Published in Health Care

Remain vigilant: After six months of the COVID-19 pandemic, West Michigan health experts warn of complacency as seasons change

BY Sunday, September 27, 2020 05:05pm

As the weather cools and winter approaches, health professionals warn about complacency and encourage residents and businesses to remain vigilant in the COVID-19 pandemic.

Health departments in Ottawa and Ingham counties each issued orders this month in response to COVID-19 outbreaks among students at Grand Valley State University and Michigan State University.

More than six months into the pandemic, the situations at both universities reflect a sense of complacency toward the need for people to protect themselves from COVID-19, according to health professionals interviewed for this story. These experts worry about higher risk factors that come with cold weather and generate the potential for increased infection rates and outbreaks.

“We’re at a very delicate position at this moment, and how the rest of this plays out really depends on people in the community continuing to be diligent,” said Dr. Adam London, director of the Kent County Health Department.

People need to “buckle down” and keep following basic public health recommendations like using facial coverings in public places, maintaining social distance and good hygiene, London and others say.

Complacency on top of the change in the seasons threatens the progress made over the summer to minimize COVID-19’s spread and contain outbreaks, London said.

“At this moment, I think we’ve been victims of our own success to some extent. As things get cooler, and we have school and other things happening that bring people in tighter proximity, our risk is increasing,” London said. “If people think that this is over or that the next couple of months are going to play out the way the last handful of months have played out, that’s a mistake.”

London “wasn’t really surprised” at the county orders for MSU and GVSU students after outbreaks appeared to result from students at social gatherings outside of school. Controlling the spread of the coronavirus has been more of a challenge at the college level than K-12 schools, he said.

After all, college students “have a lot more leeway to behave how they want to behave and that’s not always great for disease prevention,” London said.

‘General fatigue’

Part of the complacency, especially among younger people, comes from frustration after months of restrictions and requirements for social distancing and wearing face masks.

“Without a doubt there’s a general fatigue that has set in for so many because this has been going on for six months. It’s hard to be apart from people, it’s hard to wear masks and we’re definitely seeing complacency,” said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan. “In particular, when you start bringing people together for college and things like this — where for the last six months have been really apart — it’s natural to want to congregate.”

As the weather cools and many people remain indoors, Elmouchi worries that “it’s going to be harder for people to do things that we need to do to keep this at bay,” he said.

“I think we’ve gotten lucky because we had a beautiful spring and summer and so we all enjoyed being outdoors so much more. Once we’re all indoors by virtue of what will invariably come in the winter, I think we will have more problems unless people can be very diligent with the spread of COVID inside,” Elmouchi said.

After schools returned in recent weeks, Spectrum Health has seen increases in hospitalizations from COVID and a slow rise in positive tests, Elmouchi said.

Health departments for months had the “advantage of summer time and schools being out of session (and) people outdoors more,” reducing the risk and spread of COVID, London said, while Kent County hasn’t seen outbreaks near the degree as college campuses.

“We have had cases, and that’s not a surprise at all. We know we’re going to have cases wherever there are people at this point. The key is identifying them quickly and making sure they’re isolated and their close contacts are in quarantine,” London said. “If we can do that, I think we can prevent the kind of outbreaks other places have seen.”

Acting as partners

Key to controlling campus outbreaks is college students “acting as partners with us in this,” London said. That’s been an issue for health departments.

The orders in Ingham and Ottawa counties target students not following public health guidelines. Ingham County Health Officer Linda Vail, in announcing the order on housing around the MSU campus, specifically cited how the outbreak was “being fueled in part by a lack of cooperation and compliance from some MSU students, many residing in the properties now under mandatory quarantine.”

The Ottawa County Department of Public Health said in issuing a stay-in-place order Sept. 16 that “many students report having no contacts or refuse to disclose contacts.”

The Ottawa County stay-in-place order that runs through September requires GVSU students who live in off-campus and on-campus housing to remain in their residences. The order does include exceptions that allow students to attend in-person class or labs, get food, go to a medical appointment or religious event, as long as they obey “strict adherence to preventive measures.”

Ottawa County took the action after testing since Aug. 23 detected more than 600 cases of COVID-19 among students living on or near the GVSU campus in Allendale.

In Ingham County, the Health Department this month quarantined 39 large houses around the MSU campus after a 315 percent increase in COVID-19 cases since Sept. 1.

The targeted orders in Ottawa and Ingham counties are preferential to the broader restrictions in place during the spring and early summer, said Brian Calley, president of the Small Business Association of Michigan.

“It’s aimed at the problem, as opposed to saying, ‘Hey, we have these increased cases because of Michigan State or Grand Valley students, therefore we have to make these changes across the whole landscape,’” Calley said during a recent SBAM briefing. “It was targeted and we hope that’s the approach we take going forward.”

‘Careful balance’

The outbreaks at MSU and GVSU — and to a lesser extent at other campuses and K-12 schools — illustrate the “careful balance” educators are seeking between resuming classes in a pandemic and the public health risk, said Dr. Matthew Biersack, chief medical officer at Mercy Health Saint Mary’s Hospital in Grand Rapids.

The orders “definitely provide a strong message to the community and all of us that we can’t downplay the significance and severity of the virus and we have to be just as vigilant,” Biersack said.

Outbreaks earlier in the pandemic affected people who are more vulnerable: the elderly and individuals in frail health or with chronic medical conditions. Of late, outbreaks have been occurring among a younger population.

As of last week, nearly 20 percent of the COVID-19 cases in Michigan were among people ages 20 to 29 years old, which was the highest of eight age groups, according to a state database.

“The tide has really shifted toward a younger population of people who are now being affected and I think in part because schools are returning and in part because it’s just hard to keep our guard up and our vigilance up after doing this for months,” Biersack said.

Biersack is “terribly worried” about what happens this fall and winter when “we’re all cooped up indoors” with the onset of cold and flu season.

“We still have a lot of the population at risk,” Biersack said.

Over the past six months, much has been learned on how to contain the virus’ spread and to treat people who become infected, said Dr. Ronald Grifka, chief medical officer at Metro Health-University of Michigan Health. If “we completely let our guard down, we’ll be back to where we were in March,” he said.

Grifka hopes to see a continued easing of remaining restrictions and the opening of businesses, although “we need to be smart about how we do it” and proceed with “good health practices and process. We still need to just continue to be careful.” 

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