Michigan is not ready to declare victory over COVID-19

source: PhotosByMahin via Pixabay

Not yet, Michiganders.

This is still a siege and the coronavirus is still at the gates. We have done an admirable job of patching the walls and flushing out raiding parties, but if we drop the portcullis and lower the drawbridge in the next few weeks, we are going to be overrun once again.

I know the GOP is threatening to end the lockdown on May 1, but we are not ready. That is not just my opinion — it is the opinion of doctors and epidemiologists across the country.

There have been many posted models that provide criteria states should reach before they start the slow process of returning things back to normal.

One constant is a steady decline in the rate of new COVID-19 cases. A study by the American Enterprise Institute (AEI) suggests at least 14 straight days of declining case numbers as the first benchmark on the way to a safe reopening, and Michigan is getting close.

According to the state’s database, the onset of new cases peaked on April 6 with 1,259 and was down to 628 on April 21. It has not been a smooth downward slope — test rates are still too erratic — but the graph has consistently trended in the right direction. The only exception came in mid-April when a slight uptick in Wayne County caused the state’s numbers to flatten out for a few days.

However, a steady decline is only the first hurdle the state needs to clear. Every road map to normality stresses the ability to do massive amounts of testing and contact tracing. A Harvard report estimates Michigan will need about 15,000 tests/day to have a strong enough grip on the disease to consider relaxing physical distancing. For various reasons, the state and federal governments have failed to get Michigan close to the needed levels. The best day thus far was March 30, when 7,308 tests — less than halfway to the goal — were administered. In the past two weeks, the average has barely broken 4,000, with a low of 3,049 on Sunday, April 19.

The state has dropped most of the barriers needed to get a test — any essential worker can be tested, as can anyone with mild symptoms — and Governor Whitmer is confident they have built out enough lab capacity to handle 15,000 tests a day. The problem, as it has been throughout the pandemic, is the inability to get enough complete test kits.

“We have the capacity to double or triple the number of tests that we’re doing, but we need some of these supplies,” Whitmer said on Sunday. “If the federal government would use the Defense Production Act and say ‘we’re going to make every swab people need and we’re gonna expedite creation of the reagents,’ we would be able to know how prevalent COVID-19 is.”

That step is the key to the process — Whitmer cannot safely reopen the state until tracking teams can find quickly find cases, isolate the carrier and track down their contacts. South Korea did a better job than any other country at containment, because they did massive amounts of testing, isolated anyone who came back positive and got their contacts into quarantine for either 14 days or until they tested negative.

At Michigan’s current testing levels, that plan would fail — too many carriers will slip through the net to safely allow people to congregate again. At some point, a political compromise will have to be reached to get supplies flowing smoothly from the federal government to the states. The Harvard study found only one state was testing at the levels needed — Rhode Island.

The state does have another key part of the testing system in place — the ability to test all essential workers even if they have shown no sign of illness. If there is a sudden outbreak among delivery drivers, grocery workers or truck drivers, our already fragile supply system would come to a complete stop.

Michigan has also made significant progress on the third pillar in AEI’s plan for moving to Phase II — the ability to treat coronavirus patients without moving back into crisis mode. As of Wednesday, every part of the state had enough beds, negative-pressure isolation rooms, ICU beds and ventilators to handle the current patient load. At the peak of the first wave, ventilators were the biggest problem, but 66% of the state’s supply is currently unused, including 54% in metro Detroit. If testing and tracking reaches the suggested levels, the load on hospitals should be significantly less than it is now.

Of course, moving to Phase II of the AEI plan does not mean Comerica Park, Little Caesars Arena and the Fox Theatre will be filling back up. While most business will be allowed to reopen, there would still be a ban on gatherings of more than 50 people and teleworking should continue if possible. Schools would be allowed to start their school year in the fall, although with increased hygiene and attempts at basic physical distancing.

In Tomas Pueyo’s brilliant essay “Coronavirus: The Hammer and the Dance”, that is the point on the timeline where we gracefully dance along the line between reopening society and allowing a second outbreak to take place. There might be times where we must take a few steps back to cool off growing hotspots, but the idea is to slowly reach a state where carriers are quickly isolated and their contacts can be tested to rule out infection. Taiwan and Hong Kong have had similar success to South Korea while Japan and Singapore are dealing with isolated pockets of infection.

Make no mistake, Michigan has had to climb a long way to even consider when they might start opening for business. We have a death rate of 8.3% among confirmed cases — the highest in the country and only a few points behind the hardest-hit Western European nations — and we are sixth in the nation with 281.3 deaths per million inhabitants. To make things worse, the ongoing supply issues mean the state has fallen back behind the national average in per-capita testing.

Still, cases are declining and deaths appear to have peaked. The number of patients in critical-care units has dropped 15% in the last 10 days while patients on ventilators are down 25%. The numbers from Metro Detroit are even better, with critical-care patients dropping 18% and patients on ventilators down 26%.

Things are headed in the right direction, but Michigan cannot move forward without a vastly improved testing-and-tracing program. That will require more assistance from the federal government — something in short supply these days.

Things are headed in the right direction, but Michigan cannot move forward without a vastly improved testing-and-tracing program. That will require more assistance from the federal government — something in short supply these days.

Freelance writer and data scientist in Metro Detroit. Covered pro sports for NHL.com and the Associated Press before COVID-19. Mentally ill and not ashamed.

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