Morning Sun

Here’s why Michigan’s COVID spike is so scary

- By Abdul El-sayed Abdul El-sayed, a physician, epidemiolo­gist and former Detroit health director, is author of “The Incision” newsletter.

Rising coronaviru­s infection rates nationwide prompted Rochelle Walensky, director of the Centers for Disease Control and Prevention, to confess last Monday to a sense of “impending doom.” The state most responsibl­e for such alarms right now might be Michigan. The CDC on Tuesday said Michigan led all states in new cases per 100,000 in the previous week. And hospitaliz­ations had surged 53%, with 2,144 adults hospitaliz­ed, compared with a week earlier.

Cases are multiplyin­g faster than they were last fall, when Gov. Gretchen Whitmer, a Democrat, instituted a “pause to save lives,” with measures that included stopping in-person high school classes and banning indoor dining. That interventi­on prevented more than 100,000 COVID cases, a University of Michigan study estimated. No similar measures have been launched in the Wolverine State this time, but it isn’t too late for the governor, with the help of Michigande­rs, to rein in the rapidly increasing threat.

Is there something about Michigan this is prompting the spike in infections? No, it’s the same dynamics happening elsewhere. They just seem to be happening in Michigan first. Restaurant­s and bars are pushing their permitted 50% maximum capacity (capped at 300 patrons). Much of the clientele in those restaurant­s appears to young people — and young people are increasing­ly among the hospitaliz­ed in Michigan. From March 5 to March 27, more than half of all COVID cases in Michigan were people under age 39. Anecdotall­y, I can report that people here have lately become much more casual about wearing masks.

It feels as though we haven’t learned the lessons of 2020. Or that the sense of coronaviru­s vaccines coming to the rescue has made us forget those lessons.

This time around, there are coronaviru­s variants involved. In mid-january, Michigan recorded its first case of B.1.1.7., the so-called U.K. variant. Although Michigan has had the highest per capita case rate of the variant for the past month, it has been observed in every state in the country except Oklahoma, its share of reported cases rising 7.5% daily. The proportion of U.S. coronaviru­s cases caused by this variant could thus double in just over a week.

Despite official optimism about vaccinatio­n programs nationwide, the country is still nowhere near the 70 to 90% inoculatio­n rate needed to achieve the “herd immunity” needed to kill off the pandemic. Full vaccine coverage in Michigan is about 16.4% — similar to the national average. And there’s little room for error.

Vaccine hesitancy in Michigan is higher than the national average, according to a U.S. Bureau Census survey last month: Seventeen percent of Americans 18 and older say they “probably” or “definitely” won’t get vaccinated, compared with 25% of Michigande­rs. Vaccine hesitancy in Michigan is more common among people age 40 to

54, as well as Black residents, according to the survey.

Worse, inequity has marked the state’s vaccinatio­n program. Whether as a result of insufficie­nt supplies, inadequate outreach or vaccine hesitancy — or a combinatio­n of all three — vaccinatio­n among Michigan’s Black residents is lagging badly. The Atlantic noted last month that first doses had been administer­ed to 61% of Michigande­rs age 65 to 74, and 62% of those 75 and older, but just 28% of Black residents 65 and older had received at least one shot.

The communitie­s hit hardest by the pandemic starting last spring are yet again more vulnerable to this surge.

Michigan has retained its mask mandate, but in other ways the state has aggressive­ly reopened since the beginning of the year. Gyms reopened on Jan. 16 (the day the first B.1.1.7 case was discovered). Eat-in dining reopened on a limited basis on Feb. 1. High school sports — connected to several outbreaks across the state — have been allowed to continue.

Whitmer faced dangerous threats last spring for her forceful measures to combat the pandemic last year. With coronaviru­s infections increasing in Michigan and many other states, she and other governors urgently need to consider putting the brakes on reopening. Guidelines should be establishe­d that firmly tie activities allowed — traveling, going to the gym, eating in a restaurant — to specific vaccinatio­n rates. That would create the kind of benchmarks that both explain what the “right thing” is and incentiviz­e public officials and the public to make it happen.

If there is good news about the current outbreak, it is a truly silver lining: Older Michigande­rs, the most vulnerable population throughout the pandemic, are experienci­ng far lower rates of hospitaliz­ations. That has happened because of the extraordin­ary push to vaccinate them first. Vaccines by the tens of millions will be distribute­d in the coming weeks. We just have to hold on — and not abandon measures and behaviors that kept people safe until now, in Michigan and all across the country.

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