Has Michigan Finally Solved Its COVID-19 Testing Issues?
Michigan’s biggest flaw in handling the COVID-19 pandemic has been its poor testing rate.
Now, just when it looked like that rate might delay any chance of a safe reopening, they may have gotten the stalled testing program into gear.
For more than a month, as Michigan’s death toll climbed higher than any state outside the New York metropolitan area, the state couldn’t even match the anemic national testing rate.
This week, after more than 3,000 deaths,that may have finally changed. On April 22–23, the state carried out 15,523 tests — their highest two-day total since the pandemic began. On the 22nd, there were 7,368, surpassing the previous high of 7,308 on Monday, March 30, and that jumped to 8,155 on the 23rd.
Michigan’s goal is twice that level — on Friday, a release from the state health department cited a Harvard study calling for more 15,000 tests a day before the state could safely reopen.
“MDHHS would like to see 15,000 tests completed daily in Michigan per recommendations by the Harvard Global Health Institute, which published a recommendation of 152 tests per day per 100,000 population to begin to re-open the United States. That level of testing is necessary to identify the majority of people who are infected, and isolate them from people who are healthy, according to the Harvard researchers.”
For most of April, though, the idea of Michigan even managing 15,000 tests in a week seemed like a fantasy.
The state’s first two cases were reported on March 10, leading Governor Gretchen Whitmer to immediately declare a state of emergency. Large gatherings were banned on March 13, which was also the last day of operation for the state’s education system. Many businesses, including bars and restaurants, were already closed before the state’s first death on March 18 and Whitmer’s “Stay Home, Stay Safe” order shut down all non-essential business on the 24th.
Those moves undoubtedly saved lives, and it appeared the state would also quickly put together a massive testing program. Most cases were located in the southeastern part of the state, home to four large health-care groups: University of Michigan, Henry Ford, Beaumont and the Detroit Medical Center.
On Monday, March 30, the state performed 7,308 tests — the most it had done on any day — but things had already started to go wrong.
Whitmer angered Donald Trump by calling for a more robust federal response to the crisis, and on March 27, she claimed vendors were “being told not to send stuff to Michigan.”
As usual, Trump fired back on Twitter, then announced at his daily press briefing he had told Vice President Mike Pence not to call Governor Jay Inslee of Washington and “the woman in Michigan.”
The struggle for federal supplies — something Whitmer still cited as a problem in late April — derailed Michigan’s testing efforts. After more than 7,000 tests were performed on March 30, there were only 4,406 the next day and the state spent crucial weeks without coming close to 7,000 again.
During that stretch, with testing limited to people already showing symptoms, Michigan suffered more deaths than any state other than New York, New Jersey and Louisiana. Its case fatality rate (CFR) — the death rate among confirmed cases — is still at 8.4%, the highest in the United States.
The situation reached a low point in the first week of April. With statewide test numbers hovering around 5,000, more than 40% were coming back positive — as high as New York and only trailing New Jersey. The situation was even worse in Metro Detroit. The northern suburbs — Oakland, Macomb and St. Clair Counties — were seeing positive rates in the high 40s while Wayne, Washtenaw and Monroe counties were approaching 60%.
All those positive tests resulted in a wave of patients that threatened to overwhelm the new COVID-19 ICUs in area hospitals.
“Every day, it was just more and more and more,” one doctor said. “It never slowed down.”
In the first six days of April, the state averaged 1,988 positive tests despite the drop in overall testing. That drop continued throughout the first half of the month, with only 3,103 tests performed on April 11. That was the Saturday of Easter weekend, when test numbers would naturally low — but the ensuing week only saw a rebound to 6,031 tests on Friday, April 17. That’s when the Harvard study found states needed to be testing at least 1,540 people per million citizens every day if they wanted to safely end lockdowns. For Michigan, that meant just over 15,000 tests a day, seven days a week.
With Michigan’s daily deaths and hospitalization numbers slowly improving, the weak testing system was the biggest hurdle the state faced if it hoped to regain some normality in May.
However, there was one bit of good news, though. On April 17, those 6,031 tests only returned a 17% positive rate — the lowest in over a month. The test numbers dropped again over the weekend, but the record 14,362 tests on Tuesday and Wednesday came with another 17% positive rate. On the same two days, Detroit’s northern suburbs had a positive rate of just 23%, while the city and its southern neighbors were down to 22%.
The battle is far from over. On April 19, Whitmer said the state could perform and process tests at double or triple the current rate — enough to reach Harvard’s recommendations — but were still being hampered by a lack of supplies from the federal government. Coming just two days after Trump tweeted “LIBERATE MICHIGAN!” in support of protesters who had shut down Lansing, it still isn’t clear if Whitmer’s nationally televised remarks will cause another presidential tantrum.
After all, Trump should logically be supporting Whitmer against the protesters — Michigan doesn’t come close to meeting the reopening criteria laid out in his own report — but intellectual stability has never been one of his strengths.
According to COVID Exit Strategy, Michigan ranks second in the nation in effective interventions by the state government, trailing only tiny Rhode Island. The one flaw, of course, is the lack of testing.
That’s borne out by the state’s own statistics: the number of critical-care cases has dropped by 26% since April 12 and is down 30% in Metro Detroit. There are also available ICU beds and ventilators in every section of the state.
On April 24, Whitmer extended the state’s stay-at-home order until May 15. That gives Michigan three weeks to reach the criteria generally accepted as the pillars of a safe program to begin lifting lockdowns — a steady, unbroken decline in deaths, confirmed cases and hospitalization numbers, the ability to protect essential workers, especially medical professionals, and the testing and tracking capacity to quickly isolate any new COVID-19 clusters.
The statistics are already headed in the right direction and the state has begun testing all essential workers regardless of symptoms. That leaves the testing-and-tracking system, which starts with the high levels outlined in the Harvard study.
For the first time in April, it looks like they might have a chance.
(UPDATE: Michigan surpassed 10,000 tests for the first time on April 29, testing 10,452 people with an 11.6% positive rate.)