CDC director wants 'stronger' restrictions in Michigan, countering Whitmer

Melissa Nann Burke and Karen Bouffard

Washington — The head of the Centers for Disease Control and Prevention is pushing for stronger restrictions in Michigan to slow a spike in COVID-19 infections, such as a pause on indoor restaurant dining and tighter rules around youth sports.

"I would advocate for sort of stronger mitigation strategies, as you know, to sort of decrease the community activity, ensure mask-wearing, and we're working closely with the state to try and work towards that," CDC Director Rochelle Walensky said about Michigan in a Wednesday briefing. 

The CDC director's remarks came as Michigan's top epidemiologist said Wednesday the state has the highest number of cases, the highest case rates and the highest rates of coronavirus hospitalizations and intensive care unit use in the nation. Epidemiologist Sarah Lyon-Callo also noted that Michigan ranked 12th highest in the nation for its number of COVID deaths and is tied for No. 28 for the highest death rate in the last seven days.

Walensky suggested that in areas of substantial or high community transmission — which includes Michigan — "I encourage communities to consider adjustments to meet their unique needs and circumstances," such as refraining from youth sports that are not outside and cannot be conducted at least 6 feet apart.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, speaking at a White House briefing in January.

It was the first time that Walensky has publicly suggested Michigan tighten its COVID controls since the state's cases began spiking in recent weeks.

In early March, Gov. Gretchen Whitmer's administration eased COVID-19-related restrictions on businesses, nursing homes and other gatherings, a move the governor described as "good news" for Michigan. The orders, which included doubling capacity limits at restaurants from 25% to 50% and moving the curfew for indoor dining from 10 p.m. to 11 p.m., are set to expire on April 19.

Rather than imposing stricter COVID rules, Whitmer told CNN on Tuesday that Michigan might be able to lift most remaining COVID-19 business restrictions this summer if the state's vaccination rate increases. But she said youth sports "may be one area that we've got to do more in."

Michigan's goal is to vaccinate 70% of individuals older than 16. The rate was nearly 24% through Tuesday.

Asked to comment on Walensky's remarks, the governor's office said Michigan continues to have "smart" health policies in place, such as a mask mandate and capacity limits on large gatherings, unlike states such as Texas and Florida where limits were dropped.

"We are still very much in this pandemic, but we’ve learned a tremendous amount about how to protect ourselves and our loved ones," Whitmer spokesman Bobby Leddy said.

"That’s why every Michigander has a personal responsibility to do their part by wearing a mask, washing hands and maintaining social distancing to help us slow the spread of this virus." 

The state is moving ahead with plans to ramp up testing for schools, businesses and nursing homes and expanded testing protocols for all student-athletes, in addition to growing the state's vaccine program in the last two weeks, he noted. 

Michigan's COVID spike

The state and federal briefings Wednesday highlighted how Michigan has become the worst-hit state for COVID-19.

The state's test positivity rate is up 348% from six weeks ago, increasing from 4.3% on Feb. 19 to 15.6% on Wednesday, said Lyon-Callo, director of Michigan's Bureau of Epidemiology and Population Health, during a press briefing in Lansing.

Case rates are up 375% since the Feb. 19 low point, from 190 per million to 491 per million currently, she said. About 5,000 new cases a day are being reported in Michigan, with the numbers exceeding 8,000 on some days, Lyon-Callo added. 

Michigan added 8,015 cases and 30 deaths on Wednesday, according to state health department data.

Michigan state epidemiologist Sarah Callo-Lyon works in the Michigan Department of Health and Human Services.

Walensky said Wednesday that CDC teams are on the ground in Michigan working to assess outbreaks in correctional facilities and facilitate more testing in the context of youth sports.

Her agency is also doing increased public health surveillance and sequencing to better understand "what is happening with the B.1.1.7" variant and others, Walensky said.

She was referring to the United Kingdom variant that is 50% to 100% more transmissible than the original strain and is now the most common strain in the United States, according to the CDC. There are 517 B.1.1.7 cases among Michigan's prison inmates and the state had a total of 2,152 U.K. variant cases through Wednesday, according to the state health department. Michigan's total is the second highest in the nation behind Florida's 3,192 cases, according to the CDC.

Federal public health officials said there are no plans to boost the supply of COVID vaccines to Michigan, as the federal government continues to allocate doses based on population.

However, Walensky noted Michigan officials are "surging" vaccine supply to areas of the state that are experiencing more outbreaks of COVID-19.

"We have within the state the ability to move vaccines around, of course, but we're in close contact — both through the CDC and in direct conversations with the governor and her team — around what are the resources that can be most helpful at this point in time," White House COVID-19 adviser Andy Slavitt said of Michigan.

"And nothing is off the table in those conversations in terms of the kind of support that we can provide, and we'll keep all options open as we as we stay close."

Slavitt noted there's a "menu of things" that his team reviews with states in these kinds of situations, including staff, personnel, therapeutics and locations.

Variant challenge

All three COVID variants of concern are present in Michigan, according to Lyon-Callo. The number of confirmed cases is expected to be lower than the number of actual infections because variants can only be confirmed through genetic sequencing of virus samples. 

The United States has found 386 cases with the B.1.351 variant, first identified in South Africa, including 11 in Michigan through Wednesday. And of 356 U.S. cases of the P.1 variant, first identified in Brazil, Michigan has confirmed six cases. 

The state has recently emphasized doing more testing. Michigan's seven-day average state testing rate increased from 3,253 tests per million residents per day last week to 3,497 tests per million residents per day this week, Lyon-Callo said.

One area where Michigan has seen outbreaks in recent weeks has been in youth sports settings, contributing to COVID cases among children ages 10 to 19, rising for the last five weeks — greater growth than among any other age group.

Walensky noted the CDC's guidance in this area of youth sports is "pretty clear," in regard to having substantial or high transmission.

"These activities should be happening outdoors and more than 6 feet apart," she said, adding that testing should happen at least twice a week if these are sports at high risk for virus transmission. 

An epidemic order issued by Michigan officials last month requires rapid COVID testing for all youth athletes ages 13-19 — rules that apply to middle schoolers through high schoolers, as well as private club sports.

Whitmer said Tuesday that officials might need to take additional action to stem the transmission through school and club sports. 

Beaumont Dearborn Hospital has a separate COVID-19 unit. Across the nation, hospitals are seeing more young adults — individuals in their 30s and 40s — admitted with "severe disease," Centers for Disease Control and Prevention Director Rochelle Walensky said.

"We are seeing the spread continuing in teenage sports and, frankly, it's something that we're very concerned about," she said. "... This may be one area that we've got to do more in."

An advocacy group last week sued Michigan's health director over the new COVID-19 roles and protocols for youth sports rules, arguing they are "invalid" and violate due process rights.

Nationally, the CDC is also tracking a surge in outbreaks in day care centers, Walensky said Wednesday. Hospitals are seeing more young adults — individuals in their 30s and 40s — admitted with "severe disease," she said.

Staff Writer Beth LeBlanc contributed.