Current COVID-19 Surge Predicted to Last Another 2 Weeks, Then Flatten as Vaccinations Take HoldApril 21, 2021
April 20, 2021
- Positivity rate drops from seven-day average of 17.9 percent to 13.2 percent on April 18
- Michigan reported nearly 794,000 COVID-19 cases and logged more than 16,900 deaths
- 31% of Michigan residents ages 16 and older have been fully vaccinated
Experts are predicting the ongoing third surge of COVID-19 hospitalizations, deaths, and positive cases in Michigan could last another two weeks before leveling off as vaccinations take hold.
This week, Michigan’s COVID-19 positivity rate dropped from a seven-day average of 17.9% on April 6 to 13.2% on April 18, lower than the December peak of 16%.
Michigan has reported more than 793,000 COVID-19 cases as of April 18 and logged more than 16,900 deaths. The state says 31 percent of Michigan residents ages 16 and older have been fully vaccinated, or 2.5 million, with 280,000 in the week ending April 18.
Based on predictive modeling analysis by Henry Ford Health System, “we anticipate that this current surge of hospitalizations may continue for another two weeks, and then we will begin to see a plateau,” said Bob Riney, the Detroit-based health system’s COO and president of hospital operations.
Michigan Medicine’s Dr. Vikas Parekh, the academic system’s associate chief medical officer, said statewide data on hospitalization trends show a possible beginning of a flattening of COVID-19 numbers.
“We see ourselves on what I kind of call a wobbly plateau. What I mean by that is hospital census have been relatively stable around the range of 4,000 or so, but not rapidly accelerating,” said Parekh, who also is associate chief clinical officer medical services for Michigan Medicine’s adult hospitals in Ann Arbor.
“In (February-March) we were going up 50% a week, then that slowed down to 25% two weeks ago,” he said. “This most recent week, statewide, the census only grew about 5 to 6%.”
Over the next week, if hospital admissions and discharges hold steady, Parekh said there is a good chance Michigan could be on a plateau or fast approaching one.
“We need to see a few more days of declining admissions before I say we’re kind of coming down the other side of that plateau,” Parekh said.
Lynn Sutfin, a spokesperson for the Michigan Department of Health and Human Services, said state epidemiologists use state COVID-19 data through two models (covidestim.org and epiforecasts.io).
“The models are picking up that cases in Michigan are not increasing at the same rapid rate we saw in early/mid-March,” Sutfin said in an email. “But the models are not able to forecast yet whether that means we are in a period of slower growth, a plateau, or a decline.”
Earlier this week, Gov. Gretchen Whitmer, who has resisted calls the past two months to increase business restrictions, said Michigan could be seeing a drop in COVID-19 infections.
Despite calls from some physicians for tougher actions to contain community spread, Whitmer has been relying on vaccinations, masks, and social distancing instead of stiffer measures that has placed Michigan as a national hot spot the past month.
“We are starting to see, you know, the beginning of what could be a slowdown, which is welcome,” Whitmer said on NBC’s “Meet the Press” on Sunday. “But what also is welcome is we’ve gotten a lot of help from the Biden administration to surge some therapeutics here, get some boots on the ground, and I think all of these things are really going to be important to us stemming the tide of what we’re seeing.”
Sutfin said the recent spike in COVID-19 cases in Michigan can be attributed, in part, to more contagious coronavirus variants, including the primary United Kingdom B.1.1.7.
“All of these factors threaten our progress in control of the epidemic and MDHHS continues to monitor data closely including three key metrics: case rates, percent positivity, and hospitalizations,” she said.
Parekh said the rise in COVID-19 hospitalizations is definitely slowing. “The past week, day to day, there were days where it went up a little bit, then went down a little bit, then it came up a little bit, but the variation is very, very small,” he said. “There were some ups and downs in that zone of 4,000 to 4,200 (patient hospitalizations). So that’s kind of what I mean by why we plateau. It’s no longer accelerating.”
John Karasinski, director of communications with the Michigan Health and Hospital Association, said data shows slightly declining COVID-19 emergency department visits and daily inpatient admissions the past week also indicate the current surge may be plateauing.
“We are optimistic this is an indication we will see a reduced burden placed on hospitals,” Karasinski said in an email. “However, we still have a large number of COVID-19 patients in our hospitals and with the presence of more contagious variants, hospitals and health care workers still need the public’s help in following proven preventive measures that include masking, social distancing, washing hands, and receiving a vaccine.”
Based on previous COVID-19 surges and declines, Parekh said there are two reasons COVID-19 surges slow.
“One, there either is a hard intervention, a lockdown, or some sort of version of a lockdown,” he said. “When that happens, usually you see a kind of decline curve, and that impact happens over a period a couple of weeks, then growth decelerates pretty quickly.”
The second reason is what Parekh called a “topping out phenomenon,” which essentially is when a pandemic gets to its potential maximum size in a region, county, or city.
“It has hit a maximum number of people you can infect,” he said. “That’s my suspicion of what we’re seeing right now, a topping out phenomenon. If that’s true, we should see early signs where certain communities will plateau.”
For example, Michigan Medicine’s modeling data shows the state’s Thumb region starting to show declines in COVID-19 hospitalizations, Parekh said. St. Clair and Macomb counties also have reached peaks and are seeing declining cases, he said. However, some regions in western and southwestern Michigan are still showing high numbers.
“Part of it is vaccinations. It’s our race. As we vaccinate more people, we limit the potential maximum size,” he said.
Dr. Mark Hamed, director of emergency and hospital medicine at McKenzie Health System in Sandusky, said the next two weeks will determine which way hospitalizations and acuity of cases goes for the next month.
“This past week alone in Sanilac County we received hospital notifications that we lost five people, three of whom were greater than age 60, one in 30s who was hospitalized for a month, and one in 40s. Each of those is hitting the community hard and I pray it makes them really shift behaviors even more, we need it up there.”
Dr. Jeffrey Band, an infectious disease doctor in Royal Oak, said the data he has seen indicates to him another two to three weeks of the current surge before a plateau is reached.
“I will be very interested in what is decided on the Janssen (Johnson & Johnson) vaccine,” Band said. “It sounds as if will restart but possibly with caution or restriction in women in child-bearing age. … The Astra Zeneca vaccine I do not believe will ever be approved in the U.S. (because rates of serious thrombosis are five times rate of Janssen vaccine).”
Sutfin said Michigan has increased its vaccine program the last several weeks, allowing the state to hit the historic milestone of 6 million vaccine doses administered in four months.
“The most important thing people can do is to get the safe and effective COVID-19 vaccine to protect themselves and their families, and help us eliminate this virus once and for all,” Sutfin said. “As vaccination is now open to all Michiganders, we urge everyone 16 and older to make their appointment to be vaccinated as soon as they are able. “
Riney said bed occupancy remains in the 90-plus percent range with Henry Ford Macomb Hospital treating the most COVID-19 patients within the six-hospital system.
“We are flexing our capacity to make certain that we can meet the needs of all of our patients, including those non-COVID patients who come to us for outpatient or hospital care,” said Riney, adding that personal protective equipment supply is stable.
“Staffing continues to be our biggest worry, we continue to redeploy those working in nonclinical areas to support the clinical areas. Our workers are exhausted, but if you get to know any of them, they are incredibly resilient.”
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