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COVID variant “like a powder keg” amidst surge in cases, hospitalizations

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With more than 3,500 Michiganders in the hospital with confirmed or suspected COVID-19 infections, the state’s hospitalizations have hit their highest point since December.

Meanwhile, a surge in cases predominantly among younger, unvaccinated residents means Michigan is now adding more new cases per day than any other state, based on population size.

“I shudder to think what we would be...for our hospitalizations, if we hadn't that breadth of [vaccine] coverage,” said Dr. Christine Nefcy, chief medical officer of Munson Healthcare.

Cases spreading like “wildfire”

Health officials point to a number of factors, including school outbreaks, pandemic fatigue, and the spread of the more easily transmissible B.1.1.7 variant.

“The pattern we’ve seen is, it’s just like someone dropped a powder keg of COVID off in a location,” said Dr. Jennifer Morse, medical director for District Health Department #10, which covers 10 counties in northern Michigan.

“So we're seeing an extremely rapidly evolving outbreak in locations...And we'll say ‘That’s likely the variant. Can we get samples? And we'll send samples off [to labs that can sequence positive test results to detect the variant.]

“And... a couple of weeks later [those results will come back, and], we'll find out, ‘Yes, that was the variant.’ And several of our variant cases have been from extremely large outbreaks… And again, given how we're seeing our numbers increasing regionally, we know that to me is very consistent with how this variant spreads. It is just much more communicable and spreads much more easily.”

Combine that with pandemic fatigue and outbreaks among middle and high school students, and you’ve got a crisis.

“If we are a bit more comfortable with gathering together, or not wearing masks, and then you throw in a virus that has mutated so that it can spread a bit more easily? Those two things separately may not have been as major, but those two things together has really caused this wildfire spread. And so it has been an unfortunate combination.”

Younger, unvaccinated people driving the surge

The good news, Nefcy said: there’s an inverse relationship between the age of those being hospitalized, and those who’ve been vaccinated.

“This new surge in cases is really being driven by our younger population. We are seeing younger numbers, younger ages of people being hospitalized additionally. So when we look at the vaccination rate here, you can really see that the people that are being hospitalized are those that are not immunized.

“And in fact, the state did release some new information: when you look at this surge statewide, and how many people who have been vaccinated that are hospitalized, that is at 4.6 cases per 100,000 [residents.] If you compare that to people who are not immunized, that rate is at 345 per 100,000 [people.] So a significant difference between being vaccinated and not vaccinated.”

Potential cases of vaccinated people getting sick are extremely rare

Reports came out Tuesday about 246 “potential breakthrough” cases of Michiganders testing positive for COVID, despite having been vaccinated. That includes 3 deaths, according to the reports.

But the context here is critical, says Lynn Sutfin, spokesperson for the Michigan Department of Health and Human Services. It doesn’t mean the vaccines aren’t extremely safe and effective.

“The number of potential cases identified to date is not in excess of what might be expected with vaccines with 95% efficacy,” Sutfin said in an email Tuesday.

“Some of these individuals may ultimately be excluded from this list due to continuing to test positive from a recent infection prior to being fully vaccinated... To date, more than 1.7 million Michiganders have completed their COVID-19 vaccine. This represents, .0001 of those vaccinated.”

So far, the state has received hospitalization data about 117 of those cases.

“Of the 117 with hospitalization data entered, 11 were hospitalized, 103 were not hospitalized, and 3 are reported as unknown. There have been three deaths, all persons 65 years or older, and two of which were within three weeks of completion of vaccination. While the majority of the population develops full immunity within 14 days of completion of their vaccine series, a small proportion appear to take longer to mount a full antibody response. CDC is actively working to better understand the risk characteristics of this group.”

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