DETROIT — Michigan quietly surpassed 100,000 novel coronavirus cases — when both confirmed and probable cases totaled 100,724 on Friday, five months into the pandemic.

Using that metric, at least 6,500 people have died of COVID-19, the Michigan Department of Health and Human Services reported — a number higher than those who died in the 9/11 terror attacks and the attack on Pearl Harbor combined.

There have been more cases in the Great Lakes State than in dozens of nations with higher populations — including China, Australia, Japan, the Netherlands and Egypt.

Still, by most measures, Michigan has managed to contain the spread better than many other states in a country that leads the world with 5.3 million cases and more than 168,000 deaths, according to the Johns Hopkins COVID-19 Global Case Tracker.

But it’s nowhere near over yet. The state should prepare to see another 100,000 new cases in the next five months, said Dr. Peter Gulick, an infectious disease specialist and associate professor of medicine at Michigan State University.

“We’ll be at more than 100,000” additional new coronavirus cases by mid-January, he predicted.

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“Nothing has changed as far as the virus goes,” Gulick said. “We have nothing beyond what we had in March (to treat it or prevent it). So, we still have to go by the old principles: Wear face masks, social distancing, don’t go into crowds.”

The problem is many people have grown weary of the restrictions, the shutdowns, the social distancing. Many have refused to wear masks, and are eager to resume life as they knew it before the pandemic.

“Wherever we deviate a little bit _ and I know that people want to get together; they want to go to restaurants; they want to kind of get back to normality _ you’re going to get outbreaks,” Gulick said. “There’s no question about it.”

Plenty of examples of COVID-19 outbreaks tied to crowded events in Michigan where people didn’t adhere to those public health guidelines support that premise, Gulick said.

Among them: an indoor wedding reception at Crystal Gardens in Southgate; a summer camp at Springs Ministries in Gladwin; unofficial proms and graduation parties in Oakland, Genesee and Livingston counties, and partying college students at Harper’s Restaurant & Brew Pub in East Lansing.

Silent spread still a problem

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The tricky thing about controlling outbreaks of this new virus is it can spread even before people show symptoms.

“One thing we’ve learned, more and more, is that asymptomatic infection is a clear transmission driver,” said Dr. Arnold Monto, a professor of epidemiology and global public health at the University of Michigan.

And that’s a major concern as college campuses and schools reopen and people resume activities that more closely mirror their pre-pandemic lives.

“We have to be very careful,” Monto said. “I think that there is the possibility of an increase in transmission because we can’t identify who is infected and capable of transmitting. We have a real issue here as universities open, as we bring in people from many places, and we have to be cautious.”

Gulick agreed, noting that opening K-12 schools for in-class learning is another concern.

“When you get a lot of kids going to school, and then they’re exposed, they bring it home,” he explained. “They’re going to cough and sneeze and hug each other. Kids, they don’t understand what’s going on, and you can’t blame them. When you get them together, they want to touch each other and they don’t understand social distancing mitigation.”

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What’s happening in school districts in other parts of the country where classes have already begun might provide a preview for what’s coming to Michigan in communities where face-to-face learning is planned.

— Two weeks into the school year in the Cherokee County School District north of Atlanta, the number of students with COVID-19 rose to 66 and the number of staff members who contracted the virus totaled 22, the Atlanta-Journal Constitution reported Friday. More than 1,100 students and employees are in quarantine in the school district of about 40,000 students.

— At least 97 confirmed cases of COVID-19 have been identified in 109 school districts in Tennessee since classes resumed, the Tennessean reported. Many have closed to in-person learning, and hundreds of students and teachers are in quarantine.

While Monto said he isn’t as concerned about schoolchildren driving community spread of the virus _ some studies suggest it is more transmissible among older kids and adults _ he said children are likely to bring the virus home to their parents and other relatives, and that could become a source of higher rates of infection once the school year starts.

“We’ve got a virus which is behaving very unlike most respiratory viruses that we’re used to dealing with,” Monto said. “Most respiratory viruses affect young people, and schoolchildren drive outbreaks. This affects older children and young adults more.

“There’s been a lot of transmission with family gatherings, people getting together, thinking that they’re safe because these are people that they know. … We need to assume that those people might be infected. … It’s individuals and households that it’s going to affect.”

