TRAVERSE CITY — The ongoing COVID-19 pandemic is on the brink of a disastrous public health crisis across all of Michigan.
That’s what the state’s hospital leaders argued Thursday when they implored Michiganders to follow public health guidelines to bend the curve of coronavirus spread: wear a mask, maintain physical distance and practice enhanced hand hygiene.
Should the public not adhere to their advice, the hospital leaders said during a joint online press conference that Michigan’s hospitals soon will reach their capacity limits — and decisions about who receives rationed care will become necessary. The state is teetering on the edge of dire circumstances, they agreed.
“It doesn’t matter where you live. We are facing the same situation,” said Ed Ness, chief executive officer for Munson Healthcare, the largest health care provider in the region.
“Even in our rural communities, you have to be diligent. … In smaller hospitals, they are the only hospital in a community. There isn’t a safety valve.”
Ness said the percentage rate of COVID-19 positivity in this part of the state has almost tripled during the last several weeks. And as hospitals across the Upper Peninsula fill up, he said, it results in pressure on hospitals in Lower Michigan and downstate.
Munson Healthcare operates nine hospitals across northern Michigan. Some are served by McLaren Northern Michigan hospital in Petoskey. Among them all, only four maintain designated COVID-19 units: Munson Medical Center in Traverse City, the McLaren hospital in Petoskey, along with Munson hospitals in Grayling and Cadillac. Collectively they had 91 patients hospitalized and of them, eight using ventilators as of Thursday.
The state’s hospital leaders warned there are more than 3,000 COVID-19 patients currently hospitalized across Michigan, and with a rate that doubles every two weeks, the situation can be expected by month’s end to top the spring’s peak of around 4,000.
Unlike six months ago, the virus is surging not just in metro Detroit, but statewide — making it tougher for hospitals to manage by transferring patients or bringing on staff from elsewhere. Hospital executives echoed pleas by Gov. Gretchen Whitmer to practice basic infection prevention, noting that as many as 40 percent of infected people exhibit no symptoms. Some reported continued resistance to face coverings from some visitors.
“We see it in our own lobbies,” said John Fox, president and CEO of Beaumont Health, the state’s largest hospital system.
Ness argued that mask wearing, physical distancing and hand washing are simple things people should do not only when out in public, but in every social circle. There has been a wrong perception that if you know and trust somebody, they couldn’t possibly have COVID-19.
“Just because you know somebody, just because you’re friends, doesn’t mean you shouldn’t be cautious,” Ness said.
That’s a message that was underscored later in the afternoon by local health department officials.
Health Officer Lisa Peacock, who serves the six counties served by the Health Department of Northwest Michigan and the Benzie-Leelanau District Health Department, said she was literally pleading with people to follow COVID-19 guidelines.
“As cases and positivity soars and hospital beds fill up, we need the help of the community,” she said. “Remember that our bubble may be bigger than we think it is.”
Recent contact tracing has revealed that small and private gatherings are driving this recent spike in cases, said Dr. Joshua Meyerson, medical director for the same two health departments and District Health Department No. 4.
The hospital leaders said it is unnecessary for government to impose a broad stay-at-home order like in the spring — but some targeted restrictions may be needed. They want to avoid prohibiting elective or non-emergency procedures, a ban the governor ordered early in the pandemic and later lifted.
They said they have contingency plans, adequate personal protective equipment, and that their concern is less about bed capacity and more to do with doctors and nurses testing positive and being overworked as the virus spreads through their communities.
“The health care system can capsize if you don’t keep it under control,” Fox warned.
In northern Michigan, some elective procedures already are being rescheduled at Munson facilities, officials said, in order to re-arrange employee duties to care for the growing number of patients hospitalized by the pandemic.
Some of the rescheduling, though, is the result of reduced testing capacity statewide and with partner agencies, confirmed Dianne Michalek, Munson’s vice president of communications.
“Where we think it will impact the most will be free procedural testing,” she said, such as when patients are tested before certain procedures and surgeries.
Michalek said another laboratory already has been lined up to take on needed testing after Spectrum reduced its capacity to process tests for outside hospitals such as Munson — part of existing contingency plans.
Asked if the state should open or reopen field hospitals, the executives cautioned that they are not a panacea, and said staffing them could be problematic because the whole country is confronting surging cases.
“Our issue is not beds. It would be having the staff to staff those beds,” Ness said.
