Rising variant cases fuel fears Michigan relaxed COVID restrictions 'too soon'
Mar. 23—Michigan has the second-highest number of cases of the United Kingdom variant of COVID-19 in the nation, leading some public health experts to suggest Michigan is relaxing restrictions on businesses and gatherings too soon.
The B.1.1.7 variant is known to be more contagious than the original strain and quickly became the dominant strain in the U.K. after the first cases were identified there.
Michigan had 908 confirmed cases of B.1.1.7 through Monday, according to the Michigan Department of Health and Human Services. Florida — where thousands of people are partying for spring break and other reasons — is leading the United States with 1,040 cases through Sunday, according to the latest data available from the federal Centers for Disease Control and Prevention — whose information lags that from the state of Michigan.
But Florida has more than twice the population of Michigan at 22 million. This means Michigan at about 10 million people has a greater confirmed concentration of B.1.1.7 variant cases, experts said.
Michigan is also the site of the biggest U.K. variant outbreak in the United States with 420 state prisoners becoming infected in addition to 27 prison employees through Monday — all occurring after a prison worker was confirmed with a B.1.1.7 variant case at the Bellamy Creek Correctional Facility in Ionia.
Michigan likely has had more cases of the variant than is reflected in the numbers, said Ali H. Mokdad, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington.
But Michigan Chief Medical Executive Dr. Joneigh Khaldun isn't convinced the U.K. variant is the dominant strain of COVID-19 in the state.
"Based on the information we have now, I would not say that the B.1.1.7 is the dominant strain in Michigan," said Khaldun, adding that nearly half of the cases that the state sequenced are linked to a Michigan Department of Corrections outbreak of the variant.
"We have seen some other clusters of the variant associated with athletic programs or sports teams. But I cannot say at this point that I believe that this variant is definitely the dominant strain in Michigan."
Still, the trend worries other public health experts.
"Michigan is a big concern for us because it could be a canary in the (coal) mine," Mokdad said. "States are opening up so fast assuming that the vaccine will catch up, but the vaccine is slow because there are no supplies.
"We are afraid that what we are seeing in Michigan ... may be what's coming for the U.S. You shouldn't be afraid of hitting the brakes as hard as you can."
Michigan has experienced four straight weeks of rising cases, but deaths have declined for 11 consecutive weeks. Deaths are considered a lagging indicator of cases and hospitalizations, state health officials say — and hospitalizations have increased for two straight weeks. The percentage of COVID-19 tests bringing positive results has been rising for four weeks and is at 6.2%.
Michigan's virus statistics are resembling those in mid-January, when the first variant case of B.1.1.7. was identified.
Through Monday, Michigan has totaled 629,612 cases and 15,903 deaths since the virus was first detected in March 2020, according to the state Department of Health and Human Services.
'Too aggressive in opening up'
Dr. Nigel Paneth, a professor of epidemiology at Michigan State University, said he's concerned about the uptick in cases. The greater the spread of the virus, he said, the greater the opportunities for the virus to mutate into a new, potentially dangerous version.
"Let me be frank," Paneth said. "I think we're being a little too aggressive in opening up."
Gov. Gretchen Whitmer has gradually been loosening COVID-related restrictions on businesses and gatherings since February. Restaurants can fill to 50% of capacity now, and the curfew has been raised to 11 p.m.
On Friday, Whitmer opened outdoor stadiums to a 20% capacity limit, meaning the Detroit Tigers could expand the April 1 home opener to more than 8,200 fans — up from the prior cap of 1,000 fans.
But the governor warned that coronavirus metrics were going in the wrong direction as her state health department issued a new epidemic order requiring rapid testing for all youth athletes ages 13-19 beginning April 2, a mandate that will apply to winter sports that are still being played and upcoming spring sports for middle schoolers through high schoolers. It also applies to club sports.
The testing requirement was prompted because Michigan is experiencing increasing cases among individuals ages 10 to 19, who have the highest current case rate and faster growth than other age groups, the state Department of Health and Human Services reported. The state is paying for and distributing the rapid tests for schools and club sports teams alike.
"Michigan's path forward out of the COVID pandemic is clear," Whitmer said Friday. "We have to keep masking up. We've got to ramp up testing. And we're going to invest billions in federal funds from the Biden administration to help small businesses, support working families and get our kids back in school."
