UM isn’t only Michigan hospital system canceling procedures over COVID-19 cases

Karen Bouffard
The Detroit News

The top surgeon at Michigan Medicine expressed alarm Thursday over rising COVID-19 infections, begging for intervention from Gov. Gretchen Whitmer, the White House and the Centers for Disease Control and Prevention.  

Dr. Justin Dimick, chairman of the Department of Surgery at the University of Michigan, tweeted the Ann Arbor-based health system was canceling surgeries due to the intake of COVID-19 patients.

He noted there had been no recently imposed restrictions to combat the spread of the virus and pleaded for help from Whitmer, the Michigan Department of Health and Human Services and White House COVID-19 adviser Andy Slavitt.

"We are starting to cancel surgical cases again to accommodate rapidly accelerating Covid-19 admissions. Entire state is high-risk," Dimick tweeted.

"Bars and restaurants are open. People are out and about. No new restrictions. We need some help @MichiganHHS @GovWhitmer @CDCDirector @aslavitt46"

Dimick's tweet came a day after the head of the CDC pushed 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.

On Thursday, the Warren-based Ascension Michigan health system said it was delaying certain non-essential elective surgeries on a case-by-case basis, and Henry Ford Health System in Detroit said it was limiting surgeries. Other health systems around Michigan did not cancel surgeries but expressed concern about the infection rate in the state.

Michigan, as of Wednesday, had the highest number of COVID-19 cases in the country, as well as the highest case rates, hospitalizations and number of intensive care patients. And hospitals across the region, their officials say, are struggling to keep up with the surge. 

"Our employees are exhausted. They're not tired; they are exhausted," Henry Ford Health System Chief Operating Officer Robert Riney said at a Thursday press briefing.

As of Wednesday, the state reported 3,549 adults were hospitalized with the coronavirus, a 274% jump from one month earlier when there were 950 hospitalizations.

Michigan U.S. Reps. Fred Upton and Debbie Dingell wrote Thursday to President Joe Biden urging him to boost the state's COVID-19 vaccine allocation amid a serious surge in virus cases, saying it would "help save lives."

Upton, a St. Joseph Republican, and Dingell, a Dearborn Democrat, said the spike in cases has placed "significant strain" on the state’s public health infrastructure.

"There is now substantial evidence of community transmission throughout Michigan" and an increase in the "prevalence of more contagious variants," the lawmakers wrote.

Asked if Whitmer might tighten restrictions to curb the spread, spokesman Bobby Leddy on Thursday instead outlined elements of the state's COVID-19 strategy, such as increasing testing and vaccinations and encouraging people to mask up and take other precautions. 

United Kingdom variant blamed

At the eight-hospital Beaumont Health System, headquartered in Southfield, health system data show the positivity rate climbed from 5% on March 9 to 20% on Wednesday. Michigan's largest health system, Beaumont normally tests about 1,000 people per day.  

The hospital system had about 700 COVID-19 inpatients across its eight hospitals on Thursday, officials said, but were not canceling elective surgeries.

Beaumont CEO John Fox blamed the surge on B.1.1.7., 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 were 517 B.1.1.7. cases among Michigan's prison inmates and a total of 2,152 U.K. variant cases statewide through Wednesday, according to the state health department. Michigan's total for B.1.1.7 variant cases is the second-highest in the nation behind Florida's 3,192, according to the CDC.

Fox said people are starting to relax safety precautions, not realizing how much more contagious the U.K. variant is than the strain that was circulating in 2020. He said the key to ending the surge is for more people to get vaccinated and following safety precautions. 

"I drive around town, I see too many people out without masks. I know they're not all vaccinated," said Fox, whose hospitals have treated more COVID-19 patients than any other health system in the state. 

"A lot of them are young people, and they don't realize that there's a new COVID in town — and it's different than what we were living with through most of the pandemic. It can move very fast and create lots of problems and disruption very quickly."

