114 takeaways after Michigan officials discuss COVID variant, recent trends, restaurants reopening

LANSING, Mich. – A state epidemiologist took a deep dive into Michigan’s COVID-19 numbers, including the new variant of the virus, an update on vaccinations and how the critical metrics look overall.

Sarah Lyon-Callo, the Director of the Bureau of Epidemiology and Population Health at the Michigan Department of Health and Human Services, spoke Tuesday in the form of a virtual presentation and Q&A.

You can watch the full presentation in the video above.

MDHHS Chief Medical Executive Dr. Joneigh Khaldun and MDHHS Director Robert Gordon both participated in the Q&A portion at the end of the presentation, addressing restaurants, vaccines and the possibility of new restrictions triggered by the variant.

Here’s a list of the facts Lyon-Callo shared in the presentation. She said all statistics are as of Jan. 16.

Restaurants

1. “I think the governor has said, and we said last week, that the plan was, if trends continued in the same direction, to allow for the reopening of indoor dining on Feb. 1,” Gordon said. “I think the trends have continued and that continues to be the plan right now.”
2. Gordon said the state has made tremendous gains because of the MDHHS pause, so the target date for reopening restaurants remains Feb. 1.
3. “While restaurants will be reopening on that date, there will continue to be risk associated with indoor dining and we will be talking about that more on Friday,” Gordon said.

National trends and how Michigan compares

1. Michigan has the 23rd highest number of confirmed COVID-19 cases of any state in the last seven days.
2. Michigan has the 14th highest number COVID-related deaths in the county in the last seven days.
3. Michigan has the fifth-lowest case rate in the country over the last seven days.
4. Michigan has a death rate that’s tied for the 23rd highest in the nation over the last seven days.
5. Michigan has the 34th highest hospitalization rate in terms of percentage of total beds, and the 16th highest in terms of number of COVID-19 patients in the ICU over the past seven days.
6. There are currently five states seeing increasing one-week COVID case trends.
7. 46 states have significant outbreaks ongoing. Arizona, Alabama, Georgia, Nevada and California have the highest per capita hospitlaization numbers.
8. The states with the most rapid one-week case growth are Virginia, Maine, Washington, New Hampshire and South Carolina.

Midwest trends

1. Wisconsin is showing a slight drop in hospitalizations and a moderate drop in cases.
2. Indiana has a slight decline in hospitalizations and a drop in cases.
3. Illinois is showing a slow decline in hospitalizations and cases are dropping.
4. Ohio has a decline in hospitalizations and a slow drop in cases.
5. Michigan is showing a continued decline in hospitalizations and cases.

Michigan’s current COVID-19 trajectory

1. The case rate is at 287.5 cases per million population, which is up 21.7 cases per million since the previous update.
2. The case rate has plateaued for the third week in a row.
3. Michigan’s percent positivity is down to 7.6%, which is 2.2% lower than the last update. That rate decrease comes after a week of increasing, and testing has increased.
4. 10.7% of available inpatient beds are filled with COVID patients, which is down 1.4% from the previous update.
5. State trends for COVID-19 hospitalizations are decreasing overall.
6. There were 480 COVID-19 deaths between Jan. 3 and Jan. 9, and the death rate is 8.9 deaths per million residents.
7. Daily diagnostic tests increased to an average of 41,400 per day over the last week, up 7,300 from the previous week.
8. The state is administering 3,972.9 tests per million people per day.
9. Seven of the eight geographical regions in the state are now below 10% positivity, and those regions are also showing a decline over the previous week.
10. The CDC case trend indicator is showing declines, but that indicator is very sensitive to small declines.
11. The positivity rate in the 0-29 age might be seeing an increase.
12. Michigan’s number of active outbreaks is down 12% from the previous week.
13. The number of reported school outbreaks decreased again since the previous week, from 50 to 40, with only outbreaks in high schools increasing.
14. The Jackson Region is over 400 cases per million. Grand Rapids, Kalamazoo, Saginaw and Lansing are over 300 cases per million.
15. We have seen a long decline in COVID-19 cases since the end of November, however, since around Christmas, that decline has plateaued.
16. While experts don’t want to see the numbers plateauing, it’s a positive sign that numbers aren’t increasing following the holidays.
17. 21 of Michigan’s 83 counties saw double-digit positivity in the last week, which is a decrease from 46 the previous week.

