COVID-19 cases post-holidays: an uptick that is steadying
Michigan — so far — has not seen a large spike in COVID-19 cases since the winter holidays.
“While I am concerned about the slight uptick in cases after the holidays, we are not seeing the surge of hospitalization that we saw in the beginning of November,” Michigan’s chief medical executive, Dr. Joneigh Khaldun, said at a press conference Jan. 13.
Dr. Khaldun raised her worries about the holiday impact during a Jan. 8 conference, pointing out that the percent positivity (percentage of COVID-19 tests that come back positive) had increased since December 27. The declines the state was seeing before the holiday seemed to be “reversing,” she said.
In the recent update, Dr. Khaldun had slightly heartening news: While the case rate and positivity have both risen since the end of December, they both now appear to be plateauing. However, she said the state will be watching the numbers closely.
Statewide percent positivity as of Jan. 13 was 9.1%, according to Dr. Khaldun. She said half of Michigan’s regions’ positivity rates are over 10%.
The fatality rate has, however, increased by .1 percentage point — it had been 2.5% consistently in the beginning of December. And January has so far seen a high number of daily deaths. January’s 7-day average for deaths peaked on Jan. 8 at 128 deaths, matching the high 7-day averages in December, but has since declined to 91 deaths.
Dr. Khaldun also said hospitalizations were high but decreasing — although the rate of decline has slowed.
“So overall, we are in a much better place with our numbers than we were in the beginning of November,” Dr. Khaldun said. November had been a difficult month for Michiganders: The month started with 178,180 confirmed coronavirus cases and ended with 360,449 cases.
Many experts rely on a 7-day average to judge the trajectory of COVID-19 cases. Currently, Michigan is doing better compared to other states.
Ryan Malosh, an assistant research scientist at the University of Michigan School of Public Health, said there are multiple factors at play that affect case rates.
“It’s really hard to pinpoint one exact cause of a specific trend in the data,” he said. “There’s a combination of things that we've been doing that have worked to drive the case counts down.”
The statewide pause
Dr. Teena Chopra, an infectious disease specialist at Wayne State University and physician at the Detroit Medical Center, said the United States as a whole is seeing a surge after the holidays — something to be expected since millions traveled in a week, she said. Chopra said the travel did impact the cases and deaths in Michigan, but the pause helped the state greatly.
The pause she is referring to is the set of restrictions Michigan placed on indoor gatherings mid-November.
“The one good thing in Michigan is that the (indoor) dining was closed down and schools were closed during the holidays, which may have kept some sort of normalcy in helping us with managing the hospitalizations, unlike California, which is badly surging,” she said.
Michigan has the lowest cases per 100,000 among its neighboring Midwestern states, according to Michigan Department of Health and Human Services director Robert Gordon. He attributed this to the pause.
Gordon said before the pause in November, Michigan’s case rate was higher than Ohio’s and was going up. However, after the pause, Michigan’s case rate had the lowest post-holiday peak among its neighboring states: Illinois, Ohio, Indiana and Wisconsin. The next best, he said, was Illinois, which has similar restrictions in place.
“Because of the actions we have taken, we have avoided thousands of COVID cases and there is every reason to believe we have saved hundreds of lives,” Gordon said.
Travel and contact
Another factor could be that some Michiganders decided to stay home.
According to the Michigan Department of Transportation, traffic on Christmas Day was down 34% compared to last year, and down 33% New Year’s Day. Christmas week did see an increase in average daily traffic volumes, according to MDOT. A representative said some of the increase could be due to the Dec. 21 epidemic order that allowed for recreational and entertainment facilities to reopen.
“It’s all about contact,” Malosh said, explaining that mobility does decrease during the holidays because people are also not going to work.
The holiday season, he said, sees increases and decreases of interactions: more people are gathering indoors but fewer people are going to work and doing daily tasks like going to the grocery store.
“So maybe it ends up being sort of a wash, and that kind of is playing out in this little plateau that we’ve had where our decrease kind of stopped, maybe bumped up a little bit, and now we've kind of leveled off, particularly in the percent positivity rate,” he said.
Malosh said some of the numbers show that some Michiganders were limiting their gatherings or keeping them small. He points to cases in other parts of the country, or the world, that have been skyrocketing after the holidays.
“And they are sort of on this almost vertical trajectory following the holidays,” he said. “And the fact that we don't see that here, so, it's a lot about the efforts that people did to reduce the risk of transmission.
“The people in Michigan deserve a lot of credit for listening to public health authorities.”
The numbers are still too high for health experts like Chopra and Malosh, especially with news of a more contagious strain of coronavirus in the country that has yet to be recorded in Michigan. (Only two labs in the state are currently looking for the virus.) Higher case rates can also interfere with the vaccine rollout, said Malosh.
As of Jan. 14, Michigan has 531,004 confirmed coronavirus cases and 13,672 confirmed deaths.
“If we sort of relax everything and open back up … we're likely to see an increase in cases and then in hospitalizations and deaths, just like we saw in the fall,” Malosh said.
“The fact that Michigan is doing mass vaccination … and the governor has opened up vaccination for older adults, teachers and other high risk individuals -- I think those are all positive signs,” Chopra said.