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After months of COVID's "slow burn," Michigan hits full fledged "fourth surge"

Doctors in protective suits put on a ventilation mask on a sick patient.
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One of the big questions right now is, why is this happening in Michigan? And why now?

While COVID cases and hospitalizations may be waning in many parts of the U.S., Michigan is not one of them. Cases and hospitalizations, which have continued to rise the last few months in a steady “slow burn,” are now straining the state’s health systems yet again, even sending one North Michigan hospital into a “Pandemic Response Level Red” status this week for the first time in its history.

“I consider this to be our fourth surge,” said Dr. Nick Gilpin, Beaumont Health’s director of Infection Prevention and Epidemiology, at a press conference Thursday morning.

“Starting in about late August, early September, we've been experiencing this slow burn, this slow, steady increase with a very shallow slope of increases in COVID patients in our hospitals,” he said. “And that number has gone over the last few months [from] a very slow slope, to in the last week or so a very sharp increase to where we currently are. So again, we are dealing with a somewhat lower number of COVID patients right now than we've seen in prior surges. But I am very concerned about the trajectory of this new wave.”

That “new wave” includes more than 2,700 adults and 59 children currently hospitalized with confirmed or suspected COVID, according to the most recent state data.

“In the last 7 days, only one other state reported more cases than Michigan...and Michigan's case rate is 8th highest nationally,” according to the latest state epidemiology report. And children are disproportionately affected this time: cases among kids 12 and under have increased 30% since last week, and 10-19 year olds are “experiencing the greatest case burden” of any age, with some 625 cases reported daily.

So why is this happening in Michigan, and why is it happening now? No one knows for sure, Gilpin said, but there are probably several factors. Cooler weather is driving people indoors, and people are increasingly relaxing their behaviors.

“There's been a lot of news reports over the last several weeks that COVID has been in decline, and I think that's true for a lot of regions in the country...but that's certainly not been our experience here in the Midwest,” Gilpin said. “So I think some signaling that things are starting to get better has led to some more relaxed attitudes. We're seeing relaxed behaviors with regard to masking, physical distancing. We're seeing more and more large gatherings take place, and we know that those are the conditions that are going to make for more transmission.”

Vaccination rates are also leaving certain areas particularly vulnerable: 69% of Michiganders 16 and up have received at least one shot, but the level of immunizations varies widely by region. Just 42% of Detroiters are vaccinated when data for kids 5 and older (who became eligible for the COVID vaccine last week) is included. Vaccination rates are similarly low in the counties along Michigan’s southern border, the Thumb region, mid-Michigan, and parts of North Michigan and the Upper Peninsula.

“Metro Detroit once again is becoming a hotspot,” he said.

While hospitalization numbers still remain lower than previous surges, the current crisis is being exacerbated by an increase in non-COVID patients who are severely ill after delaying care for months during the pandemic. Combined with staffing burnout and shortages so dire that some hospitals have had to close more than 100 beds in recent months, and the state’s health care system is buckling beneath the cumulative weight.

“I'm not going to lie: it's kind of brutal,” Gilpin said. “We're all very much tired of this. And taking care of sick COVID patients is incredibly labor intensive. But we mask up and we do our job...but it is difficult. And as especially as we look ahead to the prospect of a fourth surge that could last another three or four months or take us through the winter, this is going to be a tough one. Every surge up to this point has had a little bit of a different flavor to it. This one, as I said, is shaping up to be a little bit more of a marathon, not a sprint.”

Kate Wells is a Peabody Award-winning journalist currently covering public health. She was a 2023 Pulitzer Prize finalist for her abortion coverage.
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