Apr. 15At least eight hospitals across Michigan were listed Thursday at full capacity for COVID-19 patients as Michigan’s largest hospital system said it’s nearing its capacity, a development Beaumont Health CEO John Fox called “troubling and alarming.”
Beaumont Health issued an “urgent warning” that its number of hospitalized patients has risen from 128 on Feb. 28 to more than 800 on Thursday, more patients than experienced during the fall surge of coronavirus cases. Beaumont’s Farmington Hills, Royal Oak and Troy hospitals were listed as filled at 100% capacity, according to the Michigan Health and Hospital Association’s database.
The Southfield-based system urged Metro Detroit residents to “personally take immediate steps” to help to curb the spread of the coronavirus as most of its eight hospitals reach 95% capacity.
Henry Ford Health System’s five hospitals have been running at 90% to 95% capacity depending on the day, Chief Operating Officer Robert Riney said at a Thursday press conference. Ascension’s Macomb-Oakland-Warren hospital and its Borgess, Genesys and St. Joseph facilities also were filled, according to the hospital association’s database.
Overall, hospitals in Metro Detroit are at or nearing capacity, with COVID-19 units at 75% to 100% capacity, according to state data.
Health care officials attribute Michigan’s case surge to a combination of COVID variants, including B.1.1.7, a United Kingdom variant for which Michigan has the second-highest number of cases in the nation; a lack of herd immunity; hesitancy to get the vaccine; and Michigan’s cool weather driving more people indoors.
“This variant seems to me like a whole new pandemic because it is more virulent, it is highly contagious and it causes serious illness,” said Dr. Teena Chopra, a professor of Infectious diseases at Detroit’s Wayne State University Medical School.
Beaumont’s Fox acknowledged hospitals now have a better understanding of the virus from the first two surges in the spring and fall of 2020 as well as effective vaccines, but said more action is needed.
“To flatten the curve again, we all need to work together now: Wear masks, wash hands, avoid large gatherings, practice social distancing and get vaccinated,” he said. “We cannot do this alone. We need everyone’s help immediately.”
The latest surge is straining medical staff that has been working to help patients battle the virus for more than a year, Beaumont said.
Surge wears down workers
Hospital health care workers are running ragged across southeast Michigan, Chopra said, contending people need to be isolated to stop the spread.
“We have to do as we did in the past, and that worked for us,” she said. “Isolating is something we have control over. Shutting down is one good way of bringing the surge down.”
Michigan State University Dr. Mona Hanna-Attisha, a pediatrician who helped uncover the Flint water crisis, has made the same suggestion. Hanna-Attisha urged on Twitter Wednesday that the state “shut down,” noting a friend who is a nurse is “overwhelmed” and the nurse’s hospital was using tents because there was no room in the ER.
Beaumont’s Grosse Pointe hospital set up a triage trailer as a workspace for the staff as they assessed incoming patients curbside in their vehicles.
“Patients who are deemed stable with COVID symptoms pull up to a designated spot and have their vital signs taken” and testing is completed if they are stable enough, said Brad Lukas, chief nursing officer at the Grosse Pointe facility. “… If they need more of an extensive workup, they are brought into the hospital.”
Hospitals across Michigan are worried about soaring admissions, said John Karasinski, spokesman for the Michigan Health and Hospital Association.
“Concerns about rising hospital admissions and nearing capacity is felt across the state,” Karasinski said. “As with the other surges, the key concern with capacity is staffing levels.”
A significant number of staff are out ill with COVID-19 or on vacation due to spring break, he said. A good share of health care workers have been diverted to provide vaccinations, he added.
“Our hospitals have been staffing vaccination clinics for the past several months, but that does require staff to be allocated toward those clinics,” Karasinski said.
Chopra said more than 60% of cases in Michigan are caused by the more infectious U.K. variant. Michigan had 3,023 cases of the U.K. variant through Thursday.
The state also had 11 confirmed cases of the B.1.351 variant that emerged in South Africa; 23 cases and 34 cases, respectively, of the B.1.427 and B.1.429 that first were detected in California; and 17 cases of the P.1 or Brazil variant, according to Michigan’s Department of Health and Human Services.