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Spread within families seems to be driving case counts in Wayne County (excluding Detroit). The Wayne County Public Health Division reported 203 coronavirus cases Wednesday.

_ In Dearborn, 61 new cases were identified Wednesday. Of them, 13 cases involved spread within six different households (two cases per home for five families, and three cases for another).

_ In Hamtramck, which reported 12 cases Wednesday, three were from within the same household.

_ In Redford Township, two of the three 3 COVID-19 cases confirmed Wednesday lived in the same household.

_ In Southgate, which reported seven cases Wednesday, three were from the same household.

_ In Taylor, two of its seven cases were from the same household.

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Michael McElrath, a spokesman for the Wayne County Public Health Division, said some of the 203 new cases reported Wednesday are not new. They can be attributed to a backlog as the state corrected and updated case numbers, as well as “a larger concentration of community spread.”

Higher case counts not exactly a bad thing

Rather than focus on total case counts, Monto said the better measure of community spread is the percentage of positive COVID-19 tests.

Higher case counts, he explained, are not necessarily a bad thing. They mean public health officials are identifying more people who have the virus, and can isolate them to slow COVID-19 transmission to others.

“We should test as much as we can test, based on availability. If things get worse _ given the fact that we have to open up somewhat _ we can identify those cases and appropriately respond with clarity,” Monto said.

Michigan has steadily increased its coronavirus testing since the pandemic began. On Wednesday, it conducted 40,443 diagnostic tests _ the most in a single day, according to MDHHS data.

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The percentage of positive tests statewide averaged 3.3% between Aug. 7 and Aug. 13. That percentage has held relatively steady since early June. And it’s well below the national average, which was 8% on Friday, according to the COVID-19 Tracking Project.

Dr. Joneigh Khaldun, chief medical executive and chief deputy director for health for the Michigan Department of Health and Human Services, said reports of new cases have plateaued statewide, following increases in June and July.

“We continue to be cautiously optimistic,” she said during a news conference Friday, noting that some parts of Michigan are controlling the spread of coronavirus better than others, with lower rates of positive COVID-19 tests and lower case counts per million population.

Macomb County has the highest numbers in southeastern Michigan, Khaldun said, tallying 82 cases per million people per day and a COVID-19 positivity rate of 7.4%.

Comparatively:

The city of Detroit: 26 cases per million people per day with 2.6% of COVID-19 tests coming back positive.

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Wayne, Monroe and Oakland counties: More than 40 cases per million people per day with more than 4% of COVID-19 tests coming back positive.

The Saginaw region: 50 cases per million people per day with a positivity rate of 3.7%.

The Grand Rapids, Kalamazoo and Upper Peninsula regions: 30-40 cases per million people per day, with a positivity rate below 3%.

The Jackson region: Just under 30 cases per million people per day with a positivity rate above 2%.

The Lansing and Traverse City regions: Fewer than 20 cases per million people per day with a positivity rate below 2%.

“So this is why it’s so important that businesses, schools and others work very closely with their local health departments to implement strategies to fight this disease at the local level,” Khaldun said.

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“We also continue to see a low level of deaths. These are all good signs.”

But she warned, even if the trend is stabilizing, “it only takes a few people to create an outbreak and have the disease spread rapidly in a community.

“We’re still seeing outbreaks across the state in every region, and these are occurring in many different settings,” such as skilled nursing and long-term care facilities, social gatherings, agricultural and food processing facilities, child care and youth programs, manufacturing, health care facilities, restaurants, schools and colleges.

“What these outbreaks mean is that the virus is still very present among us, and we must remain vigilant,” she said.

Monto agreed, noting that the difficult part will be to continue to successfully manage the balance, maintaining a Goldilocks level of reopening and targeted closures _ not too much, not too little, but just right _ to hold the spread of novel coronavirus in check.

A box of clean masks sits near the entrance for Pippen Palace Childcare Academy on Detroit’s west side on August 13, 2020.

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To do that with any success, Gulick said, people must continue to adhere to the public health recommendations.

“Masks are critical and so is social distancing,” he said.

“We don’t know the long-term consequences of COVID. … I’m hearing about kidney problems. I’m hearing about central nervous system/cognitive problems where people … can’t think clearly anymore. Some of them develop cardiac problems who never had it before. … Young adults are getting strokes from COVID.

“Don’t try to be a rebel or something like that because you’re not going to win the battle. You’re going to lose the war.”

 

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