The signs point to one thing: Michigan is headed to a potentially dangerous place, again, when it comes to COVID-19.
New coronavirus case numbers in the state have spiked to levels higher than they were in March and April. The Michigan Department of Health and Human Services reported 1,826 new COVID-19 cases Friday — with a seven-day average of 1,655 daily cases — and 18 new deaths.
Although there’s also been an uptick in hospitalizations and deaths, those statistics still haven’t reached anywhere near the heights the state recorded in the early days of the pandemic, when hospitals in southeastern Michigan were filled to capacity with sick COVID-19 patients.
“We’re not at that point right now,” said Dr. Anurag Malani, an infectious diseases specialist at St. Joseph Mercy Hospital in Ann Arbor, “but the hospitalizations are definitely going up.”
They’ve risen more than 80% in recent weeks, the Michigan Health and Hospital Association reported. It issued a joint statement signed by the top doctors at 110 of Michigan’s hosptials Thursday, warning:
“This concerning jump puts our entire healthcare system at risk of another capacity crisis. If the trend continues, doctors and nurses, therapists and custodians, food services and support staff, who have barely begun to recover from the terrible stress of the initial COVID-19 surge, will suffer additional stress and risk their own infection, illness, and mortality.
“If Michigan doesn’t change its approach to this disease, we could have crowded hospital emergency departments and approach exceeding the capacity of our hospitals as we did in Southeast Michigan this past spring.”
In early April, nearly 1,000 people were hospitalized for treatment of confirmed or suspected cases of COVID-19 in the Henry Ford Health System’s six hospitals, said Dr. Adnan Munkarah, Henry Ford Health System’s executive vice president and chief clinical officer.
Today, there are 93 people hospitalized with confirmed or suspected cases of COVID-19 at Henry Ford, he said. And though it doesn’t seem like a lot, Munkarah said the situation can change rapidly.
“We have seen this come up very fast in March and April, and this can do that (again) if we are not careful and we don’t follow the measures that we think are protective,” he said.
That means wearing a mask when you leave home, staying away from others, avoiding large crowds, staying home when you’re sick, and hand-washing.
What’s different about this fall than in the spring is that the virus is ciruculating right now more among younger, healther people who are less likely to have severe complications or need hospitalization, both Munkarah and Malani explained.
As younger people have returned to schools and college campuses, started venturing out to restaurants and bars, “exercising their … freedom to kind of enjoy their social life,” the virus is spreading, Munkarah said.
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Pandemic fatigue is also playing a role in the rising case numbers.
“People are letting their guards down,” Munkarah said. People aren’t wearing their masks when they’re out, they’re not social distancing as much as they should, and they’re not avoiding large gatherings.
“Unfortunately, we are seeing more and more people get together,” Munkarah said. “And now with the weather being colder, people are tending to be doing more indoor activities and, accordingly, being more exposed to the virus that weren’t exposed to it in March, April.”
His concern is that if these young people start to bring the virus home to older, more medically vulnerable adults, the state could see a crush of sick patients overwhelming hospitals in the state — as they did in metro Detroit in March and April in metro Detroit — and many more deaths.
“If the infection starts spreading with our with our elderly population and more vulnerable populations, we are going to be in trouble,” he said.
The death rate from COVID-19 in Michigan also is lower than it was in late March and early April, Malani said. That’s a trend he attributes to a better understanding of the virus and how to treat it as well as the same shifting demographics that have reduced hospitalizations.
“We know how to manage COVID-19 better — from a hospitalization standpoint, from a critical care standpoint, and even in terms of a ventilator standpoint,” he said. “More treatments are available, and we understand how to approach treatment better than we did in March and April. So mortality sure seems to be lower.
“But it’s October, but based on where we are, with the cooler weather people spending more time indoors and the holidays coming up, there is a lot of concern that the numbers are going to go up,” he said.
First, the state will see a spike in cases, he explained, followed by a rise in hosptializations and finally deaths, a lagging indicator of the spread of the disease.
That concern is exacerbated by the added pressure flu season could place on health care providers and hospitals, as the state could be hit with a “twindemic” with both a swell of influenza and COVID-19 infections.
“We are starting to see some concerning patterns,” Munkarah said.
People should get their flu shots now, he said, to try to protect themselves, and make plans to celebrate the upcoming holidays remotely.
Even trick-or-treating at Halloween is an unnecessary risk, Munkarah said.
“All you need is one person who has the virus and does not know it to transmit it from one person to the other and you have a major spread,” Munkarah said. “So this is the time where we need to be extremely careful and extremely thoughtful. … I do not think it is good idea for us to be to have people be in contact with each other for things that are not essential, that are not health-related.
Opting for in-person Thanksgiving this year, he warned “might spread a virus that might cause the death of a loved one.”
Malani warned that if people don’t start taking the threat of the virus seriously, sharply rising case numbers in Michigan could lead to another side-effect: People may once again hesitate to seek medical care for other conditions.
“We know not just in Michigan but across the United States that when we had the lockdown happen, people were scared to come to the hospital,” he said “And we know that that compromises care in another way. It may not be directly COVID, but it impacts cardiovascular outcomes and outcomes of strokes, and even basic sort of things like preventive care. There’s been a lot of discussion about childhood immunizations and how immunization rates have gone down because of the pandemic.
“There’s always a secondary effect. For every case of COVID that is occurring, that is just propagating the pandemic even further. I think that that’s why doubling down on all the prevention efforts is so important right now.”
Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.