Michigan marked its worst week yet in the coronavirus pandemic as 44,019 people were newly diagnosed and 416 died.
The unprecedented surge sparked a cascade of school and college campus closures, along with shuttered city halls in Warren and Grosse Pointe and a warning from some hospital systems that they're nearing capacity as sick patients flood emergency rooms.
"We are potentially looking at some of the deadliest, most grim days of this entire pandemic ahead of us," said Dr. Joneigh Khaldun, the state's chief medical executive, pleading with Michiganders once again to wear masks and socially distance, wash their hands, avoid large gatherings, and stay at home as much as possible in the weeks ahead.
The state is now seeing exponential growth in newly confirmed cases that is nearly four times higher than it was during the peak of the virus surge in early April. And it comes as coronavirus cases also flare nationally. The U.S. leads the world in cases and deaths, and set records this week for new daily case numbers and hospitalizations, according to the COVID-Tracking Project.
"If you had two jetliners falling out of the sky and killing everyone on board every day, we would probably think that was an emergency, right?" said Dr. Dawn Misra, department chair and professor of epidemiology and biostatistics at the Michigan State University College of Human Medicine. "And that's basically the equivalent of the coronavirus deaths now happening in the U.S.
"If this was anything else, if it was an acute catastrophic event like a terrorist attack, I think we'd be considering it differently," she said.
Despite a statewide public health mask mandate, too many people still don't wear masks or position their masks below the nose when they're out in the community, said Susan Ringler Cerniglia, public information officer for the Washtenaw County Health Department.
Another challenge is that too many Michiganders don't believe the virus is a real and serious threat, she said.
And when the public health officials call to alert people of a positive coronavirus test result or to tell them they've had close contact with a person who has the virus and they need to quarantine, they "don't believe or trust in the test result or they don't believe or trust that they've actually been exposed and want to take issue with that," Ringler Cerniglia said. "People have expressed concerns about a violation of their privacy. And of course, we have no interest in sharing personal information or getting people in trouble. The whole point of the process is to prevent additional cases. ... There's also continued confusion that a positive test might be a false positive and this is kind of wrapped up in the testing challenges.
"At the end of the day, falsely testing positive is very, very rare. You're much more likely to have a false negative."
There needs to be a culture change around coronavirus, said Brian Peters, CEO of the Michigan Health & Hospital Association, during a Thursday news conference with the CEOs of five Michigan hospital systems to sound an alarm that they're reaching a crisis point.
"We need to get to a place culturally here in Michigan where people understand the science and believe in the science that masking and social distancing works," he said.
Coronavirus cases are spreading among people who get together in groups both large and small, especially with friends and extended family. They put their guard down, believing their loved ones couldn't possibly have the virus or are somehow safer than others in the community, hospital leaders said. That's a real concern as firearm deer hunting season opens Sunday and Thanksgiving approaches.
"The science tells us that 40-plus% of individuals who are positive are asymptomatic," said Wright Lassiter III, president and CEO of Henry Ford Health System. "One of the issues that I think people still do not acknowledge is that your friend or family member or co-worker can be right next to you, looking completely healthy and sound, and be positive and spreading, shedding the virus and potentially infecting you or others.
"That's the reason why mask wearing is so important. It is because we're dealing with a virus that at times is sort of the silent attacker."
Khaldun explained that the massive volume of new cases and widespread community transmission limits the ability to do contact tracing, and it means as many as two-thirds of people in Michigan who've been exposed to the virus don't know it.
"Only 28% — less than a third of the positive cases that we are investigating — were in quarantine at the time of their diagnosis," she said. "This means that over two-thirds of positive cases are out and potentially spreading the virus to others."
Statewide, there are now 747 active coronavirus outbreaks, said Khaldun, who also is chief deputy director of the Michigan Department of Health and Human Services.
"That's the highest number since we started tracking outbreaks and 25% more than we had just a week ago," she said, noting that the outbreaks are largely associated with nursing homes, manufacturing facilities, schools, and in health care settings, restaurants and bars.
The state's nursing homes are seeing an increase in cases and deaths among residents and staff, and several groups sounded the alarm last week to protect these vulnerable residents and those who care for them.
About a third of the state's COVID-19 virus deaths — 2,304 — are among nursing home residents. So far in the pandemic, 9,977 nursing home residents have been infected, as have 6,283 employees of those facilities. Twenty-four staff members have died.
