For a lot of people who haven’t necessarily witnessed or experienced a direct impact from COVID infections, I think it’s hard to really understand the gravity and the impact that it’s having,” said Dr. Russell Lampen, an infectious disease specialist at Spectrum Health in Grand Rapids.
While Michigan is no longer in crisis mode, there’s a sense the current lull “is really fragile and things can turn around quickly,” said Susan Ringler-Cerniglia, public information officer for the Washtenaw County Health Department.
Lampen, Ringler-Cerniglia and others are concerned about a false sense of complacency around coronavirus. Here are the reasons they offer about why coronavirus remains a serious threat, even with the state’s low death and hospitalization numbers.
Hospitalization and death rates are lagging factors
Through June, the state was averaging about 220 new coronavirus cases a day. This week, the seven-day average went past the 700 mark for the first time since May 2.
McBroom is among those who aren’t worried. “The only numbers that matter are deaths and hospitalizations,” he sajd.
Like others, he points out increased testing means many of the current patients have much more mild cases of coronavirus compared to patients diagnosed in March and April.
Public health officials acknowledge that. But they also say rising case numbers very much matter, because they typically are a precursor to rising hospitalizations and deaths. And once hospitalization and death rates start accelerating, it becomes very, very hard to stem the tide.
“While the vast majority of recent illnesses have been occurring in younger people and have not resulted in hospitalizations, it’s still a marker there’s disease transmission in the community,” Lampen said.
“And my fear, and the fear of many, is that if you have a constant, constant viral transmission in low-risk populations, it eventually is going to cross over” to more vulnerable populations, Lampen said.
And once coronavirus starts spreading among older, more vulnerable residents, hospitalizations and deaths are sure to follow, experts say.
“When we look at the data, the hospitalizations tend to follow a positive test by about 14 days, so you begin to see hospital spikes about two weeks after you see a spike in infection rates, and mortality tends to linger about a month after testing,” Lampen said. “So hospitalizations and death rates are a real lagging metric.”
And “once you get into that overwhelmed scenario, it’s hard to get out of it” without taking drastic measures, said Dr. Matthew Sims, an infectious disease specialist at Beaumont Health in metro Detroit.
“It’s like a hose,” he said. “You don’t cap off the hose at the end; you have to turn off the flow.”
Dr. Deborah Birx, who coordinates the White House coronavirus task force, recently said the statistic she watches most closely is the percent testing positive on coronavirus tests, terming it “the most sensitive indicator” of how the coronavirus situation is unfolding.
“It only has to go up a tiny bit,” Birx told Fox News’ Bret Baier in a July 22 interview. “So let’s say you have 3% test positive and the next week you have 3.3%. That is when to start really watching.”
Michigan’s positivity rate has been creeping up in recent weeks. It averaged a 2.5% in June and is now 3.4%,
Other states serve as a cautionary tale
The idea that rising case numbers eventually results in hospitalizations and deaths -- and can quickly snowball into a full-blown crisis -- is not just a theory. It’s a scenario that has played out again and again this summer in states from Florida to Texas to Arizona to California.
In each state, many initially dismissed increasing coronavirus caseloads, saying as long as more vulnerable populations were protected, people shouldn’t worry.
Throughout June, for instance, Florida Gov. Ron DeSantis repeatedly downplayed the growing case numbers in his state, saying it was mostly young people and noting hospitalization and death rates had remained low.
Then, just as health officials feared, coronavirus infections began rising in older populations.
Florida now has about 8,400 people hospitalized for COVID-19, and Miami hospitals in particular have been strained, with intensive care units filled to capacity. Meanwhile, coronavirus deaths are on a steep upward trajectory.
Florida started the month with a total of 3,505 coronavirus deaths. It’s added another 3,338 in July, including 1,112 this week. For each of the past four days, Florida has set a single-day record for virus-related deaths.
Florida nursing homes have been particularly hard-hit; 40% of Florida coronavirus deaths have occurred in long-term care facilities. In the month of July alone, more than 6,700 residents and staff at nursing homes and assisted living facilities have become infected with COVID-19, a 129% rise, according to the Miami Herald, with 250 deaths last week.
