Michigan hospital executives sound siren about COVID-19 surge

Amid another surge of coronavirus cases in Michigan, the chief executives of five major hospital systems across the state sounded the alarm Thursday about the "exponential" rate of infection spread as patients fill emergency rooms and hospital beds.

The hospital leaders pleaded with community members to take "personal responsibility" to help the spread by wearing masks, washing their hands, practicing social distancing and staying away from large social gatherings so that medical centers don't become overrun with patients.

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"You can really bend the curve on this in a very positive way, and we need everyone's help to do that," Beaumont CEO John Fox told reporters on a call.

"We don't want to go back into the spring of this year, when it really was getting to be a very difficult situation. The health care system can capsize if you don't keep it under control."

New cases of COVID-19 doubling every two- to two and a half weeks in Michigan, and hospitalizations of virus patients are up more than five-fold over six weeks. The healthcare executives projected that Michigan will exceed the spring hospitalization peak late this month.

Michigan Health & Hospital Association CEO Brian Peters said the state is "squarely" in the midst of a public health crisis.

"If this continues in the coming weeks, we will surpass our all-time record high in terms of COVID in-patient hospitalization numbers here in the state of Michigan," Peters said.

"We need to take this very seriously because not only are the numbers very alarming, people are dying. Michiganders need to understand how serious this virus is." 

The stark warning came as COVID cases are rising swiftly again in Michigan, far surpassing the spring surge, with the seven-day average of daily cases hitting 5,312 cases a day through Wednesday —  a more than 100% increase over the average two weeks ago.

About 3,186 adults are hospitalized statewide with COVID-19, including over 600 in critical care, compared to 928 COVID inpatients a month ago on Oct. 12, according to state data.

Michigan reported another daily record Thursday with 6,940 new cases confirmed and 45 coronavirus deaths, according to tracking by the state health department. At least 7,811 deaths have been tied to the virus in Michigan — 8,185 when probable deaths are included.

The state's positivity rate stands at nearly 11%, according to state officials. A positivity rate above 3% is concerning to public health officials.

Gerry Anderson, executive chairman of DTE Energy Co. who serves on Gov. Gretchen Whitmer's economic recovery council, said he expects that folks in state government are watching the pace of increased spread and thinking about "what they need to do to intercept it."

The hospital executives did not signal an imminent need for widespread shutdowns like the state instituted in the spring or restrictions on businesses, but they said communities need to recognize the critical impact the surge could have clinically on the health care system. 

"I think none of us want to go through the shutdown and the brute force of what happened in the spring. I think we don't need to do that," Fox said.

"But I do think that government and frankly, all of our communities play a critical role in reinforcing the way that we can control this virus." 

Fox said it would be useful for Whitmer to try to work with the Legislature as much as she possibly can "to try to get this more tightly coordinated on the state level."

"She has been an advocate for a good Michigan response to COVID since the start of the pandemic and, like I said, we're now into a marathon and we really need to stay at it," Fox added.

"I really hope our government officials listen to what we're saying, process that and come up with new approaches that will help all of us in Michigan, bend the curve on this infection rate, and put this genie back in the bottle."

Henry Ford Health System CEO Wright Lassiter III said it remains to be seen whether "simply asking Michiganders will be enough."

"If doing the right thing and using ration and science isn't sufficient, then there may be other steps that end up being necessary," Lassiter said. 

Munson Healthcare President and CEO Ed Ness noted the difference from the March and April peak in Michigan is the surge now is not concentrated in southeast Michigan but is occurring across the state.

The health care leaders were not concerned about exceeding bed capacity at this time but worried about having enough staff to care for people in those beds or in field hospitals should they be needed again.

They stressed that because this COVID surge is happening around the country, hot spots are everywhere, so it's tougher to pull staff from other places to supplement their ranks.

If the hospitals do become overwhelmed, the executives suggested they would be forced to pull back on non-COVID services at some point. 

"We do not want to do that — do not think that is in the patients’ best interest," Beaumont's Fox said. 

He said Beaumont's COVID inpatient volume has tripled in less than 30 days, with over 400 hospitalized across the system's eight hospitals. "And, again, that is accelerating," Fox said.

He said hospital officials are struggling to get people to wear masks even in hospital lobbies. "We get resistance," Fox said.

Henry Ford's Lassiter agreed, saying there are pockets of communities around the state lacking good compliance with mask-wearing.

As an example, he cited Macomb County, noting Henry Ford Macomb Hospital has twice the COVID inpatient volume that Henry Ford Hospital has even though the latter has twice the number of beds as the Macomb facility.

