Lansing — Michigan Gov. Gretchen Whitmer is asking communities to reduce the spread of coronavirus by canceling or postponing large gatherings, reducing in-person gatherings, considering telework or tele-learning options and limiting nonessential work. 

Whitmer also has called for hospitals to limit visitors or implement screening measures after a man in Wayne County and a woman in Oakland County tested presumed positive for the virus. The first-term governor made the requests during Wednesday afternoon from the state Emergency Operations Center.

“These recommendations should be considered minimums,” she said in a public address Wednesday. “We encourage people to consider going further. Ultimately, these recommendations are about slowing the spread of the disease to ensure that medical facilities have adequate staffing and resources for vulnerable populations and those who are sick.”

The governor told Michigan residents on Wednesday that the state had "tough choices" ahead as it responded to new cases of COVID-19 and asked all Michigan residents to take the recommendations seriously. 

"We’ve gotten through tough times in Michigan," Whitmer said. "We’re going to get through this.”

Whitmer asked Michigan residents to think of the most vulnerable in the population before going out in public while feeling ill.

“Don’t put yourself or them at risk,” she said. “Our kids, our education system, our economy is counting on every one of us to do our part.”

Chief Medical Executive Dr. Joneigh Khaldun and Department of Labor and Economic Opportunity Director Jeff Donofrio encourage employers to relax sick day rules so employees felt free to stay home if sick. Khaldun also recommended schools limit large gatherings. 

"While we do not currently know of any broad community spread in Michigan, we are recommending preventative measures," Khaldun said.

The mitigation recommendations could change as the situation in Michigan progresses. 

"At every juncture, we are going to make decisions based on fact and science and what is in the best interest of Michigan residents," Whitmer said.

About Wayne, Oakland patients

The governor and Khaldun had no updates on the first infected patients. But Oakland County officials believe the county's only confirmed case of COVID-19 presented little to no exposure to others within the county limits.

Within a day of arriving back to Michigan after international travel, the woman reported to the hospital, said Dr. Russell Faust, medical director for Oakland County. She is in good condition and is being held in a respiratory isolation unit at an undisclosed hospital, Faust said.

The woman was tested Monday night and, roughly 24 hours later, the state announced she and a man in Wayne County who had recently traveled domestically were the state's first presumed positive results.

The state confirmation of the virus in Michigan prompted Whitmer to declare a state of emergency Tuesday night and, on Wednesday, the state’s large universities announced they would move all instruction online. 

Specimens from the individuals in Wayne and Oakland counties were sent to the state Monday night but didn't arrive at the state laboratory in Lansing until Tuesday morning. They were tested that day and identified as positive at 9 p.m., said Lynn Sutfin, a spokeswoman for the Michigan Department of Health and Human Services.

At least one of the patients confirmed positive Tuesday night is being treated at the University of Michigan Health System and is in stable condition, spokeswoman Mary Masson confirmed. The hospital used proper precautions to isolate the patient, she said. 

"Based on that, risk of infection is low for our employees and visitors, even if you work in our hospitals or near the unit where the patient is isolated," Masson said. 

Additionally, a Michigan State University student who had contact with the individual in the Wayne County case and is symptomatic, said Amanda Darche, a spokeswoman for the Ingham County Health Department. 

The individual's test was submitted Wednesday to the state. 

Wayne County is working to assess how many people, if any, its patient came into contact with, said Mike McElrath, a spokesman for the health division. 

Overall, the county is monitoring 11 people and has monitored a total of 18 since the beginning of the outbreak. Eight people have been tested, including the most recent confirmed case. 

Wayne County is expected to launch an outreach program that would involve training for 60 managers who would then train 900 volunteers to deliver meals and educational materials to seniors throughout the county, McElrath said. The county hopes to reach the most vulnerable to the virus through the outreach. 

"We’re delivering to our 3,500 (Meals on Wheels) participants first and then working with our community partners to deliver to other seniors," he said.

Michigan gets federal aid

The Centers for Disease Control and Prevention on Wednesday gave Michigan $14.5 million to help with its response to the coronavirus outbreak. The money comes from the $8 billion supplemental spending package that Congress passed last week and that President Donald Trump signed. 

That package allocated $1 billion for state and local response, roughly half of which was expected to be distributed to certain localities. Wednesday's allocation was $560 million nationwide.

Michigan municipalities would also be able to apply for $350 million in "hotspots" funding in case of an outbreak, said U.S. Sen. Gary Peters, D-Bloomfield Township. Another pot of funding is available to reimburse states and localities for activities they already carried out related to the virus, such as testing, monitoring and infection control, according to Peters' office. 

Hospitals across the state have been preparing for a COVID-19 confirmation in Michigan for weeks, and many have activated emergency response plans, according to the Michigan Health & Hospital Association. 

Hospitals treating COVID-19 patients are working to minimize "the risk of exposure for all other patients and hospital employees," said Brian Peters, CEO for the association.

The Veterans Administration has canceled non-treatment activities such as ceremonies outreach activities for the next 30 days to help prevent the spread of the virus, U.S. Rep. Debbie Dingell, D-Dearborn, said Wednesday. People with appointments or who are feeling sick should still come to VA offices, including those in Detroit and Ann Arbor.

Oakland officials respond

Oakland County will not release where the individual with coronavirus traveled to, but Faust said it was a country that, at the time, had no confirmed cases of COVID-19.

"The country they traveled to at that time had no positive cases of coronavirus report, which just tells you its everywhere now. It’s a global phenomenon," Faust said. 

Oakland County is well-positioned to address the case and the likelihood of additional ones, in part because of its experience stemming a measles outbreak last year, he said. 

The county has evaluated 70 possible cases; 35 of which were not positive and 34 of which are currently under evaluation, Executive Dave Coulter said. Coulter partially activated the Oakland County Emergency Operation Center Wednesday morning to coordinate response.

"We know that this isn’t going to be the last case here so we encourage people to be cautious," Coulter said. 

The Oakland County Board of Commissioners recently approved roughly $500,000 to ensure the county has the resources it needs, but the question remains whether enough testing resources are available, Faust said. 

"There are not adequate resources in the United States for all of the testing that could be done," he said. 

Nationally, the number of cases has risen to more than 1,000 in 40 states with 37 deaths, according to the Associated Press.

In Michigan, 57 individuals had tested negative for COVID-19, and 18 test results were pending as of Tuesday night, which is the most recent information provided by the state.

Michigan public health officials since Jan. 31 have asked a total of 493 people to self-quarantine for 14 days due to travel to areas with a high risk of exposure to the coronavirus, according to the state's data. 

There are 87 people in isolation under active monitoring by county health departments in Michigan. The remainder were released after completing their 14 days of quarantine without showing symptoms.

Patients with confirmed infection have reportedly had mild to severe respiratory illness with symptoms of fever, cough and shortness of breath. The CDC believes that symptoms might appear in as few as two days or as long as 14 days after exposure. 

The Michigan Department of Health and Human Services activated the state's Community Health Emergency Coordination Center last month to coordinate with local health departments and medical providers.

Michigan can test for COVID-19 at the state laboratory in Lansing with a turnaround time of four hours per test. The testing that confirmed the cases in Wayne and Oakland counties was performed in the state lab.

Staff Writer Melissa Nann Burke contributed.

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