Experts: COVID-19 deaths in Michigan point to thousands of cases

Craig Mauger
The Detroit News

Michigan's three fatalities tied to COVID-19 likely indicate that there are thousands of people infected with the virus in state, according to experts who study the spread of diseases.

The deaths may indicate more about how widespread the virus is than testing results unveiled each day by government officials, the experts said Thursday. Michigan had 334 confirmed cases of coronavirus as of midnight Wednesday night, according to numbers from the state Department of Health and Human Services.

"The testing is problematic in both directions," said Joseph Eisenberg, a professor of epidemiology at the University of Michigan.

An undated electron microscope image shows the Novel Coronavirus SARS-CoV-2, yellow, emerging from the surface of cells, blue/pink, cultured in the lab. Also known as 2019-nCoV, the virus causes COVID-19. The sample was isolated from a patient in the U.S.

In one direction, not everyone who has coronavirus is being tested because of problems with access to testing and because people with mild symptoms aren't prioritized, Eisebenberg said. However, in the other direction, as testing becomes more widely available, the confirmed cases will shoot upward — apparent spikes tied to the expansion of testing.

On Thursday, the Michigan Department of Health and Human Services released the first statewide testing numbers that included hospital and private laboratory data. And the number of confirmed cases of COVID-19 in the state increased from 80 as of midnight on Tuesday night to 334.

Eisenberg, who has studied epidemiology for 25 years, pointed to the three deaths as a better indicator of the reach of the virus. That's because experts can make projections based on the mortality rate — somewhere around 1% — and the approximation of how the virus spreads, he explained. For COVID-19, the number of people with the virus about doubles each week without intervention, Eisenberg said.

Someone who dies because of COVID-19 likely got infected three or four weeks ago, he said. At that point, there were likely 100 cases because of the 1% mortality rate. If the cases double each week, that would mean there would be about 800 cases three weeks later, Eisenberg said.

The first death tied to COVID-19 in Michigan was a Southgate man, announced  Wednesday. Two additional deaths were announced Thursday.

The three deaths mean there are now likely thousands of cases in Michigan, Eisenberg said. But he added that Gov. Gretchen Whitmer's effort to limit public gatherings and  close schools could lower the rate at which the virus spreads.

Dr. Teena Chopra, an infectious disease specialist in Detroit, agreed with Eisenberg's analysis and with the idea that Michigan likely has thousands of cases. Someone who dies because of COVID-19 likely had the virus for 30 days, Chopra said.

"In that 30 days, there has been a lot of exponential spread of infection," she said.

Chopra said there is simply not enough testing happening to determine who has the virus and how many people have it.

“The more you test, the more you isolate, the more you flatten the curve," Chopra said. "That is our biggest problem and challenge.”

Officials want to "flatten the curve" of how many people are getting sick to minimize deaths and prevent a sudden spike in cases from overwhelming hospital systems. But Eisenberg recommended that people not panic about the virus.

What Whitmer has done to prevent the spread is "good" in the short term, but can't be sustained and eventually the restrictions will have to be relaxed, he said.

Perhaps, in the future, the state could bar large gatherings and require online teaching at universities and schools while lifting other bans, such as the closure of dine-in service at restaurants, he added.

“We need to be able to have restaurants open because those people will go out of business," Eisenberg said.