Much of US experiencing ‘severe’ virus outbreaks amid ‘third COVID wave,’ researchers say

Michigan sees highest COVID case, hospitalization numbers since onset of pandemic

A screenshot of Covid Act Now's map of the U.S. with states color-coded according to their "Covid Risk Level." Michigan is labeled as experiencing an "active or imminent" COVID outbreak, according to data from Covid Act Now. Most of the country is at "severe risk" for a COVID-19 outbreak (maroon), or "critical risk" (red). Photo courtesy of Covid Act Now's website. -- Nov. 28, 2020. (Covid Act Now)
A screenshot of Covid Act Now's map of the U.S. with states color-coded according to their "Covid Risk Level." Michigan is labeled as experiencing an "active or imminent" COVID outbreak, according to data from Covid Act Now. Most of the country is at "severe risk" for a COVID-19 outbreak (maroon), or "critical risk" (red). Photo courtesy of Covid Act Now's website. -- Nov. 28, 2020. (Covid Act Now) (Covid Act Now)

A research group who has been identifying states’ risk levels for a coronavirus outbreak had to create a higher, more severe risk level to account for the country’s current surge in COVID spread, cases and hospitalizations -- and a good number of states have been moved into that grave category.

Since the summertime, we’ve been following data from Covid Act Now, a group of technologists, epidemiologists, health experts and public policy leaders that monitors and identifies each state’s risk level for a COVID-19 outbreak. For months, the group had only four risk level categories: “low,” “medium,” “high” and “critical.” As of Saturday, however, the group has included a new, fifth risk level: “severe.”

The map of color-coded states in “America’s COVID Warning System,” as the group calls it, is doing just that with its daunting red hues: warning Americans that the entire country has reached a critical moment with the virus. Covid Act Now has even labeled this virus surge as the country’s “third wave” of the coronavirus.

As of Saturday, 20 states -- primarily those in the midwest -- are colored maroon, meaning they are identified as experiencing a “severe outbreak” of COVID-19. Most of the remaining states -- 27, to be exact -- are labeled red, meaning they are experiencing “an active or imminent outbreak,” according to the data.

Michigan is currently labeled as experiencing an active or imminent outbreak, which is considered the critical level.

Vermont and Maine are the only two states that are “at risk of an outbreak,” which is considered the high risk level. Hawaii is the only state experiencing “slow disease growth,” a medium risk level, as of Saturday.

There are currently no states labeled at low risk for a coronavirus outbreak by the group.

Like most other states, Michigan’s risk for coronavirus spread has constantly shifted throughout the year due to fluctuating rates of COVID-19 infection, hospitalization, contact tracing and more. Throughout October and November, the state’s risk level consistently trended in an adverse direction as the virus spread more rapidly than in previous months.

On Oct. 11, Covid Act Now had labeled Michigan at high risk for an outbreak. Just two weeks later, the state was considered at critical risk.

Now, nearly one month later, Michigan is still labeled at a critical risk level -- but the data and key factors driving that title have largely worsened during that time.

Daily new COVID cases in Michigan

One of the key factors contributing to Michigan’s critical risk status -- and potentially the most significant -- is the number of new COVID-19 cases recorded each day per every 100,000 residents in the state.

As of Saturday, Covid Act Now reports that Michigan is seeing a “critical” average of 70.8 new COVID cases every day per every 100,000 people -- near its worst mark on record. According to the data, Michigan’s highest average on record was 75.7 new cases per every 100,000 people on Nov. 21, which the group considers “extreme.”

In sharp contrast, in October the group’s data showed Michigan was recording 25.7 new COVID-19 cases each day per every 100,000 residents.

Over the last week, Michigan has averaged 7,073 new confirmed cases per day (70.8 for every 100,000 residents). Over the next year, this translates to around 2,600,000 cases and an estimated 13,000,000 infections (100.0% of the population). -- Nov. 28, 2020 (Covid Act Now) (Covid Act Now)

Any number higher than 1 is considered “medium” and anything above 10 is considered “high.” A state has reached “critical” standing if it reports more than 25 daily new cases per every 100,000 residents, according to the group.

The state was reporting a “high” rate of 11.7 new confirmed COVID cases per day for every 100,000 residents on October 11. Over the summer, Michigan reported a “medium” rate of 7.1 daily new cases on August 26 and 7.3 on July 31.

The group’s data aligns with coronavirus case and death data reported by the state of Michigan.

Michigan is currently experiencing its largest spike in COVID-19 cases on record. Over the last two months, the state has consistently broken record after record for single-day increases in new COVID-19 cases. So far, the highest daily total of new COVID cases in Michigan was 9,799 on Nov. 20.

Contact tracing -- lowest ever in Michigan

As COVID cases rise in Michigan, the amount of contact tracing conducted has significantly dropped off. Contact tracing in Michigan has been steadily decreasing since June, and has dropped sharply between mid-September and the end of October.

Contact tracing is cited by experts as a key factor in containing COVID-19.

As of Friday, Covid Act Now reports that Michigan is contact only tracing 3 percent of new COVID-19 cases within 48 hours of infection -- which health officials say is insufficient to contain the virus. Experts recommend that at least 90 percent of new COVID-19 cases are traced within 48 hours to contain the virus.

