‘We seem to let our guard down too quickly, and the virus comes roaring back’

After going through “far and away the biggest outbreak we’ve seen,” Michigan’s COVID-19 cases and hospitalizations have begun to drop following a months-long surge. That’s because vaccination rates continue to increase and the omicron variant has infected such a large swath of the population that it now has far fewer people to find as hosts, public health experts said.

While health experts are welcoming the drop in COVID infections, they expressed dismay that mask mandates are being dropped around the state and country and urged the public to get vaccinated, boosted and continue to wear masks to prevent another COVID-19 surge that could once again leave Michigan’s health care system teetering on the edge of collapse.

“There’s a lot of criticism that it may be too soon [to drop mask mandates], and there’s probably some validity to that,” said Dr. Liam Sullivan, an infectious disease specialist at Spectrum Health in West Michigan. “With the past surges, we’ve done this as well. We seem to let our guard down too quickly, and the virus comes roaring back.

“We had that big surge in winter 2021, then everybody started to let their guard down in mid- to late February of 2021 and look at the big surge we had in the spring,” Sullivan continued. “Then, again, people started letting their guard down this past summer, and look at what happened with delta and the prolonged surge we got. Then we got omicron on top of that.”

Cases soared to more than 20,000 per day in Michigan just last month, but this week sank dramatically to fewer than 2,000 daily, according to the state Department of Health and Human Services (DHHS). 

Hospitalizations also are down — at Beaumont Health in Southeast Michigan, for example, there are 200 COVID-19 patients hospitalized throughout its system. Slightly more than one month ago, that number was at 850. While COVID-19 deaths typically lag behind case and hospitalization trends, the DHHS reported they expect those to soon decrease, as well. 

Statewide, there were 2,236 adults and children hospitalized with confirmed or suspected COVID-19 cases as of Monday, according to DHHS. That’s down from approximately 5,000 COVID-19 patients in hospitals at the beginning of January.

While experts said these numbers are going in the right direction, they remain higher than this time last year. Case numbers are approximately two to three times higher than this point last year, hospitalizations are higher, and there are slightly more deaths as well, DHHS reported. State health officials said they expect these numbers to continue to fall.

In light of these recent numbers, governors across the country — as well as county health administrators and school district leaders in Michigan — have been rapidly dropping mask mandates two years into the pandemic. While Michigan hasn’t had a statewide mask mandate since June 2021, some county health departments and school districts in the state had implemented mask requirements. Now, however, there’s set to be no county left in the state with a mask mandate by the end of February — and schools are following suit.

Other states, including New York, New Jersey and California, are also rolling back pandemic health requirements — including mask mandates. 

Since the start of the pandemic, a total of 2,037,742 Michiganders have tested positive for COVID-19 and 30,959 have died from the virus, according to the most recent numbers from DHHS. Nationally, 923,977 people have died from COVID-19, and about 77.9 million individuals have been infected with the virus since the start of the pandemic, according to Johns Hopkins University.

Dropping these pandemic health requirements, experts said, begs the question: Are we abandoning efforts that have allowed these decreases in cases and hospitalizations to occur? 

After all, while omicron caused case numbers to skyrocket in little time and is now receding because, essentially, it can’t find as many hosts, that doesn’t mean these individuals are now permanently immune from COVID-19 — far from it, experts cautioned. 

As happened with omicron, future variants could reinfect people who’ve already had COVID-19 — and future variants “will occur no matter what,” Sullivan said. And while vaccination rates are continuing to go up, they’re nowhere near the levels that would leave us with true herd immunity, said Dr. Matthew Sims, the director of infectious disease research at Beaumont Hospital, Royal Oak. 

To reach herd immunity, the country, and essentially world, would need to reach a vaccination rate close to 100%, Sims said. In Michigan, about 59% of the population eligible for a COVID-19 vaccine has gotten both shots of the Moderna or Pfizer vaccine or one shot of the Johnson&Johnson vaccine, according to DHHS. Of those who have been vaccinated, just under 50% have received a booster shot — something that’s needed in the face of variants like omicron, Sims said.

While omicron has been the most contagious variant in the pandemic so far and caused more breakthrough cases among vaccinated individuals, it was the unvaccinated population that made up the overwhelming majority of individuals who were hospitalized with and died from COVID-19, said Rick Sadler, an associate professor in the division of public health at Michigan State University.

“The outbreak we just went through was far and away the biggest outbreak we’ve seen, and the reason the case fatality rate wasn’t as high was because so many people are vaccinated,” Sadler said. “Death rates among vaccinated people who got breakthrough cases were way, way, way lower. Hospitalizations were also way lower among vaccinated people. It’s not that omicron wasn’t or isn’t dangerous; it’s that we have protection now.”

With the way the variants are going — mutating further and further from what the virus originally was and becoming increasingly contagious — it becomes even more crucial to be vaccinated, boosted, potentially receive variant-specific vaccines in the future, and continue to wear masks, socially distance and wash hands, Sims said. 

If people did this, it wouldn’t mean there would be no additional variants — that’s pretty much a given, experts said — but it could stop another surge and keep hospitals from once again overflowing with COVID-19 patients.

“People need to realize we’re all tired of this virus, and health care workers are just as tired of this as anybody else,” Sullivan said. “This has been enormously stressful for everyone in society, but we can’t let our guard down. Just because you’re done with the virus doesn’t mean the virus is done with us. It’s been crystal clear that this virus is going to do what this virus is going to do. The best thing we can do is protect ourselves, and the number one way you can do that is to become vaccinated. Please get vaccinated.”

Plus, Sims and Sullivan said, the more people get vaccinated, the more health care workers will feel as though the public cares about them. 

“We have vaccines and treatments, and we have people saying, ‘I don’t want to get vaccinated; I don’t want to wear a mask,’ and doctors and nurses are still going in and treating patients with COVID and trying to save them and losing too many,” Sims said. “That gets to you. There’s burnout. 

“I go in and see people who refuse to believe they have COVID, or they want to believe they need some drug that doesn’t help them,” he continued. “It’s hard when we know there are things people can be doing to help themselves, and they won’t do it.”

Sullivan said the past surge, which has been occurring since about October, has left health care workers “really physically and mentally exhausted.”

“It’s been really challenging on a whole number of fronts, and it’s been prolonged and exhausting for everybody,” he said. “All of us are really tired. We’re grateful the numbers are starting to go down, and people are breathing a sigh of relief, but we’re holding our breath a little bit, too.

“We hope this is the last major surge, but we’re cognizant of the fact that it might not be,” he added. 

Still, that future surge isn’t inevitable. It will, however, likely be so if people stop wearing masks, attend large gatherings without protection, and don’t get vaccinated and boosted, experts said.

“I’m going to keep wearing a mask, and my kids are going to keep wearing their masks to school, no matter if there’s a mandate or not,” Sims said. 

Everyone interviewed by the Advance said they hope those who have not gotten a vaccine will reconsider their decision.

“It’s heartbreaking, frankly, because people who’ve died from COVID since November are people who fell for [anti-vaccine] propaganda,” Sadler said of the unvaccinated individuals who have died during the most recent surge.”

To reach those who are still living and have a chance to become vaccinated, Sadler said individuals who were once anti-vaccine and changed their position need to be vocal about their decision.

“There are people who change their minds,” he said. “Maybe they needed to see a relative get sick or they got real sick. There needs to be messengers from the prominent group of people who are publicly denying its severity to come out and say, ‘No, really, I messed up and we should take it seriously.’”