Michigan’s recent rise in hospitalizations create “perfect storm” as other states’ hospitalizations fall

As COVID-19 hospitalizations and cases drop nationwide, Michigan’s COVID numbers are significantly growing with a 23% increase in COVID hospitalizations over the last 14 days. COVID hospitalization increases are coupled with an influx of non-COVID care which creates a “perfect storm”, says Joshua Kooistra, chief medical officer of Spectrum Health. 

Kooistra thinks Michigan’s surge is different because of external factors like weather conditions and the start of the school year

 

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According to the New York Times, the 14-day change for COVID cases in Michigan went up by 24%, tests went up by 19%, and deaths went up by 11%. As of Oct. 13, 82% of intensive care unit (ICU) beds are occupied in Michigan. 

Michigan is one of only five states to see increases in hospitalizations in the last week. Kooistra says every hospital and health system in Michigan is at or over capacity. 

Instead of fluctuating, Kooistra said Michigan is seeing a steady increase in cases and hospitalizations. Here is a graph from the New York Times showing this phenomenon:

 

Image: New York Times

 

Kooistra says Michigan’s surge was delayed by a few months in comparison to the rest of the country, and he thinks the surge in Michigan will most likely run the same course as other states. 

He thinks states like Florida saw their peaks and surges earlier due to seasonality and the start of in-person schooling. He says:

“I don’t know if anything is necessarily fundamentally different in Michigan with the exception of seasonality and the return to school, [which] happened a couple weeks later than other states. Our weather is turning colder so people are doing more indoor activities than in those other states [Florida] which are hot in the summer and people tend to flock to the indoors then. It is kind of the reverse of what we see here.”

Kooistra also highlights the influx of non-COVID related hospitalizations since deferred care is leading to complications in people’s health. He says patients were afraid to come into hospitals for fear of catching the virus which led to many Michiganders deferring needed care until it got to the point where emergency treatment was needed. 

He says the health system was seeing decreased utilization in colonoscopy screenings, mammography screenings, and even routine physical exams. 

“I think that some of that deferred care, whether it was put in place intentionally or not, has resulted in patients now experiencing complications from missing early detections of certain cancers, or of failure to control their hypertension or diabetes, and now we are seeing some of the results of that.”

Kooistra says this has effects on the financial health of the system since they cannot provide high margin procedures. Instead they have to defer those procedures to lend the bed to an acute care patient, which has lower reimbursement rates. He says:

“It’s kind of a double whammy because we want to be able to care for our community and care for those patients. We want to be able to provide those services expeditiously, and us now having to defer that care and lose that volume and reimbursement for some of those higher margin procedures, does impact the health care system.”

Kooistra says the state can help by providing more staffing resources to supplement staffing shortage and build up more capacity in hospitals.