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Yes, hospitalizations are rising again, but this time might be different

Hospital Clínic Barcelona @franciscoavia

The rapid rise in COVID hospitalizations over the last few weeks has health officials worried, but still hoping vaccinations can help curb the fallout of climbing case counts.

As of Tuesday, more than 1,500 adults and 21 children are currently in the hospital with confirmed cases of COVID-19, according to the state’s dashboard.

That’s still far lower than the peaks in November and last spring, when some 4,000 Michiganders were hospitalized. And it’s “too soon to tell” whether this is the start of yet another spike, said Brian Peters, CEO of the Michigan Health and Hospital Association.

“We're optimistic that because we have a new tool in the toolbox now - which is the vaccine - that this will lead to a leveling off in the days and weeks ahead. As opposed to the unmitigated rise that we saw in previous surges… But certainly the numbers are cause for concern and cause for continued emphasis on those [safety] protocols.”

COVID hospitalizations tend to mirror overall case trends, plus lag time. And after months of steeply declining case numbers starting in early December, Michigan cases started picking up again in mid-February, and kept climbing through mid-March.

But many of the outbreaks have been tied to schools, athletic events, and workplaces, with fewer at long-term care facilities. Which could be why current inpatients are “much younger” than what doctors have previously seen, said Dr. Christine Nefcy, Chief Medical Officer at Munson Healthcare in Traverse City. 

“We think that that’s likely related to the fact that we had such a hard push to vaccinate many of our older community members,” she said at a press conference Tuesday.

Other regions of the state are seeing similar trends, according to Peters.

“That's been consistent in every region of the state, that it is a relatively younger population now that we're seeing testing positive and also being hospitalized,” he said. “And in a way, it really does indicate that the vaccines are working. Because clearly the 70 and older population were among the priority groups who initially received the vaccine. The 70 and older population, for the most part, is not testing positive and is not hospitalized.”

Credit Kroger
A healthcare worker administers the COVID-19 vaccine at a Kroger clinic. The race between vaccinations and rising case counts continues as hospitalizations increase, but there's cause for some optimism too.

While fewer of today’s inpatients need ventilators compared with last spring, many are still seriously ill. “Many [are] requiring ICU level care,” Nefcy said. “And most of them [are] requiring some form of oxygen and support in their respiration.”

Statewide, ICU numbers have been rising since the beginning of March, but are still far below the spring and November peaks.

“That's a good gauge for the severity of the illness... And I think indicative of the way we've learned and developed new tools to combat the pandemic,” Peters said. “And so that's cause for optimism. We're not out of the woods yet ... the positivity rate is another metric we watch. And that positivity rate, which dipped as low as 3% in many regions of the state, is now creeping back up,” to around 9%, according to the most recent available state data.

Deaths, another lagging indicator, are also extremely low, with a current weekly average of just 6 deaths. That’s around the lowest the death rate has been since the pandemic began.

Meanwhile, Michigan is ranked 29th of all states in terms of proportion of population vaccinated, according to an analysisof CDC data by Becker's Hospital Review. Just over 13% of Michiganders are fully vaccinated, or about 1.4 million people. 

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Kate Wells is a Peabody Award-winning journalist currently covering public health and the COVID-19 pandemic.
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