“With 7,073 new daily cases on average, Michigan needs an estimated 35,365 contact tracers on staff to trace each new case to a known case within 48 hours of detection,” the report reads. “Per our best available data, Michigan has 1,050 contact tracers, fulfilling only 3% of this staffing requirement. With insufficient contact tracing staff, Michigan is unlikely to be able to successfully identify and isolate sources of disease spread fast enough to prevent new outbreaks.”

When a state’s contact tracing falls below 20 percent it is considered “low,” and when it falls below 7 percent it is considered “critical,” according to the research. Between 10 and 90 percent is considered “medium.”

The state’s current percentage of contact tracing is the lowest it has ever been since the beginning of the pandemic.

Michigan’s positive test rate

While COVID-19 testing has increased in Michigan in recent weeks, with more than 45,000 diagnostic tests reported per day, the positive rate of those tests has also increased to near 13 percent over the last week, according to the state’s data.

Covid Act Now is reporting a similar number for Michigan: 13.1 percent of COVID tests were positive as of Nov. 23, according to the group.

“A relatively high percentage (13.1%) of COVID tests were positive, which indicates that testing in Michigan is limited and that most cases may go undetected,” their report reads. “At these levels, it is hard to know how fast COVID is actually spreading ... Caution is warranted.”

According to the group, the “World Health Organization recommends a positive test rate of less than 10%. The countries most successful in containing COVID have rates of 3% or less.”

Related: Michigan health officials want COVID tests positivity rate to fall below 3%

Virus hospitalizations increase in Michigan, cause worry

Yet another worsening factor contributing to Michigan’s critical risk status is the increase in COVID-19 hospitalizations, including upticks in critical care and ventilator use, in recent weeks.

Covid Act Now claims that, based on these trends, Michigan’s healthcare systems may not be able to “absorb a wave of new COVID infections” and may become overwhelmed with virus patients. The group determines this risk level by identifying how many intensive care unit (ICU) beds are available in the state, and how many may be needed based on the state’s level of coronavirus spread.

“Michigan has about 3,092 ICU beds. Based on best available data, we estimate that 57% (1,751) are currently occupied by non-COVID patients. Of the 1,341 ICU beds remaining, 843 are needed by COVID cases, or 63% of available beds. This suggests hospitals may not be well positioned to absorb a wave of new COVID infections without substantial surge capacity. Caution is warranted,” the report reads.

A number of healthcare systems and medical leaders in Michigan have warned in recent weeks that numerous hospitals are already overwhelmed, showing concern that the influx in COVID-19 patients may impact frontline workers and other hospital services and care.

Read: Leaders from 4 major hospital systems in Michigan share harrowing COVID-19 numbers

“Medium” COVID infection rate in Michigan

When compared to Covid Act Now’s data from last month, it seems that Michigan’s COVID infection rate is the only factor that has shown improvement.

As of Saturday, the data shows that Michigan currently has an infection rate of 1.08 -- meaning each person infected with COVID-19 is infecting 1.08 other people. One month prior, the state reportedly had an infection rate of 1.28.

Covid Act Now considers an infection rate “critical” if it surpasses 1.4. Michigan’s current infection rate of 1.08 is considered “medium,” and means that “COVID is still spreading, but slowly,” the group says.

While this factor has shifted in a promising direction, it is not enough to outweigh the other key factors that are trending downward and contributing to the state’s critical risk status.

COVID-19 by county

Covid Act Now does also break data down at the county level, assigning a coronavirus risk level for every county in each state. The research group has done this for months, but it now features the option of viewing all U.S. counties on a map at one time (see the image below).

A screenshot of Covid Act Now's map of all U.S. counties color-coded according to their "Covid Risk Level." Michigan is labeled as experiencing an "active or imminent" COVID outbreak, according to data from Covid Act Now. Most of the country is at "severe risk" for a COVID-19 outbreak (maroon), or is currently experiencing an "active or imminent" COVID-19 outbreak (red). Photo courtesy of Covid Act Now's website. -- Nov. 28, 2020. (Covid Act Now) (Covid Act Now)

In Michigan, a majority of counties are labeled at critical risk for a COVID-19 outbreak, according to the data. All remaining counties in the state -- excluding Schoolcraft County -- are at severe risk for a COVID-19 outbreak in both the upper and lower peninsulas.

A map of Michigan counties and their assigned COVID-19 risk levels from research led by Covid Act Now. Risk levels have been assigned to all Michigan counties by the group. Photo courtesy of Covid Act Now's website. (Covid Act Now) -- Nov. 28, 2020 (Covid Act Now)

With holiday season upon us, experts are urging Americans not to travel and not to celebrate with anyone outside of their immediate household in an effort to slow the spread of coronavirus.

Promising COVID-19 vaccines are nearing approval in the U.S. and beyond, but no such vaccine is available for public use yet. For now, to best prevent the spread of the virus, the CDC recommends that people continue to wear face coverings in public spaces, maintain at least six feet of distance from others, avoid large crowds and frequently wash their hands.


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