Spring brings dip in COVID cases. To avoid another surge, experts say take action now

Hayley Harding
The Detroit News

As COVID cases drop ahead of an anticipated lull in cases over the summer, experts say it is likely our own behavior that will determine how bad the next surge is.

Case numbers, while lower than they were during the winter months, are still relatively high. Across Michigan, five counties are considered to have "high" community levels by the Centers for Disease Control and Prevention, a level at which the CDC recommends mask wearing indoors. That includes Wayne and Oakland counties, Michigan's two most populous counties.

So even as cases are falling, the virus is still around. And doctors say the actions that Michiganians take now will inform what the fall and winter will be like

"This summer is our time to prepare," said Dr. Natasha Bagdasarian, chief medical executive for the state of Michigan.

Based on the CDC's community levels, only 36% of Michiganians live in places where they need to mask up. That number is still higher than a month ago, when only one county was at high transmission levels, but it's lower than it has been in the weeks since, when half the population or more was advised to wear masks indoors.

"We saw an uptick for several weeks," said Tammy Terrell, chief nursing officer at MyMichigan Health. "And when I say uptick, it was nothing compared to what it was in the previous wave. ... But now, I would say we've plateaued and in some locations began to drop and have almost no COVID."

Of Michigan's 83 counties, in addition to Wayne and Oakland counties, Washtenaw, Saginaw and Mackinac also are now considered to have high community levels. Another 37 have medium levels, where people are advised to test before being around others who are more susceptible to severe illness, and to mask around them, while 41 counties, or nearly half, are back to low community transmission levels.

That's a good sign, for now, but experts say that doesn't mean the virus is on its way out.

"Summer is always a better season in Michigan. This is what we know," said Dr. Vikas Parekh, associate chief medical officer for Michigan Medicine. "But because things won't be so bad in the summer doesn't mean we won't be in a tough spot later."

Future COVID upticks likely later in the year

Instead, there is likely to be two more big surges this year. The first is likely to occur a few weeks after students return to classrooms in the fall; the second is expected around the holidays, when people travel and gather with with others.

Bagdasarian said part of the reason the state has been able to avoid some of the worst outcomes from COVID-19 is because so many people 65 and older have been vaccinated. Data from the CDC on Thursday show that more than 92% of people 65 and older in the state have at least one dose of a vaccine.

But Michigan lags other states in percentage of the population vaccinated, she said. CDC data indicates Michigan ranked 35th among U.S. states for percentage of its total population that is vaccinated, with only 67.3% of all state residents having at least one vaccine dose. That's well below the United States as a whole, where 78% of people have at least one dose of a COVID-19 vaccine.

"Not only that, but we see disparities in racial and ethnic groups," Bagdasarian said. "In addition to that, we see differences based on geography and where you live in the state. What that boils down to is we have counties where there is a robust vaccine uptake across the age spectrum and we've got a good chance of keeping kids in school in person in the fall.

"And then we have other parts of the state with really low vaccine uptake in 5- to 11-year-olds, and we will struggle much more at keeping kids in person in school in the fall with the expected increase in cases that we're looking toward."

How to prepare for future COVID surges 

To try to counteract that, Bagdasarian said the state is working to meet people where they are with vaccinations. That could be pediatricians' offices, schools, churches, mobile vaccine clinics or other places. The state also is working to make therapeutics more accessible for those who do get sick to avoid getting dangerously ill.

That can help provide what Dr. John Brooks, infectious disease specialist at McLaren Health Care and chair of McLaren's emerging pathogens response team, called "adequate protection." 

But that alone can't necessarily keep people safe, he said, pointing to the Mackinac Policy Conference, where attendees were required to either be vaccinated or provide a negative test to attend. Few wore masks during the event, and at least 40 cases of COVID-19 were linked to the conference as of Wednesday out of more than 1,300 attendees.

"You put a bunch of really healthy people who are vaccinated or recently tested negative all together, and that's the thing about asymptomatic people and low-symptom people. They think they're fine, but lo and behold, they're exposing a bunch of people," Brooks said. "That's one of the reasons to make sure you're vaccinated and boosted. Your defenses are good, and they you're less likely to make people around you sick."

The messaging may have changed as the virus has evolved, Bagdasarian said, but the goal remains the same: Avoiding as many deaths and severe illness as possible.

"I think vaccinating as many folks as possible is out best shot to protect Michiganders in the winter," she said.

Encouraging people to get vaccinated, either for the first time or for important booster doses, can help keep people safe. So can having a plan in place for if you do think you've been exposed.

Having a plan means stocking up on quality masks and home tests now, rather than when quarantining is called for. That also means talking to a doctor about whether therapeutic drugs could help. If so, you are, discussing it ahead of an infection can make it much easier to get a prescription.

In the meantime, doctors said it was important to continue doing the things that have kept people safer for the past two years: Wearing masks in crowded places, choosing well-ventilated spaces to gather and managing risk.

That advice, Parekh said, can keep people safe both now and when the future waves come.

"Even though numbers may look OK, that doesn't mean there isn't a lot still going on out there," he said. "If you let your guard down, don't be surprised if you catch it."


Twitter: @Hayley__Harding