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Health

No, COVID isn't endemic yet. But Michigan is at a turning point.

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With COVID hospitalizations the lowest they've been in months, infectious disease experts agree there's room for "cautious optimism." But if we're going to avoid another big surge, then these next few weeks and months are crucial.

For the first time in recent memory, Beaumont Health infectious disease chief Dr. Matthew Sims had a day this week when he didn’t personally see any new COVID patients. He only had to put on an N95 mask once.

“Normally, I would…put on an N95 and my goggles and I would just leave them on,” he says. “And I would go from floor to floor to floor, seeing all the COVID patients. And there were times I was seeing 15, 20 of them, just me. That wears on you in a lot of ways.”

This feels like the most hopeful moment of the pandemic Michigan has had since the summer. COVID hospitalizations are the lowest they’ve been since September. Slews of school mask mandates were dropped last week, when the state health department updated its mask guidance “to reflect that Michigan is entering a post-surge, recovery phase,” according to a press release.

“...[T]his updated guidance will underscore that we are getting back to normal,” Governor Gretchen Whitmer said in a statement.

Even experts like Dr. Sims admit they are “cautiously optimistic.” But with community transmission rates still high both in the state and the U.S., there’s still a significant risk of new emerging variants that could set us back.

“When they say, ‘Oh, we're coming out of it now, we can take off the masks now, have our parties again, it's all just personal choice,’ it kind of feels like you're running the race and the finish line’s straight ahead, and you say, ‘I think I can take a nap,’” said Sims.

Yes, things are getting better. But if we’re going to really transition from a pandemic to a disease that’s endemic (when COVID is just another disease, like the flu) then experts say the next few months are crucial.

“We’re almost there,” Sims said. “But the virus is still out there and it can still beat us to the finish line.”

Hospitals, health departments feeling some relief 

That’s not to say we can’t enjoy this moment.

As of Monday, Henry Ford had only about 80 COVID inpatients - the lowest the health system has seen since August.

“Our staff certainly feels relieved that, though they’re still quite busy, the number of inpatients are going down,” said Dr. Dennis Cunningham, director of infection prevention at Henry Ford Health System.

And while staffing shortages and supply chain woes are still making things challenging, the reprieve in COVID hospitalizations is welcome.

“It gives us a chance to restock a bit, and for our team to get a little bit of downtime after having almost two and a half years of super busy hospital units.”

Best case scenario: cases keep dropping, and we’ve got enough tools now (vaccines, boosters, tests, antibody therapies, emerging treatments, etc) to contain the virus to limited outbreaks in a specific community, or seasonally, like when kids go back to school in the fall.

The Michigan Department of Health and Human Services outlined a “COVID-19 cycle” that the public can use going forward to understand these “three key phases.”

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The three-stage "cycle" the MDHHS says people can expect going forward. But how severe those surges are, depends on whether transmission rates can be reduced.

First, the “response” phase when there’s a surge. That’s when the “public may be advised to increase masking, testing, and social distancing.” That’s followed by a “recovery” phase when cases wane, and a “readiness” phase if it looks like a potential surge could be on the horizon.

But COVID still isn’t an endemic virus…yet 

But cases are still too high for COVID to be considered endemic, said Cunningham. “Endemic should be a much lower rate, such as influenza…But the numbers of COVID we’re still seeing are higher than we would expect to see with our typical influenza or other respiratory viruses. That’s why I say we’re still in a pandemic.”

And that’s where the worst-case scenario could emerge: the more the virus keeps circulating, the greater opportunity there is for a new variant to emerge that doesn’t respond to the vaccine or booster shots.

“If you look around the world right now, Hong Kong is having huge surges of COVID,” Cunningham said. “So whenever you have these big surges, there’s always the possibility for a new variant to pop out. And I don’t want people to forget that.”

That’s why some health officials worry that this talk of being “back to normal” could end up hurting the hard-won progress.

“We’re still about 10 times higher [in our case counts] than we’d like to see when we start talking about stopping mask use in public settings for personal protection,” said Dr. Jennifer Morse, medical director for District Health Department #10, which includes a massive swath of the northwest Lower Peninsula. “So as you make those decisions, just keep in mind that the overall case rates are still relatively high.”

Boosters, vaccinations, and even masking in crowded public spaces is still important, Sims said.

“Things are getting better, but things have gotten better before,” he said. “And the thing is, we come out of these surges and …everybody wants to take the mask off. Everybody wants to get back to where we were in 2019. And if we do that and then there is another start of a surge, or our antibodies start to wane, then everyone becomes more vulnerable again…We really need it to calm down more than it is now, and for the variants to stop emerging so quickly to the point where I think it's safe to go back to the way things used to be.”

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