Schools, colleges and cities feel the impact
The ripple effects from the COVID-19 virus' latest surge have been felt far and wide as school districts from Detroit to Sault Ste. Marie to Zeeland and Holly announced they would shut down in-person classes and go to a virtual education plan.
The decision came as students, teachers — and even school bus drivers — were unable to attend classes or go to work because they either had the coronavirus or were exposed to someone who did.
Paul Clark, superintendent of Cheboygan Area Schools said 11 of its 200 total staff members were in quarantine Friday.
"A few of those are bus drivers, which is the reason that we needed to shut down," he said. "Not enough drivers to transport kids. We did have 62 students in quarantine; however, their quarantine expired today."
School employees in Michigan are dying, too.
Glenna Cramer, a breakfast and lunch assistant at Waterloo Elementary School in Monroe, died last week of the COVID-19 virus. She worked as a morning greeter and temperature checker at the school before the district switched to remote learning.
“You never saw her without a smile,” said Monroe Public Schools Superintendent Julie Everly. “She was always in the spirit of service to our students.”
The disease also is spreading on college campuses, leading many to cancel in-person classes.
At least two private colleges — Albion and Alma — are allowing students to leave for home this weekend, earlier than scheduled.
Oakland University is switching to remote instruction for all but a small subset of classes, and the University of Michigan has canceled all housing contracts for next semester and is beefing up the percentage of classes offered remotely.
At Grand Valley State University, students are being told to practice "enhanced safety measures," including largely staying in their rooms to limit exposure and the possibility of taking the virus back to their home communities.
And at Michigan State University, head basketball coach Tom Izzo announced last week he'd contracted the virus, though he couldn't pinpoint where or how.
"I've been an advocate of wearing our masks and practicing social distancing. I'm still an advocate of that. ... We've got to understand that it is serious, and it is invisible. ... Don't let up for a second, especially those of you that have kids or families or even for yourself. You've just got to stick to the protocol and hope for the best."
Municipal services in at least three metro Detroit cities also were affected by the fast-spreading virus this month.
Nearly three dozen Warren city employees tested positive for the coronavirus or had symptoms that required them to quarantine, including workers in the district court, police department and city hall, which was closed to the public last week.
Warren Mayor Jim Fouts said one of the infected city workers was on a ventilator at a local hospital.
Grosse Pointe Farms City Hall also had to close because of COVID-19 virus infections as did a fire station in Troy after several firefighters tested positive.
All members of the affected station, about 30 firefighters, are under quarantine out of caution, the city said in a statement.
Hospitals brace for the worst
As COVID-19 virus cases continue to rise, so do hospitalizations and deaths around the state. At the current pace of growth, Michigan is on a trajectory to mark 345,000 total confirmed cases by the end of November and, Gov. Gretchen Whitmer said, could hit 100 deaths per day in December.
By Friday, there were 3,220 adults hospitalized in Michigan with confirmed or suspected cases of COVID-19 virus. In addition, 21 children with confirmed or suspected coronavirus cases also were hospitalized, according to state data. That's an increase of 175% compared with three weeks earlier.
And right now, it's hitting hardest in western, central and northern Michigan.
"We are facing some of the most daunting and demanding challenges since this pandemic began," said Spectrum Health President and CEO Tina Freese Decker.
Spectrum, which operates 14 hospitals in southwest and western Michigan and employs 31,000 people, is canceling nonemergency inpatient medical procedures, is moving to virtual health care visits as much as possible and is limiting visitors to its hospitals. It also is expanding its intensive care unit capacity and adding beds.
"Even with these actions, the reality is that Spectrum Health and our hospitals across the state will be hitting their capacity in a matter of days," Decker said Wednesday.
Spectrum isn't alone.
Sparrow Hospital in Lansing projects it will hit its capacity for COVID-19 virus patients within a week, and is considering reopening a closed wing of its St. Lawrence campus to handle the overflow of patients.
Both Spectrum and Sparrow say limited coronavirus testing supplies combined with a rising demand for tests also is putting a strain on their ability to return results quickly and test everyone who wants to be tested. Spectrum is no longer testing asymptomatic people for the COVID-19 virus, and Sparrow said it will now require patients to either get a doctor's order prior to testing or be screened through its app.
