ELi reached out to Ingham County Health Officer Linda Vail on Sunday about questions that our readers have recently posed on COVID-19. She spoke to us about cases related to MSU, the small but noticeable increase in hospitalizations, and what the Michigan Supreme Court’s ruling on Gov. Gretchen Whitmer’s executive orders means for residents here.
How will the court’s invalidation of many of Whitmer’s executive orders impact life here?
On Friday afternoon, the Michigan Supreme Court ruled in a 4-3 vote that Whitmer does not have the authority to extend the state of emergency related to the pandemic or to issue orders without the consent of the legislature. The ruling effectively invalidated the 180 executive orders that Whitmer had issued since March.
But the legislative system is not the only way health regulations can occur. Some state government institutions, such as the Michigan Department of Health and Human Services, can establish orders for public health emergencies. County health departments also have a significant amount of power.
Vail has explained that the powers for public health officials come from Public Act 368 of 1978. (Whitmer had claimed her executive power came from different laws.)
On Sunday morning, Vail explained to ELi that Michigan effectively has no statewide public health policy orders to enforce during the pandemic following the court’s ruling. That soon may change, but Vail doesn’t want to wait. After her call with ELi on Sunday, Vail’s office announced new Ingham County-wide public health orders.
They consist of four emergency orders issued specifically with the goal of preserving key aspects of the now-defunct statewide executive orders.
Ingham County Emergency Order 2020-21 basically takes verbatim the governor’s previous order on mask-wearing. It makes mask-wearing mandatory in public indoor spaces (including stores) and in public outdoor spaces when it is impossible to maintain 6 feet of distance from someone outside your household.
Ingham County Emergency Order 2020-22 restricts the size of indoor and outdoor gatherings and also draws upon the governor’s now-defunct orders.
Ingham County Emergency Order 2020-23 replaces an order that Vail herself issued this summer to reduce capacity in restaurants and bars. On June 29, Vail ordered that facilities with food licenses in Ingham County reduce their capacity to 50% or 75 people, whichever number was lower.
On August 13, the capacity was raised to 50% or 125, whichever was lower. The new order is the same, but removes references to the defunct statewide order.
Similarly, the last of the new orders, Ingham County Emergency Order 2020-24 continues to enforce the workplace health screenings.
East Lansing also has two additional policies that are more restrictive: a new City ordinance that makes mask-wearing mandatory in the Downtown Development Authority District; and a County order restricting gathering size in certain, student-heavy parts of East Lansing. Those policies still remain in effect.
In August, Vail told ELi that she supported the sentiment of the governor’s executive orders but acknowledged that the wording and content could be confusing to local business-owners and managers.
ELi also reported last Friday that four bars may have violated state and county health orders possibly because they did not understand what was expected of them. Pat Riley, owner of Harper’s, also told ELi that the Responsible Hospitality Committee was working together to make sense of the expectations and make sure local businesses met them.
Can the current increase in hospitalizations be linked to the MSU COVID-19 outbreak?
When Linda Vail spoke to reporters on September 8, following the rise in COVID-19 cases at MSU, she indicated that she expected the rise in cases at that time would ultimately result in an increase in hospitalizations and perhaps also death in the upcoming months.
She referred back to what happened in late June and early July when cases began to increase in Ingham County as bars and restaurants reopened. Between June 30 and July 5, Ingham County reported no hospitalizations, but soon after that, hospitalizations and ICU cases began to rise.
In September, Vail said the ten Ingham County residents who died in August most likely contracted COVID-10 due to the rise in cases four to six weeks prior.
“Maybe there wasn’t direct contact, but increased prevalence,” said Vail in September, suggesting that the infected moved about the community getting other people sick, ultimately harming those who are more medically vulnerable.
Could the same be happening now?
Ingham County reported its first novel coronavirus cases in March and has had a total of 3,600 confirmed cases since then. But Vail told ELi this Sunday that about half of all cases in Ingham County occurred in September.
Now, in the beginning of October, five people are hospitalized in Ingham County, including one person in the ICU, due to COVID-19. By contrast, around September 20, Ingham County had no one hospitalized with COVID-19.
According to Vail, it is hard to tell if the increase in cases among the MSU community is tied to the rise in hospitalizations in the county, but she pointed out the hospitalizations and deaths are often referred to as lagging indicators that community transmission had increased.
“The virus doesn’t stop at unique boundaries around campus or city. It spreads to other people,” said Vail, explaining how a hyper-localized outbreak could affect the wider community.
The next few weeks could be telling, but Vail also pointed to more promising prognosis for those who contract and are hospitalized with COVID-19 compared to those struck down in March.
Hospitalizations were higher in April even though there were fewer positive test results. Why? The answer is twofold. First, due to the shortage of tests then, only those who were hospitalized, seriously ill, and likely to die were tested. So a larger percentage of those who tested positive were very ill.
Second, Vail said, public health measures and clinical treatments have improved. We know things like physical distancing and mask wearing work. And, for those hospitalized, doctors have a better idea of which treatments work and don’t work.
Have MSU students refrained from getting tested to avoid quarantine?
It is hard to definitely prove this, but Vail told ELi that “Data suggest it. Conversations suggest it.” Even social media posts have suggested it, according to Vail.
The week of Sept. 14, MSU ran over 1,000 tests. But in the week of Sept. 28, MSU ran only 285 tests, the lowest since the week of Aug. 24, when it ran 222 tests. This suggests MSU students may be avoiding being tested in order to avoid being quarantined.
Although the number of tests run and the number of confirmed cases have dropped, the percent positive rate has remained very high – over 10 percent for the week of Sept. 28.
In his weekly update last week, MSU College of Human Medicine Interim Dean Aron Sousa explained, “There is plenty of testing available, but for whatever reason, people are not coming in for testing.”
(Disclaimer: Sousa is the spouse of ELi Publisher and Founder, Alice Dreger.)
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