Florida “is a perfect example of what happens when you opened (the economy) too fast and don’t have rules to prevent spread,” Sims said.
What prevents Michigan from becoming the next Florida is the state’s more stringent mitigation strategies, such as mandating use of masks in indoor spaces, said Dr. Sandro Cinti, an infectious disease specialist at Michigan Medicine.
“I think this mandate to mask in public places is right on the money, and that’s what they’re not doing down South in Florida and Texas, Louisiana and many of these other states and so the infection just runs wild,” Cinti said. “The virus is very transmissible, and so without those protections, it’s going to spread.”
Even if people don’t die, coronavirus can be a very serious illness
While it’s true that coronavirus deaths are heavily skewed among older patients, especially those with underlying health conditions, “at the same time, we’re seeing patients from all walks of life and, unfortunately, a big spread of ages,” said Dr. Justin Skrzynski, an Beaumont infectious disease specialist.
“Obviously, if you’re younger and healthier, you’ve got better chances, but you’re still rolling the dice and there’s a chance you can have something pretty catastrophic happen,” he said. “I can think of a several cases off-hand of very young, otherwise healthy people who ended up extremely, critically ill, literally at the edge of what life support we can provide.”
There’s also growing evidence that coronavirus can result in long-term health problems, even in people with mild cases.
“There are a number of studies now starting to look at the people who are recovering from coronavirus,” Sims said. “One that just came out said when they looked at all their patients an average of 60 days out, only about 13% of them had no symptoms at all.”
A new study published Monday in the JAMA Cardiology Journal found that 78% of recovered COVID-19 patients had permanent heart damage. The majority of the 100 patients in the study had not been hospitalized.
Other studies have indicated possible long-term effects of the virus may include blood clotting, strokes, lung damage and neurological symptoms, such as loss of smell or taste.
Transmission rates need to drop for schools to reopen safely
Even if hospital and death rates remain low in Michigan, health experts say the current case numbers in much of Michigan are too high to safely open schools.
“I think it will be easy to reopen schools, but it’s going to be hard to keep them open,” because of the likelihood of coronavirus outbreaks among students and staff, said Dr. Dennis Cunningham, an infectious disease specialist in Flint.
He and others say it’s imperative for Michigan residents to drive down coronavirus numbers now as much as possible if residents want in-person classes for K-12 students this fall.
That means stricter individual compliance with mitigation strategies such as wearing a mask and limiting social gatherings, experts say, and some even say a partial shutdown of indoor service in bars and restaurants is in order.
An analysis by the Harvard Global Health Initiative recommends that to reopen schools safely, communities should have a daily average caseload of less than one case per day per 100,000 residents. Michigan’s current average is seven cases per 100,000 residents, and only 15 of the state’s 83 counties currently meet the Harvard institute’s proposed benchmark.
A partial shutdown now could result in a safe reopening of Michigan schools this fall, experts say
Lampen has two daughters in high school, and he’s among those who say now is no time to be loosening restrictions in Michigan in regards to coronavirus.
“I really would love to see my kids back in school,” he said. “I’m hopeful that we can get things under control where it’s safe to get them back in.”
COVID-19 PREVENTION TIPS:
In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.
Health officials say you should be staying at least 6 feet away from others and working from home, if possible.
Use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and carry hand sanitizer with you when you go into places like stores.
Michigan Gov. Gretchen Whitmer has also issued executive orders requiring people to wear face coverings over their mouth and nosewhile in public indoor and crowded outdoor spaces. See an explanation of what that means here.
Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.
For more data on COVID-19 in Michigan, visit https://www.mlive.com/coronavirus/data/.
Read more on MLive:
‘Are masks bad for your health?,’ plus 8 other coronavirus myths and truths
Latest on coronavirus antibodies and immunity: What we know and what we don’t at this point
Why Michigan public health departments publicize some coronavirus exposure sites but not others
Ice cream shop owner wants customers to stop yelling at staff over mask requirement
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