"Our hospitals are rapidly filling with COVID patients at a very alarming rate," said Peters of the MHA, which represents all the hospitals in the state. "If this continues, in the coming weeks we will surpass our all-time record high in terms of COVID inpatient hospitalization numbers here in the state of Michigan."
Lassiter said it's vital to bring down the rate of COVID-19 virus infection and hospitalizations in Michigan.
"If the case escalation continues on this same pace for significantly longer, you will have every hospital getting to its capacity, and having to and having to make decisions about slowing down and or discontinuing some kinds of basic care to care for COVID patients," he said.
"As you recall, in southeast Michigan when we got to that place, we had to lean on state, and federal government for field hospitals to provide a backstop ... because we were we were at our breaking point. And we're all hoping we won't get there again. And we're all hopeful that won't be a need. But that is a scenario that could play out if there isn't a change of behavior, and thus, a reduction in the escalation of cases that we see across all parts the state."
It isn't just available hospital beds that's an issue. It's also having enough nurses, doctors, respiratory therapists and other medical staff to care for the influx of sick patients. That's especially challenging given the rate of community transmission in Michigan.
If it gets to a point where there aren't enough trained health care workers, Michigan's hospitals can't call on other states to help because the entire nation is seeing a similar surge in coronavirus infections.
Beaumont Health CEO John Fox said the contingency plan will be to cut back on non-emergency medical services — similar to what happened in the spring — and transfer employees who used to provide other services at the hospital to work in COVID-19 virus units. It's a situation Fox and the other hospital leaders would like to avoid.
"We all have contingency plans, and we don't want to have to deprive patients of non-COVID related critical services or get into ... trying to select Patient A over Patient B," Fox said. "But that's the difficulty you can get into."
Meanwhile, in Lansing ...
Whitmer has been all but hamstrung in enacting new COVID-19 virus restrictions through executive orders because of an October state Supreme Court ruling that invalidated her previous mandates to rein in the spread of the virus.
The Michigan health department scrambled after the ruling to quickly issue new public health orders that mirrored Whitmer's — requiring mask wearing, restricting restaurant and business capacity and limiting the size of indoor gatherings, among other things.
State health department Director Robert Gordon announced a new free app last week called MI COVID Alert that will send a push alert to anyone who has been near another app user if that person later tests positive for the virus.
"We want people to be as safe as they can be at this very dangerous time," Gordon said, calling the "exponential growth" in COVID-19 virus cases, hospitalizations and fatalities "extraordinarily alarming."
But so far, those measures haven't been enough to slow the spread of the virus in Michigan.
Whitmer called on the Republican-led state Legislature earlier this month to put the mask requirement and other public health guidelines into law, with the hope that bipartisan support would encourage more Michiganders to take the precautions more seriously.
House Speaker-elect Jason Wentworth, R-Clare, called it a "press stunt."
Lawmakers have yet to pass any comprehensive legislation to stop the spread of the disease, and the Legislature isn't scheduled to reconvene in Lansing until Dec. 1.
By the end of last week, at least three state lawmakers — Rep. Scott VanSingel, R-Grant; Sen. Kim LaSata, R-Bainbridge Township, and Rep. Ann Bollin, R-Brighton — said they have coronavirus infections.
LaSata tested positive one day after attending four meetings and a Senate floor session at the Capitol, she said. Video recordings of those meetings show LaSata repeatedly removing her mask.
Whitmer said she's "strongly considering" taking action to curb coronavirus spread, saying: "This is the worst week of COVID we've ever had."
Free Press staff writers Christina Hall, John Wisely, Chris Solari, David Jesse and Dave Boucher contributed to this report, along with Tyler Eagle of the Monroe Evening News; Kortny Hahn of the Cheboygan Daily Tribune; Taylor R. Worsham of the Sault Ste. Marie Evening News; Jennifer Timar of the Livingston Daily Press & Argus; Evan Sasiela of the Ionia Sentinel-Standard, and Arpan Lobo and Mitchell Boatman of the Holland Sentinel. Michigan Radio reporter Kate Wells also contributed.
The Detroit Free Press is teaming up with Michigan Radio and Bridge Magazine to report on the coronavirus pandemic. You can contact Kristen Jordan Shamus at the Free Press at kshamus@freepress.com; Kate Wells at Michigan Radio at katwells@umich.edu, and Robin Erb at Bridge at rerb@bridgemi.com.