At the Henry Ford Health System, Riney said one of the most important ways people can support health care workers is to continue to mask up. His hospital system limited surgeries scheduled for Thursday and Friday, but Riney said he remains hopeful they will be able to maintain surgeries throughout the surge.

"In spite of the surge ... it is far more dangerous for anyone to delay needed care than to come to the hospital to get the help you need," Riney said. 

In comments to The Detroit News Thursday, Leddy said the state is continuing to work with Michigan health experts to monitor trends in the spread of COVID-19 across the state. 

"Unlike other states like Texas and Florida that have abandoned public health protocols altogether, Michigan continues to have smart health policies in place, such as a mask mandate and capacity limits on large gatherings," he said. "We are still very much in this pandemic, but we’ve learned a tremendous amount about how to protect ourselves and our loved ones."

Leddy said the state is moving forward with plans to ramp up testing in schools, businesses and nursing homes. 

"We have increased COVID-19 tests and expanded testing protocols for all student-athletes," he said. "And we have increased our vaccine program over the last couple of weeks, which has helped us reach a historic milestone of 4 million vaccines in under four months.

"... We will continue to collaborate with public health officials as we analyze next steps to protect Michiganders and save lives.”

In early March, 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."

'Record high emergency room' admissions

The state's 469.4 cases per 100,000 people leads the nation, surpassing New Jersey at 322 cases per 100,000 people and New York City at 299 cases per 100,000 people, according to the CDC.

The percentage of COVID-19 tests bringing positive results has been rising for six weeks and is at 15.6% for a seven-day average.

Cases among kids ages 10 to 19 have risen for the last five weeks, faster than any other age group as outbreaks continue to rise in schools and youth sports.

As of 1 p.m. Wednesday, Michigan Medicine had 78 patients hospitalized with COVID-19, health system spokeswoman Mary Masson said. 

The health system issued a statement saying: "Similar to many health systems across the state and metro region, Michigan Medicine has experienced record high emergency room and admission volumes for both COVID-19 and non-COVID-19 care this week resulting in extremely high hospital occupancy.

"Due to rising occupancy and forecasts for continued high demand for emergency care and admissions, Michigan Medicine has had to make the difficult decision to reschedule a small number of scheduled surgeries late this week and next week in order to maintain safe occupancy levels," the statement continued.

Masson said Michigan Medicine was postponing three surgeries Friday, "which on an average day represents about 1.2% of all surgeries."

At Henry Ford, Dr. Adnan Munkarah, executive vice president and chief clinical officer, said hospitalizations at the system's five hospitals this week have surpassed peak numbers from October and November. 

“The numbers continue to increase day after day. Unfortunately, comparable to 12 months ago, not four months ago,” Munkarah said at Thursday's press briefing. “We urge the community to work together to get numbers down. It would be not long from now that we see the same peaks from a year ago.”

Riney, the COO, said the health system has had daily communication with Whitmer’s office during the ongoing surge.

“We are sending our volume and our pressure points through the Michigan Hospital Association on a daily basis," Riney said. "The governor has been very concerned and very attuned to what is going on and has expressed genuine interest and understanding when we hit capacity points.

The 16 hospitals in the Ascension Michigan health system are making decisions about surgeries on a case-by-case basis, said Dr. Ken Berkovitz, senior vice president and ministry market executive, in a statement to The News.

"As we appropriately address this recent surge and continue to protect the health and safety of our patients, families, staff and providers, some non-essential elective procedures requiring an inpatient stay may be deferred for a short period of time," Berkovitz said.

McLaren Health Care system, which operates 14 hospitals and is based in Grand Blanc, and Lansing-based Sparrow Health System are not canceling procedures.

"This latest increase in COVID-19 cases in Michigan is concerning, and we are monitoring our patient volumes daily and implementing surge plans as necessary to address increased volume demands," said Laurie Prochazka, a McLaren spokeswoman.

"If COVID volumes continue to rise, we will likely need to look at postponing certain types of elective surgeries to focus resources on caring for our critically ill patients."

Twitter: @kbouffardDN

Staff Writer Sarah Rahal contributed.