Vaccine information

1. Michigan has reported 512,906 doses of the COVID-19 vaccine, as of Jan. 19. That’s an increase of 216,318 doses since the previous week.
2. 5.4% of Michiganders have had their first dose of the COVID-19 vaccine, which is up from 3.2% the previous week.
3. Of the 512,906 doses administered in Michigan, 437,027 were first doses and 75,579 were second doses.
4. By Jan. 19, more than 1 million doses of vaccine had been shipped.
5. There were 1,615 enrolled providers as of Jan. 17.
6. The new goal in mind for how many Michiganders need to be vaccinated for herd immunity due to the COVID-19 variant is close to or greater than 90%, according to models.
7. Khaldun said more funding would go toward mobile vans for vaccinating people in vulnerable communities and additional staffing.
8. The most important thing Michigan needs right now is more doses of the vaccine, Khaldun said.
9. Michigan hasn’t heard from the manufacturer about why 21 shipments of the Moderna vaccine might have been compromised by going outside the recommended temperature range.
10. Michigan is requesting all of the vaccine doses that are available to the state each week.
11. The CDC has been providing a fairly stead level of vaccines to Michigan per week. The state learns how many doses it will receive on Tuesdays, but that number doesn’t become final until orders are put in.
12. Michigan is around 120,000 doses per week, but the numbers change. The state has made plans for 50,000 doses per day. The more vaccines the state obtains, the more quickly it will move to administer them, Lyon-Callo said.

COVID-19 spread in Michigan

1. The number of weekly reported COVID-19 cases to public health is remaining about the same.
2. In the last week, 14,402 cases were reported.
3. The estimated prevalence or proportion of people who have ever had SARS-CoV-2 in Michigan, as measured by antibodies in the blood, shows the state fared relatively better than neighboring states. -- The percentage was 8.8% for Michigan in November.

COVID-19 cases, deaths by onset date

1. The current statewide daily case rate remains more than 1.5 times the highest risk level, which is 150 case per million population.
2. More than half of the regional case rates are twice the risk of that threshold.

COVID-19 trends by age, race, ethnicity

1. The 30-49 age group continues to have the highest case rate in Michigan.
2. The 0-29 age group has continued to see its case rate increase, from 200 to 275 cases per million population, which other age groups have plateaued or decreased.
3. The number of cases reported on Christmas Day showed a decline in all age groups.
4. Michigan’s cases per million people continue to plateau for most racial groups since the decline.
5. 30% of all cases chose unknown, multiple or other races for race, so data is incomplete.
6. Cases per million are plateauing for both Hispanic/Latino and non-Hispanic/Latino residents.
7. 26% of all cases that are reported have an “unknown” ethnicity.

COVID-19 outbreaks

1. The total number of active outbreaks is down 12% from the previous week.
2. Following long-term care facilities, the greatest number of new outbreaks were reported in manufacturing, construction, retail, health care, religious services, social gatherings and K-12 schools.
3. Local health departments reported new outbreaks in all settings except agricultural processing, shelters and outdoor community exposure over the past week.
4. The number of reported outbreaks in K-12 schools decreased from 60 to 40 over the past week.
5. Outbreaks in middle or junior high schools were reduced from 12 to seven
6. Outbreaks from pre-K and elementary schools dropped from 22 to 19.
7. School administrative outbreaks dropped from six to three.
8. Only high schools saw an increase in the number of reported outbreaks among schools. The number of high school outbreaks rose from 10 to 12 over the past week.

COVID-19 deaths

1. Current deaths are a lagging indicator of cases, but the number of deaths has declined for four consecutive weeks.
2. The decrease in deaths is being seen among most age groups, races and ethnicities.
3. The current number of deaths per week is more than five times what Michigan was seeing in early October.
4. The 80 and older age group still has the highest number of deaths over the past 30 days, followed by the 70-79 age group, and descending by age.
5. Deaths per million continues to decrease among racial groups.
6. White residents have the most reported deaths per capita.
7. The large fluctuation among American Indian/Alaskan Native is due to small population size, state officials said.
8. Deaths per million people continue to decrease for Hispanic/Latino and non-Hispanic/Latino residents.
9. There are fewer Hispanic/Latino deaths per million than non-Hispanic/Latino deaths, but that number is not adjusted for age.
10. Michigan had fewer deaths compared to other states during the summer, but that changed drastically in November and December. It has since started to improve, in terms of state ranking, in January.

