Coronavirus cases are on the rise nationally, an unwelcome trend after leveling off earlier this fall. On Monday, the United States reported a seven-day daily average of just under 93,000 cases – an 18% jump from a week earlier, according to figures from a briefing by the White House covid-19 response team. Hospitalizations were also up, increasing 6% to about 5,600 patients admitted per day.
At least two dozen states have seen cases rise at least 5% in the past two weeks, with Michigan, Minnesota, New Mexico, New Hampshire and North Dakota each recording per capita jumps of more than 60%. Some highly vaccinated states, including Vermont and Massachusetts, were also seeing steep rises in cases.
The growing caseload across the country has raised the specter of another surge this winter – what would be the nation’s fifth. Expert opinions vary, but Amber D’Souza, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said a surge seems imminent. This one, though, could prove to be much milder than last winter’s due to vaccines, boosters and therapeutics that were not available last year. “We are absolutely heading into an additional wave this winter across the country that may hit at different times and it may be at different extents in different parts of the country,” she said. “The good news is that we really do have hope that the toll from this wave this winter will be much less than last winter.” For now, Michigan appears to be experiencing the worst of it, with Minnesota following closely behind. The current surge is affecting “virtually every part of Michigan, both urban and rural,” said Brian Peters, chief executive officer of the Michigan Health & Hospital Association, which represents all of the state’s community hospitals. In the two weeks between Nov. 8 and Nov. 22, cases in Michigan increased 86% and hospitalizations 37%, according to tracking by The Washington Post. The state on Monday reported 3,775 covid inpatients – more than anywhere else in the country. Peters said current trends indicated the state could hit its peak of 4,640 hospitalizations, set in April 2020. “Just doing the math, we are going to reach an all-time record high in hospitalizations in the not-too-distant future if this current surge does not reverse course,” he said. “And we’re not seeing anything that would tell us it’s going to reverse course any time soon.” There were 4,090 covid patients in the state as of Wednesday. In what feels like a flashback to an earlier phase of the pandemic, hospitals are now deferring nonessential procedures, adding beds, limiting visitors and warning of increased wait times. Some school districts canceled classes in the days leading up to Thanksgiving, pointing to increased cases and staffing shortages. The state Department of Health issued an advisory recommending everyone over 2 years old wear a mask, regardless of vaccination status. The surge can be attributed to several factors. The baseline for cases was already high toward the end of the summer, said Spectrum Health’s Elmouchi. Cold weather is driving more gatherings indoors, and a sizable portion of the public has stopped adhering to strict mitigation measures that were once common. Hospitals in Michigan, like in other states with recent surges, are largely filled with people who have not gotten the coronavirus vaccine. The unvaccinated made up about three-quarters of cases, hospitalizations and deaths in the 30 days ending Nov. 5, according to the state health department. About 54% of Michiganders are fully vaccinated, trailing the national figure of 59%. At this point in the pandemic, months after the shots became widely available, the state’s health-care workers expected to see occasional ebbs and flows in case numbers. But not at this level. “I think all of us had hoped that with relatively reasonable vaccination rates – and a year-plus under our belt – we would not get another surge like this,” Elmouchi said. Spectrum reported more than 370 people hospitalized with covid last week. The system has converted floors and tripled its intensive care unit space, yet there are still patients waiting for beds. Conference space and shared workspaces have been identified for conversion if the surge continues as expected. Elmouchi described the situation as “almost unmanageable.” The crisis echoes recent setbacks in other pockets of the country. Earlier this month, the number of covid-19 patients in parts of Colorado matched peaks from late last year at the same time previous southern state hot spots, like Florida and Texas, saw marked declines in cases. “Part of that is just how our behavior changes as things get colder and we are in more places inside and in close proximity to people where infection spreads,” D’Souza said. “The underlying issue is the same nationwide: The pandemic is not over.” In Michigan and Minnesota, members of the medical community said the current surge is in some ways more challenging than what they experienced late last year. Hospitals are filled not just with covid-related cases but also with everyone else. A high volume of non-covid patients are seriously ill, after many delayed medical care in the earlier months of the pandemic, officials said. Staffing shortages that have worsened during the pandemic also mean hospitals don’t always have enough people to handle the surge of patients. A health-care coalition representing 13 counties in West Michigan warned last week of the possibility for lengthier emergency room wait times, delayed ambulance transfers and deferred surgeries. In a Nov. 17 letter to the public, the Region 6 Healthcare Coalition said hospitals and EMS systems were operating at extremely high capacity, describing the situation as being at “a tipping point.” One hospital has been putting adult patients in a pediatric hospital due to space constraints, while smaller hospitals have been unable to transfer patients to larger ones, said Jerry Evans, the coalition’s medical director and author of the letter. “We’re in a pretty serious condition right now,” Evans said. “Our hospitals can handle it at the moment, but they’re handling it by doing extraordinary measures.” In Minnesota, hospitalizations were also approaching levels not seen in nearly a year. As of Monday, the state had the nation’s third-highest number of total new cases per capita and 1,518 covid-related hospitalizations, according to data tracked by The Post. There have not been more than 1,500 covid patients hospitalized statewide since December 2020. “This surge for us felt a little more like a slow burn as opposed to a rampant forest fire,” said George Morris, incident commander for covid-19 response at CentraCare, a central Minnesota health-care system. “During this fall, it’s just been a steady incline. However, over the past two weeks, it is a forest fire – we really saw that rate of rise go up rapidly.” Morris said the strain at St. Cloud Hospital, the system’s main large hospital, has had a domino effect across the region. “At times we’ve had to divert people or defer them, and that means patients are having to stay and be cared for in place at small rural hospitals, many of whom are associated with us, or other regional facilities where they can’t send them to us for needed care,” Morris said. “So patients stay in their small facility, and people do the best they can.” NN: Its going to get a whole lot worse….
