On that day, Whitmer stood in front of an outdoor podium on Belle Isle. Unlike dozens of previous briefings, this one took had a celebratory vibe.
“We are now dropping the (epidemic) orders,” Whitmer said. “Effective today, there is no more mask or gathering order. Effective today, there are no more capacity limits -- indoors or outdoors. Effective today, our Pure Michigan summer is back, and we can realize it.”
It’s been 92 days since she said those words, and the pandemic is far from over.
Here’s how the COVID situation has changed in Michigan over the last three months.
COVID cases skyrocket
“We are now at the lowest case rate that we have seen since this pandemic started,” Khaldun said.
That day, she reported the state was under 18 cases per million people, and the percent positivity was under 2%.
In the three months since, both of those numbers have risen dramatically.
As of last week, when MDHHS last updated its metrics, Michigan is at 173.1 cases per million people. That case rate has been increasing for two and a half months, officials said.
The percent positivity is up to 9.7% and has also been increasing for two and a half months.
Just hours after Whitmer’s briefing ended on June 22, Michigan reported 91 new COVID cases and 15 additional deaths. It was the first time Michigan had announced fewer than 100 cases in a single day since June 15, 2020.
Fast forward to the present: On Monday (Sept. 20), Michigan announced 7,185 new COVID cases and 35 virus-related deaths across three days -- an average of 2,395 cases per day. The state has twice announced two-day totals over 6,000 this month.
The delta variant was a concern in June, but now, it’s the predominant form of COVID in Michigan and many other locations.
Khaldun said June 22 that delta was accounting for 10% of COVID cases in the United States.
Michigan epidemiologist Dr. Sarah Lyon-Callo spoke in mid-August to express her concerns about rising COVID cases, and she said the more contagious delta variant is making up the majority of COVID cases in the state.
“It’s making up 99% of the samples that we had available for sequencing in the last four weeks,” Lyon-Callo said on Aug. 18.
In the five weeks since, delta has become even more predominant.
Michigan had administered more than 9 million doses of the COVID vaccine as of June 22, with 61.2% of residents 16 and older having received at least one dose.
About 52.5% of residents 16 and older were fully vaccinated at the time.
In the three months since, Michigan has seen its number of total doses administered rise to 9.8 million, and 67.2% of residents 16 and up have received at least one dose. About 58.4% of residents are fully vaccinated.
‘High’ community transmission
For more than a month, Michigan has been categorized by the Centers For Disease Control and Prevention as being under a “high” level of community transmission. This means the CDC recommends mask wearing by everyone indoors, regardless of vaccination status.
Of Michigan’s 83 counties, 75 are individually categorized as being under a “high” level of transmission.
Only eight counties are still categorized as “substantial,” meaning they are below 100 weekly cases of COVID per 100,000 population.
COVID vaccine sweepstakes
One of the biggest stories throughout July was the Michigan COVID vaccine sweepstakes, an attempt by Whitmer’s administration to incentivize residents to get vaccinated.
Anyone who received a vaccine in July or previously was eligible for two grand prizes of $1 million and $2 million. In addition, one person who was vaccinated on each day in July won a $50,000 daily prize.
Nine scholarship drawings were also announced for children between the ages of 12-17 who were vaccinated.
The number of new COVID cases dropped so low at the end of June and into July that the state stopped reporting new totals every day.
On July 2, after reporting 101 new cases and no deaths, MDHHS announced it would only report data on Tuesdays and Fridays.
That didn’t last long. On Aug. 6, after announcing 3,962 new cases across three days, MDHHS upped the releases to three times a week: Mondays, Wednesdays and Fridays.
Six weeks later, that’s still the COVID data release schedule.
Canada reopens border
Almost 18 months after Canada closed its borders to Americans due to the pandemic, fully vaccinated residents were allowed to cross, starting Aug. 9.
Americans who want to cross the border must prove they’re fully vaccinated, show documentation of a negative test result within three days before crossing and register on the arriveCAN app.
The U.S.-Canada border had been closed to nonessential travel since March 2020.
While COVID cases were on the rise in early August, MDHHS released updated COVID safety guidelines for students returning to in-person learning.
“We are committed to ensuring Michigan students and educators are safe in the classroom, including those who may not yet be vaccinated,” Khaldun said. “MDHHS is issuing this guidance to help protect Michiganders of all ages. We continue to urge all eligible residents to get the safe and effective COVID-19 vaccine as soon as possible as it is our best defense against the virus and the way we are going to end this pandemic.”
Among the recommendations were correct mask use, physical distancing, testing, ventilation and staying home when sick.
MDHHS came out nearly two weeks later and “strongly recommended” schools require universal masking.
“Because many students have yet to be vaccinated and students under age 12 are not yet eligible, layered prevention measures, including universal masking, must be put in place for consistent in-person learning to keep kids, staff and families safe,” an MDHHS release says.
School mask debate
When she joined Lyon-Callo’s virtual presentation on Aug. 18, Khaldun was peppered with questions about the state’s lack of a school mask mandate.
During her 24-minute presentation, Lyon-Callo said places that have issued mask mandates since the delta surge began have seen a slower rate of increase in COVID cases than those that have not issued new mandates.
“While other factors could have also contributed, jurisdictions with mask mandates tended to experience slower spread of COVID-19 during the delta surge thus far,” she said.
Lyon-Callo specifically referenced masking in schools, showing data that emphasized the importance of prevention measures for children under 12 years old because they aren’t eligible for the COVID vaccine.
As a result, Khaldun was asked, point blank, why MDHHS wouldn’t require masks in schools if that type of mandate could keep children safer.
“We do understand that there currently is a law that would allow us to be able to implement that mandate, but at this time, (Gov. Gretchen Whitmer) and (MDHHS Director Elizabeth Hertel) have not made that determination,” Khaldun said.
