With the arrival of spring and after an exhausting year of COVID-19 restrictions, Americans are eager to return to some sense of normalcy.
However, many health experts are asking for patience, warning that a possible fourth wave may be on the horizon, with more than a dozen states showing the first signs of an increase in the number of cases.
Dr. Anthony Fauci, the country’s leading infectious disease specialist, raised the alarm this week, expressing his concern that we may reopen faster than we should.
“There were times when we thought things were getting under control and then it exploded again,” said Fauci. “So even though we are in the right direction, we have to keep our foot on the pedal when it comes to public health measures.”
In the past week, more than a dozen states have seen increases in their daily case averages. Parts of the upper Midwest have shown particularly worrying trends, including in Michigan, where cases have been on the rise since late February.
Experts and officials fear that a combination of loosening restrictions and spreading the UK variant may be causing the increase in Michigan – a potentially worrying sign for other areas as mass vaccination is being implemented.
‘Real concern’ in Michigan
Great Lake State currently has the fourth highest average of new COVID-19 cases per capita in the country, with New Jersey leading the country. In the past three weeks, the daily average of cases has doubled. In the last week alone, the state average has increased 53%.
The seven-day average is now 2,500 new cases per day, according to data from the Centers for Disease Control and Prevention, and on Wednesday, Michigan reported a total of 3,164 new cases, the highest total of cases in a single day since the beginning of January.
In comparison, California, with approximately four times the population of Michigan, recorded just 415 more cases than Michigan this week.
“Despite several months of declining trends, we are still at high levels of transmission in the community and with [the U.K.] variant that is known to be more transmissible, there is a real concern that you can quickly get into a situation of exponential growth in cases that threaten to overwhelm health systems again, ”explained Josh Petrie, assistant professor of research in the School’s Epidemiology Department of Public Health at the University of Michigan.
Michigan has experienced a steady increase in hospitalizations since the end of February and 1,000 people are currently hospitalized, said Dr. Sarah Lyon-Callo, director of the MDHHS Bureau of Epidemiology and Population Health, during a news conference on Wednesday – an increase 45% since then February 25th.
In contrast, the seven-day average of hospitalizations fell 8.4% nationally this week, and 73% since the peak in January, according to data from the CDC.
In the past week, hospitalizations in Michigan have increased by 24%, according to the CDC, and Children’s Hospital of Philadelphia’s PolicyLab reports that emergency department visits and hospitalizations are increasing in Michigan.
Wayne and Genesee counties (home to Detroit and Flint) and Macomb county have viral reproduction numbers above 1.3, indicating “substantial transmission”, and the organization’s models project a potential doubling of the incidence of cases in these counties over the next 3-4 weeks.
Although the number of deaths in the state continues to decline, Lyon-Callo warned that the deaths are a delayed indicator. Therefore, the number of COVID-related fatalities may increase in the coming weeks.
Emergence of the United Kingdom variant
According to the CDC, Michigan currently ranks second in the country for the most reported cases of variant B.1.1.7 first discovered in the UK, with more than 725 confirmed cases in 31 counties.
“This variant is very communicable,” said Dr. Nigel Paneth, professor of epidemiology and biostatistics and pediatrics at Michigan State University, to ABC News. “It may be a little more likely to cause serious illness, but it appears to be preventable with current vaccines.”
The variant is found in the most densely populated areas of the state, with more than half of the B.1.1.7 variants identified as the result of an outbreak at the Michigan Department of Corrections, according to the state’s health department.
In addition to variant B.1.1.7 that leads to increased transmission, there is a confluence of factors that may be driving the increasing metrics, said Dr. Tara Smith, Professor of Epidemiology at Kent State University School of Public Health to ABC News, beginning with the loosening of restrictions on food, entertainment and other businesses, by Governor Gretchen Whitmer’s administration in recent weeks.
“I believe we are also seeing COVID fatigue, along with, in our state, some modest relaxation of public health guidelines,” said Paneth. “There is clearly an unfortunate tendency now for the general public to relax the distance measures and the authorities to relax public health restrictions. This is a real concern in light of the continued evolution of new strains of the COVID virus. “
In addition, with more children back to school and participating in sports programs, school-related cases of COVID-19 are increasing in the state, according to state data.
“The largest number of outbreaks occurs in K-12 schools in 162, with 54 new outbreaks reported this week,” said Callo-Lyon. Children aged 10 to 19 now have the highest COVID-19 case rate in Michigan, a rate that “is increasing more rapidly than in other age groups”.
At the national level, however, new cases of children have declined for the eighth consecutive week, according to a weekly report by the American Academy of Pediatrics and the Children’s Hospital Association.
However, she said, these new cases are associated with extracurricular activities, such as sports, and not being in a classroom. As a result, Michigan will begin demanding tests among high school student-athletes.
“The classroom environment itself has not been a strong signal for outbreaks. It tends to be more of those activities associated with schools, including sports, but not limited to them, ”added Callo-Lyon.
‘Gritting your teeth’
The outbreaks occur as the state prepares to open its largest mass vaccination site at Ford Field in Detroit, which is due to officially open on March 24.
“It’s time to clench your teeth and continue doing the work we need to do until the last second of this event is over. If we want to get back to normal … we all need to get vaccinated, encourage our loved ones and friends and coworkers and neighbors to do it, “said Whitmer on Thursday.
The state is vaccinating at a rate of 90,000 people a day, according to state officials, but so far, less than 25% of the state’s population has received at least the first dose of vaccines.
The percentage is lower for cities like Detroit, dropping to 15.1%. Earlier this month, the city of Detroit faced criticism for opting out of an allocation for the Johnson & Johnson vaccine.
Detroit Mayor Mike Duggan said the intention “for as long as possible” was “to keep the Moderna and Pfizer vaccines” because they were “the best”. However, the mayor’s office later retracted his comments and said the city is “excited” to have three highly effective vaccines to offer its residents.
Experts agree that the key to preventing a possible resurgence will not only be to vaccinate as many Americans as quickly as possible, but also to continue to follow appropriate mitigation efforts.
“Vaccinating as many people as possible as soon as possible will be helpful in reducing the impact of a resurgence. However, my concern is that it takes about a month and a half to receive both doses and develop full immunity. The transmission happens much faster than that, ”said Petrie. “Therefore, continuing to mask social distance and avoiding unnecessary contact with the community will be important until we can get a much larger proportion of the population fully vaccinated.”
“We all need to be careful and realize that we are not yet out of danger,” concluded Smith.