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What's behind the rise in COVID-19 cases in West Michigan?

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Cases of COVID-19 are rising in West Michigan for two reasons. The virus is spreading there, and testing has increased so the region is indentifying more cases.

The total number of confirmed COVID-19 infections now stands at just over 45,000 thousand cases according to the state of Michigan.

Lately, the daily number of new cases has been trending downward.

But in a briefing last week, the state’s top Medical Executive, Dr. Joneigh Khaldun noted an emerging concern.

“To date, the vast majority of cases have still been in Southeast Michigan,” Khaldun said. “However, while the rate of rise is slower in Southeast Michigan, we are seeing an increase in the rate of rise in other parts of the state, particularly in the Western part.”

Dr. Khaldun said in the past two weeks of April, cases rose 48% in Kent County, 41% in Muskegon and 23% in Ottawa.

It’s important to note those are coming off of some very low numbers earlier in the month. Both Muskegon and Ottawa counties have fewer than 400 confirmed cases each, and Kent County, which is much larger, has just over 2,000 cases, which is still a fraction of the number of cases in SE Michigan overall.

So, why are cases rising?

There are two possible explanations:

1.   The virus is spreading more in West Michigan

2.    Testing has gotten better, so the region is identifying more cases.

"I think the increase in testing is probably the larger explanation for our numbers in Kent County," says Adam London, director of the Kent County Health Department.

Which is it?

“So I think both are true,” says Adam London, director of the Kent County Health Department. “I think the actual prevalence of infection in the community has increased. However, I think the increase in testing is probably the larger explanation for our numbers in Kent County. Over the past several weeks, we’ve gone from a couple hundred tests being done here in Kent County to approximately a thousand tests per day.”

Testing capacity hasn’t just increased in Kent County. It’s increased all over the state.

According to Adam London, it matters how the county has decided to administer the tests. He says the health department isn’t sitting back waiting for cases to come to them. They’ve gone out to places like nursing homes, group homes, homeless shelters – places where people are grouped together and they’ve just tested everyone there, regardless of symptoms.

Consider what happened at Mel Trotter Ministries. It operates a well-known shelter in Grand Rapids, serving people who are homeless.

Dennis Van Kampen is the president there. He says Mel Trotter started screening its guests back in March. It performed multiple temperature checks a day, and surveyed guests on whether they’d felt any other symptoms.

“And then if we encounter someone that is symptomatic, to send them immediately to the hospital or health center, and then we go from there,” Van Kampen says.

Then, working with the health department, they decided to just test everyone for the virus, even those who had no symptoms.

They tested 251 guests. All of them had passed the screenings. And 69 came back positive. That’s 27%, all asymptomatic.

Adam London at the Health Department says that’s been pretty typical in these group settings. He says 25-30% of the tests administered in these places have come back positive, and the majority are asymptomatic cases.

It’s true that other counties have also expanded testing in this way, targeting nursing homes and other vulnerable locations. London says he believes Kent County has been more aggressive, and that’s why the number of new positive cases in the county look more dramatic than other places.

West Michigan also started the testing push with lower numbers of positive cases. By mid-April, the region that includes Kent County had fewer than 60 new cases each day, at a time when Southeast Michigan was seeing hundreds of new cases every day, according to state data. Increasing the number of positive cases by a few dozen every day had a much bigger impact on the rate of rise in West Michigan than it would in the Southeast.
 

How concerned should we be about the rise in cases in West Michigan?

There are some reasons not to be alarmed.

London says one really positive sign is that, despite the rise in positive cases, hospitalizations have been flat for a few weeks in Kent County.

"That's probably one of the better indicators that we have that we have flattened the curve," London says.

And, while the number of deaths from coronavirus have risen in the region, the rise has not been as sudden or dramatic  as the state saw in Southeast Michigan.

Those are signals that the outbreak may not be as bad in West Michigan, at least not for now.

But health professionals here also point out a big reason for that is because West Michigan had more time to prepare, and the shutdown measures have really held down the spread.

Now, the weather is getting warmer, drawing more crowds outside. Some workplaces are starting to reopen. The numbers show the virus is still out there. And there’s still the possibility of an even worse outbreak.

In the recorded conversation above, our reporter refers to Adam London as Dr. Adam London. London has a PhD, not an MD.

Dustin Dwyer reports enterprise and long-form stories from Michigan Public’s West Michigan bureau. He was a fellow in the class of 2018 at the Nieman Foundation for Journalism at Harvard. He’s been with Michigan Public since 2004, when he started as an intern in the newsroom.
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