“I have recommended that if a mask mandate were in place and it were followed, it would likely decrease the spread of COVID-19 in schools.”
The state has not mandated masks in schools, instead relying on individual school districts to do so on their own.
Detroiters told to wear masks
Detroit health officials issued a widespread recommendation in mid-August that everyone wear masks indoors, even those who were fully vaccinated.
City officials cited a rise in COVID cases and hospitalizations.
“We are encouraging Detroiters to mask up indoors out of an abundance of caution,” Chief Public Health Officer Denise Fair said. “We want everyone to stay safe and healthy. Gather outdoors instead of indoors when possible. Stay home if you are sick. Get tested if you are experiencing symptoms.”
Officials said the updated recommendation was issued in large part due to the rapid spread of the delta variant.
Hospitals prepping for fourth surge
Geneva Tatum, MD, the associate division head of pulmonary and critical care medicine at Henry Ford Health System, said she is worried about a fourth COVID surge in Michigan.
“We are all deeply concerned that we are going to have a fourth surge,” Tatum said. “We have seen the devastating effects that this virus has taken on the human body, including those who were otherwise healthy when they came into the hospital and thought that they didn’t have to worry about being affected or infected by COVID, and thought that even if they did get infected that they’d have a relatively brief or low-symptom course. But even those patients, we’ve seen devastating consequences of COVID-19 disease, and all too often, too many patients who did not survive.”
Tatum said she has spoken to many unvaccinated patients who are still convinced, 18 months into the pandemic, that they are healthy enough to beat the virus.
“Too many people, unfortunately, continue to rely on this information and disinformation that we’ve seen has drastic and deadly consequence,” Tatum said.
Michigan hospitals are starting to see staffing shortages as hospitalizations due to COVID increase, primarily among unvaccinated residents.
“Staffing shortages that are happening all around the state have us strained, as well,” Tatum said. “We are losing our sense of hope that we would be able to end this pandemic faster when we started our vaccination roll-out many, many months ago.”
Medical ICUs have not returned back to their normal patterns and volumes of patients, Tatum said. She’s concerned that we haven’t yet made it through to the other side of the pandemic.
Early-career doctors and doctors in training have been greatly challenged by the COVID pandemic. Tatum said they’re seeing many patients their same age and struggling to make inroads and helping younger patients recognize that they are at risk.
“They recognize how patients’ beliefs impact treatment plans and how they follow recommendations, and it’s challenging for them to help them understand and help their patients, more importantly understand, what science is teaching them, and talk to them in a constructive way,” Tatum said.
The strain of a fourth surge could be a tipping point for all of Michigan’s health systems, according to Tatum.
COVID affecting productivity of workers
Bill Kimble, the president of C2AE, a company that provides architecture and engineering consulting services to government, education and manufacturing clients, said the pandemic is greatly affecting the productivity of Michigan workers.
“What we’ve seen over the last 18 months is that stress level go up and a productivity level go down,” Kimble said.
That productivity decrease has been one of the greatest challenges for businesses throughout the pandemic, he said.
“In the architecture and engineering world, we rely heavily on collaboration between members,” Kimble said.
Hospital official’s powerful message about vaccines
Nicole Linder, MD, chief hospitalist at OSF St. Francis Hospital & Medical Group, delivered some powerful and passional remarks about struggling to treat unvaccinated COVID patients.
“I am fatigued and I am heartsick and I’m tired of watching people suffer needlessly and die of a disease that could have been prevented by a simple and safe and effective vaccine,” Linder said. “I don’t want to watch my patients’ families suffer with the grief of this, and also the guilt if they played some role in their family member’s decision not to be vaccinated.
“The issues that we’re dealing with in caring for these hospitalized COVID patients that weren’t present during the earlier waves, I think, do create a new dimension of stress and sadness and fatigue for those of us on the front lines. You’re taking care of people who are dying that didn’t need to die.”
She said this wave of COVID cases has been very different at St. Francis Hospital because employees know that the vast majority of COVID patients are there because they refused to get vaccinated.
“The difference is that nearly all of the patients that we’re caring for made the choice to not be vaccinated,” Linder said. “We’ve seen very few vaccinated patients in the hospital -- less than I can count on one hand. (No vaccinated patients) have been very critically ill. None of them have died of the disease during our time with them.”
Vaccines for children
Health officials are still working toward receiving authorization for vaccines to be used on children younger than 12 years old.
Pfizer announced Monday (Sept. 20) that clinical trials show its vaccine is safe for children ages 5 to 11.
Health officials are still waiting on the full results from the clinical trial to be released. The data has not been peer-reviewed or published.
Pfizer’s clinical trial included 2,268 children ages 5 to 11. Two-thirds of the children received two doses of the actual vaccine three weeks apart and the rest received two doses of a saltwater placebo.
“We looked at several doses early on in children and determined that one-third of the adult dose works just right for children to minimize the potential side effects and provide the potential for protection,” said Dr. Bill Gruber, the Pfizer vaccine clinical research and development senior vice president.
Unlike the adult trials, researchers didn’t follow the children in each group to see how many got COVID. Instead, they looked at the level of antibodies they produced after being vaccinated. They found the level matched those found to protect against COVID in those age 16 and older.
Side effects were similar to those seen in teens and adults, including fever, headache, and fatigue. Pfizer said children who received the one-third dose showed fewer side effects after the second dose than in older age groups.
Pfizer plans to submit the data to the FDA by the end of September. The FDA will then need several weeks to review it and present it to its outside panel of advisors before an emergency use authorization could be granted.
Pfizer expects data on children ages 6 months to 4 years old before the end of the year.
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