Rural, Republican counties are Michigan’s newest COVID-19 hotspots

High state death toll surpasses UWash projections months ahead of time

COVID-19 cases in Michigan | Laina G. Stebbins graphic

While Republicans in the Legislature continue to push to reopen Michigan’s economy quickly, new data suggests that relaxing restrictions too early would come at an elevated risk for a second — possibly worse — wave of COVID-19 for which the state’s hospitals would be underprepared.

And many of the areas that likely would be hardest hit are the ones they represent.

New insights from the Washington, D.C.-based Brookings Institution show the majority of Michigan counties recently experiencing a jump in COVID-19 cases are rural and voted strongly for President Donald Trump in the 2016 election.

Map showing risk status of some Michigan counties based on reopening metrics | COVID Act Now

“There is a stereotypical view of the places in America that COVID-19 has affected most: they are broadly urban, comprised predominantly of racial minorities, and strongly vote Democratic,” writes senior fellow William Frey. “This underlines the public’s perception of what kinds of populations reside in areas highly exposed to the coronavirus, as well as some of the recent political arguments over social distancing measures and the states easing their restrictions.”

Michigan’s COVID-19 outbreak is starting to slow. But that’s where the good news ends, as a popular data model shows Michigan has surpassed its most optimistic projected peak of deaths three months ahead of time and maxed-out intensive care units (ICU) in many parts of the state are unlikely to have the capacity to handle a second wave.

As of Tuesday, Michigan has reported more than 44,300 positive COVID-19 cases and 4,179 deaths. The virus has now taken the lives of more Michiganders than the population of Fremont, a city on the west side of the state in Newaygo County.

Michigan currently ranks seventh in the nation in its number of confirmed COVID-19 cases and third in deaths. Overall, the United States has more than 1.2 million positive cases and 71,200 deaths.

Surpassing the projected peak

The data model from the University of Washington, which has offered the most optimistic forecast of the COVID-19 outbreak, had predicted that Michigan would peak at 3,920 deaths from COVID-19 in early August.

But Michigan surpassed that number over the weekend – more than three months earlier than the model had predicted. The state reported 4,020 total deaths on Saturday.

Updated projection of total COVID-19 deaths in Michigan | University of Washington chart

On Monday, the UWash data forecasts underwent some big adjustments to catch up with the rising death toll. The projected peak on Aug. 4 now stands at 7,080 total deaths, almost doubling where it had been just a few days earlier.

The model also had to adjust to another rise in the number of deaths per day. Previously, April 12 to 15 and April 23 had accounted for the highest numbers of deaths per day with 135 and 133. May 1, however, also turned out to be a peak with 132 new deaths reported that day.

The UWash model, which is among those being used by the White House, has also issued big course corrections in other states and nationally over the last week. Those changes include big jumps in the forecasts for state death rates, with Michigan being one of five states with the biggest increases.

On Monday, nationwide projection jumped from 72,000 all the way to 134,000 estimated COVID-19 deaths by August. The model had been updated numerous times before then, with each update seeing a larger increase in mortality estimates.

UW model: 3K could die in Michigan even with strict social distancing

New rural hot spots 

GOP lawmakers who want to reopen the state economically quicker than Gov. Gretchen Whitmer’s plan have argued that Michigan’s rural counties should have different, more relaxed guidelines for COVID-19. At the beginning of the outbreak, those areas were slower to show positive cases and deaths.

But COVID-19 is now spreading more rapidly in many of those areas, according to a troubling new dataset from Frey that was first reported by Greg Sargent in the Washington Post.

Frey’s newest analysis uses data available from the New York Times and the U.S. Census Bureau. In the last five weeks, he found that more than 1,100 counties across the nation have newly achieved “high-prevalence status” for COVID-19. Most of these counties have one thing in common: They voted strongly for Trump in 2016.

This also is true in Michigan: 25 of the 31 Michigan counties on Frey’s list of new COVID-19 hotspots went for Trump in the 2016 election, and most of those are in rural areas of the state.

According to Brookings, the 25 Republican counties in Michigan that are now considered “high-prevalence status” are: Missaukee, Hillsdale, Lapeer, Branch, Otsego, Tuscola, Arenac, Crawford County, St. Clair, Ionia, Iosco, Livingston, Alpena, Monroe, Lenawee, Jackson, Shiawassee, Clinton, Berrien, Bay, Calhoun, Macomb, Eaton, Kent and Saginaw.

Hillsdale, Branch and Jackson counties all compose the Senate district of Senate Majority Leader Mike Shirkey (R-Clarklake), who has been one of the most vocal advocates for opening up the state with fewer restrictions.

“Our citizens have coped with loss and learned how to safely live and function in the presence of COVID-19,” Shirkey said in a floor speech Thursday.

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‘Moderate’ risk of reopening

According to another COVID-19 model, Michigan is making slow progress on containing the virus, but still needs much more testing and more available ICU beds to be considered safe to reopen.

COVID Act Now is one of the models used by Whitmer’s team to evaluate state actions on COVID-19. It is also known as the most aggressive, or pessimistic, data model. As of Wednesday, it categorizes Michigan as being at “moderate risk” for reopening – a change from “high risk” earlier this week.

Michigan shares that broad new category with 21 other states, including California and Florida. But zooming into data for Michigan’s counties tells a different story. Many counties in the Lower Peninsula, including the state’s biggest — Wayne County — still remain at high risk for reopening. 

Michigan ICU headroom usage | COVID Act Now chart

This model, however, doesn’t have sufficient data from the majority of northern counties, including most of the Upper Peninsula. This is noteworthy because rural parts of northern and West Michigan are now facing increased caseloads of COVID-19, which the doctors group the Committee to Protect Medicare notes face an additional risk of unmasked protesters at the state Capitol possibly carrying the virus back to their communities. 

The exclusion of these now faster-growing counties in the data model may mean Michigan is at a higher risk for reopening.

Social distancing impact

One thing various COVID-19 models indicate is that social distancing and stay-home orders are effectively reducing the spread of the virus overall. 

The infection growth rate in Michigan is now estimated at .96, meaning that every person with COVID-19 infects .96 other people. As long as this number is under 1.00, this indicates that active cases are on the decline.

COVID Act Now notes most experts recommend an infection rate of less than 1.0 for two consecutive weeks before reopening the state. As of Wednesday, Michigan has now had nine straight days of staying below that number.

How do we fight a 2nd COVID-19 wave? Here’s what the U of M doctor known for the ‘flatten the curve’ strategy says.

But the medium rate (8.4%) of positive tests indicates that not enough testing is being done to paint a full picture of the outbreak.

There also is modeling which indicates that the state’s ICUs are at “medium” risk of being unable to handle a “double curve” of the virus. This underscores the warnings from many epidemiologists, including the University of Michigan Dr. Howard Markel, that a second wave has the potential to be even more damaging than the first.

Right now, the COVID Act Now data models show Michigan’s percentage of ICU headroom used at 91%. This is slightly lower than earlier this week, which “suggests some ability to absorb an increase in COVID cases, but caution is warranted.”

Friday was the last time Michigan’s ICU availability was considered high risk.

COVID Act Now chart

The model also predicts that although Michigan hospitals “are unlikely to become overloaded” in the next three months if current trends and interventions continue, this would not be the case if restrictions were lifted too soon.

COVID Act Now recommends that reopening Michigan should happen slowly and in phases. 

However, if all restrictions were completely lifted today, the model projects that hospitals would overload one month from now, on June 6.