Brian Peters, CEO of the Michigan Health & Hospital Association, said adequately staffed alternate care facilities potentially could be a “landing spot” for patients who are ready to be released but whose nursing homes are unable or unwilling to readmit them.
Contact tracing and protocols
Public health officials on Thursday begged northern Michigan residents to adhere to COVID-19 guidelines in the face of overwhelming case increases and the inability to actually telephone everyone who tests positive, let alone those meant to quarantine because of an exposure.
Health officials across the 17-county region in northern Lower Michigan on Thursday reported six COVID-19 deaths and 415 additional confirmed cases since Tuesday — the most in Emmet County, which had 68 new cases in the two-day period.
Health officials reported four Cheboygan County residents died in the prior 48 hours, along with single deaths among residents in both Grand Traverse and Otsego counties.
Peacock said not everyone who tests positive for COVID-19 will be contacted by public health workers. There are simply too many people to contact and officials must prioritize their attention on the worst outbreaks, she said.
“That means some people may not get a call,” Peacock said.
The health officer said they also need anyone who seeks out a test to stay at home until results come back, even if it takes up to 4 or 5 days. They are “relying heavily on individual behaviors to do the right thing,” she said.
And if their test results come back positive, Peacock said they should isolate at home for the next 10 days and notify all close contacts from 48 hours before symptoms onset or testing that they also should quarantine themselves for 14 days.
Following these protocols is important, she said, because area residents who fall ill “may not hear from the health department in a timely way.”
Meyerson said people should strive to comply, even without a public health worker telling them to do so.
“You don’t need to wait to get a phone call from the health department. If you know you have COVID, you need to stay home and isolate for 10 days,” he said.
Peacock said a new electronic system — to send text messages or emails to those identified through contact tracing as having been exposed to a COVID-19 positive person — may be rolled out this coming weekend. It’s a way to reduce the workload on health department contact tracers, she said.
‘No one is safe’
In her press conference Thursday, Whitmer called the virus “relentless” and said the second wave of COVID-19 is hitting Michigan hard as cases and deaths skyrocket.
The curve Michiganders worked to flatten in the spring and summer months is now a “straight line up,” Whitmer said. Michigan could hit a record daily peak for deaths by Christmas, Whitmer said.
“This is the moment medical experts have been warning us about and dreading,” Whitmer said. “No one is safe. You might survive. You might not. Nobody knows. That’s the scary part about COVID-19.”
Michigan Department of Health and Human Services Chief Medical Executive Dr. Joneigh S. Khaldun reported Michigan has a total of 236,225 cases and 7,811 deaths attributed to COVID-19. The case rate is 416 cases per million, and the positivity rate is at 10.8 percent.
More than 45,000 tests are conducted every day, and Khaldun said more than 10 percent of those tests coming back positive is “alarming and means this virus is out of control.”
“Things are looking very grim,” Khaldun said.
The Traverse City region now has the lowest number of reported cases per million, 278, and the lowest positivity rate, 8.7 percent, in Michigan.
Khaldun also reported the contact tracing system is “strained” and not keeping up with the caseload. She estimated more than 67 percent of potential COVID-19 positive people might not be in quarantine.
Twenty percent of ICU beds are now filled with COVID-19 patients, Khaldun said.
Dr. Karen Kent VanGorder said the overcrowding in hospitals is nearing the breaking point for treating those with medical issues outside of COVID-19.
“I’ve never been in a situation where we have to look and say which patient’s disease is more worthy than another when we’re trying to pick out who gets the hospital bed, who gets the nurse, who gets the ventilator,” Kent VanGorder said. “Those are decisions we’ve never had to make in my lifetime.”
Whitmer expects the numbers to rise as colder weather forces people inside and as social gatherings without masks or proper social distancing continue.
Although grocery stores are open and MDHHS mandates allow for indoor gatherings of 10 or fewer people, Whitmer said people should not make the mistake of assuming that just because something is allowed does not mean that it’s safe.
“Just because you can do something doesn’t mean you should,” she said.
Both Whitmer and Khaldun cautioned people against gathering for Thanksgiving with people from outside of their households. Khaldun said even if a person gets a negative test result, that could provide a “false sense of security.” People need to be smart now so they can “have a nice holiday with loved ones alive at this time next year,” Khaldun said.
“This pandemic will eventually end, but we have to do what it takes to avoid as many infections and deaths as possible,” she said, adding that the “deadliest, most grim days of this entire pandemic” could be in the future if people do not collectively change their behaviors.
The Associated Press contributed to this article.