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Elizabeth Hertel, the director of the Michigan Department of Health and Human Services, as well as MDHHS chief medical executive Dr. Natasha Bagdasarian, spoke during the briefing.
They were joined by Dr. Michael Tsimis, MD, a maternal-fetal medicine physician with Spectrum Health, and Dr. Paolo Marciano, MD, PhD, the chief medical officer for Beaumont Hospital in Dearborn.
Here’s what we learned during the briefing.
‘Deeply concerning direction’
Two weeks removed from the Thanksgiving holiday, when officials were worried about a spike due to families gathering indoors, Hertel said the state’s COVID trends aren’t getting much better.
“Michigan continues to trend in a deeply concerning direction, heading into the Christmas holiday and the new year,” Hertel said.
“We have seen the highest weekly reported cases during this surge as we have in the whole pandemic,” Bagdasarian said.
Michigan is currently at 569 weekly COVID cases per 100,000 population. Cases are higher right now than they were at this time last year, according to Bagdasarian.
She said COVID numbers are expected to rise going forward, unlike at this time last year.
“We’re in a critical stage right now,” Bagdasarian said. “We are surging. We’re leading the nation in terms of cases. We are trailing in terms of vaccinations, and we have omicron here.”
Deaths from COVID are also increasing, with the deaths per million up to 9.6 and a daily average of 87 per day in the last week, Bagdasarian said.
Non-COVID deaths have also increased during this spike, suggesting that hospitals are overwhelmed.
“Not only are patients with COVID-19 dying at higher than expected rates, but people with other illnesses or other diseases are also dying at higher rates than expected,” Bagdasarian said.
The question comes up every time Michigan officials hold a COVID briefing: How bad would the situation have to get for restrictions to be mandated once again?
For months, the answer to that question has remained more or less the same: MDHHS is focused on vaccinations and believes that we have learned enough about COVID prevention that mandated restrictions shouldn’t be necessary.
“Right now, our focus is making sure that people are getting vaccinated when they’re eligible and getting the booster shots when they’re eligible,” Hertel said. “Masking is important while we go through trying to achieve our herd immunity through vaccinations, but vaccinations are the absolute best tool that we have, and it is imperative that people get vaccinated as soon as possible, or get their booster shot if they are eligible.”
Hertel said how easily the omicron variant spreads in comparison to other forms of COVID remains to be seen.
“All indicators are that it is more transmissible than the delta variant,” she said.
Bagdasarian said early data indicates vaccines will continue to offer protection against omicron, especially in terms of severe disease and deaths. She said booster shots are vital to that protection.
Reports from other countries suggest that the omicron variant might cause milder cases, but that doesn’t mean it’ll be milder on a population basis, Bagdasarian said.
As for the person who tested positive for the omicron variant in Kent County, Bagdasarian said she can’t reveal specifics about that individual, but that their illness is mild.
‘Not if, but when’ for unvaccinated residents
Hertel said only about 2% of people who are fully vaccinated have reported breakthrough COVID infections.
Three out of every four COVID patients hospitalized in Michigan are unvaccinated, according to health officials.
“If you have yet to receive the vaccine, or you are not yet fully vaccinated, it is not a matter of if you will get sick, but when,” Hertel said. “Particularly with a more transmissible variant spreading across the state.”
She said vaccines remain the best option to protect against severe illness and death.
Michigan continues to be below the national average in terms of vaccination rates, with only 56% of residents fully vaccinated, according to Bagdasarian. The state is also performing significantly worse in terms of vaccinations in younger age groups.
Unvaccinated residents are 4.4 times more likely to test positive for COVID and 9.3 times more likely to die from COVID, Bagdasarian said.
Bagdasarian said 21.5% of Michigan inpatient beds are filled by COVID patients -- a number that has been increasing for 20 weeks.
“We are at an all-time high,” Bagdasarian said. “In previous surges, we have never exceeded 20%.”
She said hospitals are feeling the strain both in terms of COVID cases and others who are postponing care.
Marciano said Beaumont Health System has about 650 COVID patients across its hospitals. More than three-quarters of those patients are unvaccinated.
Meanwhile, the total number of open positions across the health system is higher than 10%, and that percentage is even higher among nurses, Marciano said. That’s creating a great strain on the remaining staff members as they try to provide the best care.
He said the challenges for hospitals throughout this pandemic are constantly changing, and that continues into the fourth surge.
Beaumont is still performing emergent surgeries for non-COVID patients, according to Marciano.
“It’s a tough juggling act, to say the least, because every patient’s surgery is needed,” Marciano said.
How fourth surge compares
Marciano said during the first surge of COVID, there was a fear of the unknown, but the health care system was well-staffed.
“Today, the functional vacancy rate, overall burnout -- a lot of the health care workers thought that (the surge) was one-and-done, but it isn’t one-and-done,” Marciano said. “We’re still experiencing the same feelings that we had a year and a half or so ago, and a lot of health care workers are deciding to go other places.”
He said there are other challenges, such as equipment shortages due to supply chain disruptions.
“This is predominantly a surge of the unvaccinated,” Bagdasarian said.
While waning immunity for people eligible to get a booster shot is also a factor, the main concern remains residents who haven’t gotten vaccinated at all, she said.
COVID and pregnancy
Tsimis said he works primarily with pregnant women between the ages of 20-30. He touched on what doctors know about pregnancy in relation to COVID and vaccines.
“We know that in pregnancy, especially, there are immunologic and changes in the lung systems of expectant mothers, which actually can make moms very much more susceptible to getting sicker from COVID,” Tsimis said.
He said pregnant women have a higher risk of needing respiratory support, intubations and help for other complications.
“At the beginning of the pandemic, we would have isolated cases of moms in the ICU,” Tsimis said. “Currently, we’ve spent a large proportion of our time rounding on the inpatient service in the ICU. The only question is, how sick were the moms? And how many of them are there?”
He said this is the most time he’s ever spent in the intensive-care unit in his career.
“Why is that the case? Well, unfortunately, we know that Michigan is falling behind in vaccination rates,” Tsimis said. “So, if 56% of Michiganders are vaccinated, our pregnant moms are about half that much -- 30% is the vaccination rate estimated in pregnancy, which means that moms can actually get sicker because they’re less vaccinated.”
He said immunity from vaccination gives protection and antibodies to the fetus -- even stronger protection than a natural infection.
“So we know that a vaccine is the best way to protect not only the mom, but also protect the baby, as well,” Tsimis said.
He said vaccines do not cause infertility.
Masks in schools
Hertel was asked whether the presence of omicron in the state has caused officials to consider requiring masks in schools.
“We have recommended to schools that they should mandate masking in the classrooms,” Hertel said. “It does not change our opinion on that at all. We certainly are advocating for all those children in school over age 5 to get their vaccines.”