“We are better equipped this time,” Chopra said. “We know how to do virtual school, we know how to take care of our health without going to the gym, by spending more time outside. But I think really the way things are at this point is a combination of vaccinations and some shutdowns.”
Nearly 29% of Michigan’s adults 16 years and older were fully vaccinated through Thursday, according to the state health department’s website.
Michigan’s cases and hospitalizations have been rising for seven weeks straight, an increase Gov. Gretchen Whitmer has tried to address through a request for voluntary compliance with a two-week pause on in-person school learning, indoor dining and youth sports. She also has asked the Biden administration for a surge in vaccines, but the administration has said it will continue to administer vaccines to states based on population.
Riney said Henry Ford health supports Whitmer’s decision to encourage people “to do the right thing” by wearing masks and urging voluntary shutdowns of schools and indoor dining and avoiding mandatory epidemic orders.
“We need to rely on the awareness and commitment of everyone to working together to solve this,” he said.
Michigan hit a new record of 4,011 adults hospitalized with COVID-19 on Tuesday, surpassing the spring and fall 2020 surge peaks. By Thursday, the number had dipped slightly to 3,960 adults hospitalized still about a 300% jump from one month ago. Of those hospitalized Thursday, 833 patients are in incentive care and 497 are on ventilators.
Michigan has an 18% infection rate. The percentage of COVID-19 tests returning positive are nearly 21% in Detroit, where 419 people are hospitalized.
Detroit Mayor Mike Duggan warned residents Wednesday, saying if the city continues on a track of 700 new cases per day, the racial health care gap in the region will widen should the city’s hospitals be overwhelmed with suburban residents.
“Our lower vaccine rate is leaving our neighbors vulnerable in a terrible way,” Duggan said about the city during a Wednesday news conference. “The worst is still ahead of us. There is no doubt that that wave is going to continue to spread down into our city and we have got to protect ourselves.”
Dr. Adnan Munkarah, chief clinical officer of Henry Ford Health System, said at a Wednesday press conference with Whitmer that COVID-19 patients have grown from 75 to 550 during the past five weeks.
“Positivity rates from inpatients were 1 in 25 and are now 1 in 5. This is extremely troubling,” Munkarah said.
Why ER rooms are crowded
At Michigan Medicine emergency departments, the number of COVID patients is similar to last spring. But the situation is compounded by patients who were missing from the emergency department during the spring 2020 surge individuals with cardiac arrest or stroke symptoms or car crash victims, said Dr. Brad Uren, an emergency department doctor and University of Michigan associate professor of emergency medicine.
Uren stressed that cardiac arrest and stroke patients should continue coming to the hospital and marked their continued presence this spring as a positive change from the last surge, when individuals avoided the emergency department and increased their risk of death.
“There is always a concern that we would unnecessarily make people stay home” by announcing capacity concerns, the University of Michigan health system doctor said. “That’s not something we want. But with the combination of the regular volume and the COVID surge, it really is starting to strain the system.”
The situation is complicated by the fact that hospitals have continued to provide a full range of health care services unlike last spring, when non-COVID-19 care shut down statewide under a Whitmer emergency order, the hospital association’s Karasinski said.
“The difference between now and last spring is that pretty much all the outpatient clinics are still running, where in the past some of those staff were allocated to the hospital,” he said. “Now that virtually all health services are available, that’s not as much of an option.”
Why is Michigan surging?
About 28% of Michigan residents are fully vaccinated, 43% have at least one dose, “and that’s a far cry from where we need to be to get those herd immunity numbers that will really bring this under control,” said Dr. Nick Gilpin, Beaumont’s medical director of infection prevention and epidemiology. Whitmer’s goal is to reach 70% of the adult population.
The surge is being driven by a younger demographic of unvaccinated residents, Gilpin said.
“We know that there are specific variables here. We know the B.1.1.7 UK variant is more transmissible and another third variable is environmental,” he said. “Even though we enjoy this weather in Michigan, it’s still conducive to more indoor activities and so people are continuing to gather indoors and the cooler, somewhat drier air is better for this virus to move around.”
He noted that larger states like Florida and Texas that were hit early on in the pandemic have better climates and people are safer spending more time outdoors.
“I think it’s a bit of a perfect storm to explain why Michigan is where we are right now,” Gilpin said.