Could the latest COVID-19 surge in Michigan have been avoided?

I have written several blogs about the latest surge in Michigan because I think it is a microcosm of the adverse public health management nationwide during the pandemic. Michigan had done a remarkable job of social distancing and implementing actions to protect the population in the first year of the pandemic. This was primarily in response to the outbreak in Detroit and southeastern Michigan early on in the March-April 2020 timeframe.

After that initial outbreak, the limitations on movement, social activity, and restaurants were among the most restrictive in the country with significant detrimental economic effects (including the highest unemployment rate in the country). Most businesses were closed completely, with only food stores open but having marked limits on the number of patrons. Hardware stores were limited to selling necessities, while most restaurants were closed for months. Even golf and other outside activities were prohibited. These measures effectively kept the population from becoming infected, as much of the population avoided exposure to SARS-CoV-2. The Michigan population therefore was truly naive to the infection as compared to much of the rest of the country.

When Governor Whitmer announced that restrictions would be aggressively eased in mid-February of 2021, the state was still early in the implementation of its vaccine campaign. It had restricted vaccines to those over 65 years old and health care workers. There also was a confusing, poorly accessible system for individuals to sign up for vaccines that were mainly available to local public health facilities. Most health care organizations and hospital chains had little vaccine on hand. This meant that almost no one under the age of 65 in the state had been vaccinated.

Michigan has the highest 7-day case rate in the country in March 2021.

Soon after social distancing restrictions were eased, infections in the state of Michigan exploded. Michigan had the highest rates of infection in the country and therefore a significant increase in hospitalizations and deaths from COVID-19. The fact that those who were infected were almost exclusively, non-vaccinated individuals under 65 years old raised the question that if the government had waited until the entire population had had a higher level of immunization, could the surge have been prevented? Here is further data to support that hypothesis.

Data from Israel showing the suppression of new COVID-19 infections (Blue line) by first dose vaccinations (yellow line). The drop began when the population was 40-50% immunized.

Data (shown above) from Israel clearly shows that transmission of COVID-19 decreases drastically once approximately 40-50% of the population is immunized. The figure shows that despite social distancing being lifted in Israel when 50% of the population was immunized, there was no increase in infections. In fact, COVID-19 infections continue to drop dramatically despite the absence of social restrictions. 

Tom Finholt, dean of the School of Information at UM, generated a similar diagram of infections vs. vaccination rate in Michigan over the past six months. His curve is below.

Seven day averages of new infections (blue line) vs cumulative first dose vaccine percentage (yellow line)in Michigan over the past six months. Note that the new cases start falling when first vaccines had been given to 40% of the population.

New cases exploded after social restrictions were lifted from early February to mid-April. At this point in April about 40% of the Michigan population had at least one dose of the vaccine. Since that time new cases dropped dramatically despite no increase in social restrictions. This data totally parallels what was observed in Israel.

This analysis suggests if Governor Whitmer had waited six more weeks to release social restrictions, vaccinations would have reached a critical point that afforded protection to the majority of the population, and the surge would never have happened. Instead, much of the benefit from the incredible sacrifices made by the state’s residents has been wasted by one bad decision.

It isn’t clear why the governor released social restrictions in mid-February, and this has been the subject of much partisan debate. Only she knows for sure, and the Governor has not provided an explanation. Regardless of the reason, many lives were lost, and young people with increased susceptibility to COVID-19 paid a horrible price for this very bad decision.

Published by jbakerjrblog

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

10 thoughts on “Could the latest COVID-19 surge in Michigan have been avoided?

  1. I’m guessing that the Governor eased restrictions sooner rather than later simply because the last time she refused to lift restrictions, armed protesters marched on her office and attempted to kidnap and kill her.

    I think the legal term would be a decision made “under duress.”

    I don’t blame Governor Whitmer for the bad decision, but rather the threatening, violent anti-mitigation protesters and the right-wing Republican leaders who incited them and subsequently refused to condemn their behavior. The lives lost and the suffering of those infected are their fault.

    Would also have liked to hear the Michigan medical community and the major universities loudly support the Governor’s restrictions, and even more vociferously oppose the lifting of restrictions before it happened.

    Liked by 1 person

    1. I agree that the Gov. has been under duress for much of this time, especially last summer and fall when the crazies were threatening her (and organizing the kidnapping!). However, things had very much calmed down by February. Also, the Universities have been very supportive and the major health care systems were in favor or maintaining social restriction, but were not consulted. Vaccine distribution was also handled at the state level without much input of medical systems. So it was a surprise when the restrictions were lifted and the extent of the changes. I think everyone learned from this experience and we don’t want to lose this lesson.

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  2. The governor can do no right. She shut things down, got things calmed down and her opposition screamed dictator and abuse of power. After many months of hammering, would she shut things down again. Nope. She stated that everyone knows masks, distancing, numbers, proximity, duration, the in vs outdoors and more. It was time to say ok people take some personal responsibility to control this virus. Do the right thing. Nope. Then more complaining. It shake my head.

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    1. See Rick’s response. I am not commenting on the Governor but looking to make sure that the next time we don’t wind up wasting the incredible sacrifices made by the population by “dropping the baton” before the finish line. We are talking about only 6 more weeks after having restrictions in place for over 9 months. If we know that next time the decision will be more informed and easier.

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  3. What a myopic response. You underestimate the mental toll on young people and society. It was bad enough lockdown lasted as long as it did. How about doing what Ohio did? If you were a kid or restaurant owner in Ohio, you were much better off. So disappointing a medical professional ignores the big picture. I guess if you have a hammer, everything is a nail.

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    1. Rick. My point was not to approve the initial highly restrictive approach that limited exposure, but what was the outcome from that approach. As you suggest, severe social restrictions can only be in place for some period of time, then use as a bridge to some other approach; progressive release of restrictions, new therapies or population vaccination. In this case, new therapies were not available and or progressive social restrictions were not chosen. Also, and the state’s vaccine program was wanting (many Michiganders got their vaccines in Ohio). The result was in some ways the worst of all worlds.

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      1. Therapies not available? What?
        ivmmeta.com
        I treated many patients myself: not one death, not one hospitalization.
        Therapies exist and are extremely effective. Most Doctors are simply ignorant of published science.

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  4. We know from Stanford data and Sweden that lockdowns and social measures have no effect on mortality.
    We also know that Gretchen decision to incarcerate elders in covid infested nursing homes greatly increased mortality.
    Our Governor’s actions were and are always against scientific data. Just like reopening according to a population vaccination schedule: which is of course a punishment of Michiganders, while ignoring CDC recommendations and science.
    What a shame. What an enormous loss for the state.

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  5. This thesis relies on some pretty large assumptions. Namely, that the specific restrictions the governor relaxed (allowing indoor dining and contact sports) were the primary drivers of this wave and that keeping them in place would have all by itself prevented it.

    The data I’ve seen suggests that this is unlikely to be the case. Throughout that wave, there were far more outbreaks reported from construction, manufacturing, long-term care facilities and retail than from indoor dining. And, although there was an increase in positive tests for teenagers and young adults, their positivity rate was significantly lower than the statewide average and there were still more cases among older adults than younger ones. This suggests that the virus was less prevalent among teenagers and youth athletes compared to the rest of the population.

    Have you considered the possibility that this third wave would have occurred no matter what the governor did?

    Liked by 1 person

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