I am again confused by the discussion around the “next wave” of COVID-19.

There is much concern about the “fourth wave” of COVID-19 in the U.S., and blame has been placed on variants, reduced social restrictions, and lack of vaccines. Pressure has increased on the federal government to rethink its strategy for combating COVID since most new infections are concentrated in just a handful of states, including Michigan, New York, New Jersey, Florida, and Pennsylvania. Four of these states already have more restrictive mask requirements and social restrictions, so that does not seem to be a solution.

Michigan’s seven-day average of new infections rose from 1,503 on March 7 to 7,609 Friday, according to data analyzed by The Washington Post. This has generated much hysteria about Michigan on social media, but mis-information seems to dominate. National pundits like Scott Gottlieb and @Erictopol have been advocating to “redirect vaccines to save Michigan,” even though The Washington Post reports that current stocks in the state are poorly distributed to hot spots and are underutilized.

In this regard, it is really unclear whether Michigan is delivering vaccine to the areas of the state that are involved in the surge. These areas are geographically well defined, and there are issues about state and local co-ordination of vaccine distribution. Local officials have pointed to reduced demand, staffing challenges, and inadequate communication between state and local officials as barriers.

Mouhanad Hammami, director of the Wayne County Health Department (Detroit area) in Michigan, said, “a sharp and unexplained drop-off in the county’s share of Moderna doses meant it couldn’t operate one of its clinics,” ordinarily capable of administering 2,000 doses per day to people in the Detroit area. Given the increased cases in Macomb and Wayne county, this is counter-productive at best.

The federal government now seems focused on supporting Michigan’s inadequate vaccinating effort with nationally-supplied medical technicians to try to increase the delivery of vaccines, but does not feel there is a need for more vaccines in the state. The most pressing question is whether people will get vaccinated against COVID-19 if it is available. Surveys have identified vaccine reluctance as a major issue in the state.

Infections have marked lncreased.
Deaths have not followed infections.

There is also the issue that the number of infections does not accurately reflect the impact of the “surge” happening in Michigan. Michigan looks worse when examining new cases due to better testing than other states. Also, news reports have focused on a limited number of hospitals that are taking most of the COVID-19 cases. Beaumont, Spectrum, Henry Ford, Ascension, McLaren, UM, and Sparrow have the vast majority of patients.

ICU cases per capita have increased, but trail other states.

Overall, however, these hospitalizations and ICU cases, while increased in Michigan, are fewer than other states, as are deaths. This is potentially because few individuals over 65 are involved in the current outbreak, and that group, rather than younger cases, typically accounts for deaths.

So while there is clearly an increase in COVID-19 cases in Michigan, the reasons for this are cloudy. More importantly, real solutions appear non-existent.

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

11 thoughts on “I am again confused by the discussion around the “next wave” of COVID-19.

  1. I’m not at all surprised at this. I’ve read that the Thumb region has the largest increases of active cases of anywhere in the *country.* I can’t find data to support that, however, based on my experience out here in far-western Washtenaw county I can readily believe that rural areas like us, the Thumb, up north, etc., are being woefully neglected. We have been promised a vaccination hub out here by the county health department for a couple of months, however, as far as I can tell it still is non-existent. If we have one they haven’t been effective at letting us know it’s here. But even if it is out here (and we haven’t been told even where it would be located), we were told that it would be open only one day a week, on Friday, during regular business hours only (so much for working people), while the Ypsi hub would be open the other 4 days a week, i.e., M-Thu. At this point those of us out here who are eligible. want the vaccine, and are able to are driving to the TCF Center in Detroit (the old Cobo Hall) to get vaccinated. I have friends up in Ludington who had to drive to Big Rapids and Grand Rapids to get their doses.

    Also, didn’t I read a month or so ago that Detroit turned away a large shipment of the J and J vaccine because they said they didn’t need it? I wonder what’s up with that? Maybe they don’t trust or want the J and J vaccine?

    I predicted this mess months ago. As far as I can tell, like most people in public health, Whitmer’s team is composed of people who specialize in urban public health, however, I have been unable to determine if any of her team members specialize in rural communities. Hence, the apparent disorganized and inefficient nature of the vaccine rollout here in Michigan, especially in rural areas, does not surprise me at all. As I said, I predicted this months ago.

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    1. Agreed! Michigan has been horrid in distributing their stocks of vaccine. And restricting it to 65 and older until recently meant the 40-65 group with predisposing medical conditions did not get vaccinated. Many folks in Ann Arbor were going to Ohio to get vaccines.

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  2. The rumors that exist in the teaching community and nursing at U of M is that many of the patients in the current surge have been vaccinated. True/false?
    Lockdowns and restrictions seem to prevent spread at the cost of fewer people becoming ill and developing immunity. Lockdowns were originally designed to flatten the curve. Is this surge the result of those former successes?

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    1. It is absolutely NOT vaccinated people. It is mainly people 40-65 because no one under 65 in Michigan could get the vaccine! Yes, if you were going to have us all sacrifice for so long in Michigan you should have made sure everyone was vaccinated before releasing the restrictions. We are seeing a catch up effect. We need to get all adults, especially over the age of 30, vaccinated!

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  3. Confusing indeed. But one major solution is to educate the antivaxxers. Don’t ask me how to educate them, but that needs to be done if we are ever going to reach heard immunity.

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  4. Vaccine “reluctance”  Heavily concentrated in GOP and white evangelicals Anecdote: next door family of 5 in VT all recovering.  I asked the 3 teens 16,15,14–suggested they nonetheless get vaccine at appropriate time. Push-back–and not because of antibodies “Kids in school all say you could become infertile from the vaccine…” You’re right–no realistic solution to that bat craziness. We need all employers to say vaccinations are prerequisites for working We need all public and private schools to say vaccinations are prerequisites for returning.  No remote for just declining!

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    1. The mis-information is maddening. Efforts to diffuse past mistakes by politicians also raise doubt and suspicion. This is not a political issue but an urgent medical one! Thanks.

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  5. Eventually quality of life and mental health issues need to be considered as well as hospitalization/case/death metrics. I was recently in SW FL where people wore masks (almost 100%) in stores & malls but not outside. I walked past full-capacity restaurants and bars and heard talking and laughing that I haven’t heard in MI in over a year. Almost no one outside was masked. We could see each others faces and smiles. In MI I see many every day who are so terrified that they are wearing a mask while walking their dog alone. It is just too grim. My whole family felt that being in FL was like going back in time to a happier time. I struggle with “accepting” deaths but expecting zero deaths is not tenable. It is not something we do with Influenza season every year. Depression and anxiety are sweeping through adult and children populations this past year. That may be more/as harmful as this respiratory disease.

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  6. “nationally-supplied medical technicians to try to increase the delivery of vaccines, but does not feel there is a need for more vaccines in the state.”

    Wouldn’t it be a smarter idea to send vaccines fo doctors offices. We already know what we are doing. We have tried to sign up through the state and all I get is more bureaucratic bloviation. I don’t know how many hoops left they want me to jump through.

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