Healthcare capacity

1. Hospitalizations are the number of people in intensive care due to COVID-19 are both decreasing.
2. The number of people in the hospital with a “COVID-like illness” continues to trend downward.
3. Hospitalizations peaked Dec. 1 and have since dropped 52%.
4. ICU occupancy declined 7% over the previous week.
5. All geographical regions in Michigan are at or below 20% of adult ICU beds being filled with patients who have positive COVID-19 cases.
6. The percentage of emergency department visits by people with COVID-like illnesses, shortness of breath, pneumonia and influenza-like illnesses is decreasing, and the COVID-like illness percentage remains below 4%.
7. This week, the total number of COVID positive patients in hospitals is down 12% from the previous week.
8. Most regions in Michigan are showing decreasing or flat trends in terms of COVID-19 positive patients in the hospital census.
9. People in the hospital with COVID-19 positive cases in the Upper Peninsula and Traverse City regions are up slightly this week, though the total volume of people hospitalized in those regions remains low.
10. The northern part of the Detroit Region, along with the Upper Peninsula and Traverse City regions, saw some increase in ICU census this week.
11. No regions have more than 20% of ICU beds occupied by COVID-19 positive patients.
12. Testing volume has increased from last week and is up to 49,466.
13. 14.9% of the tests done last week were antigen tests. -- 3.5% of those tests are positive.
14. Testing by county ranges from 900 to 11,000 daily tests per million residents.

Case investigation

1. Case investigations are improving after the holiday dip.
2. A consistent proportion of cases interviewed have a source of known infection, which indicates community spread.
3. Among the cases interviewed, there is a low proportion of those quarantining when their symptoms begin.
4. State officials want to see both the percentage of people who know their source of infection and the percentage of people quarantining increase.
5. From Jan. 9 to Jan. 15, there were more than 12,000 cases reported.
6. During that week, 43% of the investigated cases knew their infection source.
7. During that week, 26% of the investigated cases said they had been quarantining before they noticed symptoms.

COVID variant

1. There was an individual sample in Washtenaw County of the B.1.1.7 variant.
2. Gordon said there aren’t numerical thresholds for how much the new variant would need to spread for MDHHS to issue more restrictions across the state, but officials are monitoring the trends.
3. The variant is not expected to change the effectiveness of the COVID-19 vaccines.
4. Masking, social distancing and hand washing are considered crucial to avoiding the spread of this variant.
5. The variant transmits between humans more easily, so case rates might rise.
6. Safely achieving herd immunity through vaccination can reduce or eliminate the spread of the disease from person to person.
7. Officials expect to see the variant show up in other parts of the state soon.
8. A more transmissible B.1.1.7 variant means a higher herd immunity threshold is needed.
9. Most recent data shows some return toward baseline mobility patterns, particularly for non-essential visits. Traveling and gathering could increase the risk of spreading the new variant.
10. The B.1.1.7 variant was first identified in the UK and has now been found in several US states, in addition to Michigan.
11. This variant doesn’t give a current indication of affecting any approved vaccines or treatment options, but it does lead to increased transmission between people.
12. UK data suggests the rate of reproduction for the variant is 1.5 times higher than the original form of the virus.
13. The variant gives Lyon-Callo cause for concern because instead of maintaining a decline in case rate, Michigan might see an increase in trajectory.

SARS-CoV-2 genetics

1. Viruses infect human cells because they lack the ability to replicate themselves in order to survive.
2. When the virus replicates it can be error prone, causing mutations.
3. Most mutations won’t affect the virus cause there’s either minimal change in the protein or the virus is no longer viable due to damaged proteins.
4. RNA tells proteins to form, and proteins fold and make things happen in a cell.
5. Damaged proteins can be bad for the virus or for people.