In the last two weeks, the Henry Ford system's COVID-19 admissions have risen by 128%, Lassiter said.

"We are seeing significant escalation across our southeast Michigan hospitals and central Michigan hospitals," Lassiter said, noting that the positivity rate for Henry Ford patients has risen extensively and was 16.4% as of Thursday morning. 

"We are here this morning asking all Michiganders to support our essential workers in health care with the kind of practices that will help us help you."

Amid this escalation, Lassiter and other hospital executives indicated they're worried about the mental and physical toll on medical professionals and frontline caregivers, with Fox saying "we've got to be very careful with them and very respectful of their potential for exhaustion."

"We've been in a battle for the last eight months, and when you're in a battle for that long, you lose a bit of energy, steam and resiliency," Lassiter said.

"I would tell you that the amazing physicians, nurses and other health care workers, essential workers that work in our healthcare systems, are working tirelessly on behalf of the state of Michigan on a day-to-day basis. I ask you to help them in not having to have the volumes return as they were in the spring." 

The country is setting records for new infections, with more than 144,000 new cases reported Wednesday, according to the COVID Tracking Project. 

Michigan set new weekly highs last week, adding 29,614 cases and 221 deaths from the virus, shattering the record of 20,154 set the previous week and marking the fourth consecutive weekly record for case counts.

Fox said the community is transmitting the virus much faster than they were 30, 60 or 90 days ago. "It’s an accelerating trend. It’s very serious," he said.

Wayne County health officials said Wednesday that the county hospitals are running above 75% capacity and that an increase to 80% or greater could prompt restrictions in hospital services. 

The Detroit Medical Center announced on Thursday new visitor regulations for it's five adult inpatient facilities - one adult, 18 or older, will be allowed to visit per day. Visiting hours are from 8 a.m. to 6 p.m. every day. Any visitors will be screened for temperature, must wear a face mask, sanitize their hands and observe social distancing. 

Patients diagnosed with COVID-19 will not be allowed visitors. Patients at Children's' Hospital of Michigan can continue to have two parents or guardians in inpatient units, emergency departments, observation unit and surgery. No siblings or extended family are permitted. 

Visitors to the DMC Rehabilitation Institute of Michigan must be 18 or older and will be permitted to visit during the hours of 11am – 6pm.

In west Michigan, the 14-hospital Spectrum Health said this week its hospitals across the state will be hitting their capacity in a matter of days. The system is restricting COVID-19 testing, expanding intensive care capacity and deferring non-essential surgeries to cope with an explosion of COVID infections.

"One of the good news is that we aren't seeing the demographic disparity that we did see in the spring. It is affecting all populations," Spectrum Health President and CEO Tina Freese Decker told reporters Thursday.

"That's why it's critical for us to come together as communities to practice the things we know that work, but also limit the in-person gatherings so that we can flatten this curve, and continue to care for our communities."

She said Spectrum runs about 4,000 COVID tests a day and is reporting a positivity rate about 15% compared with two months ago in September when that rate was 3%. 

Five of Trinity Health's eight Michigan hospitals are "pretty much full," Dr. Rosalie Tocco-Bradley, chief clinical officer at Trinity, told The Detroit News on Tuesday.  

Testing supply challenges are also cropping up again, particularly in terms of Michigan's supply of rapid tests that can offer results in two hours, executives said Thursday.

"The government has to redistribute some of these test kits nationally. So what we're left with is more over-reliance on other testing platforms that can take a day to get the result back, and so that's a challenge in and of itself," Beaumont's Fox said.

"That is a resource that, for example, in Beaumont, we've been cut 20% by the government in the last two weeks, as they've reallocated to other hotspots around the country."

Testing capacity is better than in the spring, but Freese Decker said more testing and supplies are still needed.

"What I'd like to see is the faster turnaround times, so that people get those results in less than a day or two, so they can take action or and even be quarantined without having to worry or understanding what's going on," she said. 

Dr. Abdul El-Sayed, an epidemiologist and former director of the Detroit Health Department, said he’s “really worried” about the winter that’s coming.

“When the story is told about the COVID-19 pandemic, this surge is what they’re going to write about,” he said in an interview.

Politics is currently in the way of public health in Michigan because of an “ideological break” from science on the right, contended El-Sayed, who ran for governor in 2018 as a Democrat.

In the spring, Whitmer saved thousands of lives by issuing restrictions on gatherings and public outings, he said.

Now, after the Michigan Supreme Court struck down a law that allowed her to institute those policies, the Legislature either has to act or the governor has to find a way to get her unilateral powers back, El-Sayed said.

mburke@detroitnews.com

Staff Writer Craig Mauger contributed.