Whitmer's loosening of restrictions drew mild criticism from one of President Joe Biden's closest COVID-19 advisers.
Dr. Anthony Fauci, director the National Institute of Allergy and Infectious Diseases, said last week she should "hold off for a bit" on easing COVID-19 restrictions. Fauci told CNN on Thursday night that Whitmer is a "really good governor," but state officials should "pull back gradually" on limitations aimed at stemming the spread of the virus.
"I think she's done some really good things," Fauci said of Whitmer. "But I am telling them just hold off for a bit. When you get the overwhelming majority of your population vaccinated, the chances of there being a surge are minuscule. Just hang in there. Don't turn the switch on and off."
The following morning, Whitmer's health officials loosened outdoor sports seating capacity limits but issued the rapid testing requirement for middle school and high school age sports.
On Monday, the governor responded to Fauci's remarks, saying: "We do see our numbers up. We have the variants, which are highly contagious, and we've re-engaged these things. So he's concerned, I'm concerned, Dr. J's concerned," according to MLive.
The governor also recently touted the efforts of her administration and the Biden administration to increase COVID-19 vaccinations. On Monday, the state opened the vaccine to people 50 and older and plans to further expand vaccinations to people 16 years and older starting April 5.
Khaldun said Monday people should continue to follow safety precautions even after they're fully vaccinated.
"It's really important for people to continue to do the same things — wearing masks, washing hands, socially distance — and getting the vaccine," Khaldun said.
Michigan's testing advantage
But Michigan has an advantage over other states because it has a state lab that can identify variants through whole genome sequencing, where scientists compare the genetic fingerprints of the new virus sample to those of the original strain. The United States has lagged far behind other developed nations on the amount of sequencing it does.
In Michigan, the state Bureau of Laboratories has sequenced more than 9,000 coronavirus samples, including 3,074 so far this year, said Lynn Sutfin, spokeswoman for the state Department of Health and Human Services. Some states don't do any sequencing of the coronavirus, Sutfin said.
A coronavirus test only confirms whether an individual is positive or negative for a form of COVID-19. The result is then sent to the state health department for the genome sequencing to figure out if the case involves the U.K. variant or the South African variant B.1.351 — the first case of which was confirmed by the state Bureau of Laboratories in a boy living in Jackson County earlier this month.
The process takes a week from the time they start the sequencing, Sutfin said.
The first case of the variant was identified in January in a University of Michigan student who had traveled from the United Kingdom. The variant has spread significantly in Washtenaw and Wayne counties, which have 73 confirmed cases each.
The largest number of cases have occurred in the state prison system but have been contained, said Michigan Department of Corrections spokesman Chris Gautz.
All of the variant cases have been traced to the Bellamy Creek facility, where 402 inmates have confirmed cases. Another 27 employees at Bellamy Creek also have variant cases.
Because some Bellamy prisoners were transferred, there are also two B.1.1.7 cases at the Duane Waters Health Center in Jackson and 15 variant cases at the Macomb Correctional Facility in Lenox Township, according to the corrections department.
The spread of the variant in a Michigan prison is a reminder of how it can spread quickly in other close quarters, experts said.
In Florida, which has among the loosest COVID-19 restrictions in the country, spring breakers and pandemic-weary tourists have inundated Miami Beach, resulting in street fights and business damage that forced authorities to bring in SWAT teams to restore order. The city has ordered an emergency 8 p.m. curfew that is considered likely to extend well into April after the spring break season is over.
Of the gatherings in Miami Beach, MSU's Paneth said: "The spread is just exactly the petri dish for new variants."
"New variants spread in exact proportion to the number of new transmissions," he said. "Young people feel they can transmit this virus between themselves without too much hazard to themselves, but they increase tremendously the possibility of a new variant emerging.
"We've been lucky so far, the main new variants in the U.S.A. are vaccine susceptible. Will our luck hold out? Your guess is as good as mine."
Research is continuing to determine whether the COVID-19 vaccines are effective against the variants.
"While studies are ongoing, it does appear that the vaccines that are currently authorized for use in the U.S. are effective against the B.1.1.7 and the B.1.351 variants," Khaldun said Monday.
