Get a COVID vaccine booster, doctors say, as delta spread ratchets up in Michigan

This article originally appeared in the Detroit Free Press. Read more here. 

The message should be more urgent in Michigan: If you’re eligible for a COVID-19 booster shot, get one now, said Dr. Anurag Malani, director of infection prevention for the St. Joseph Mercy Health System.

If you haven’t had a dose at all, get vaccinated. And if you’re not wearing a mask in public, indoor places, put one on.

The delta variant of the virus isn’t done with Michigan just yet, Malani said. Cases and hospitalizations are climbing in the state once again — despite falling trends in much of the rest of the country.

“We have not seen a decline in cases. We have not seen a decline in hospitalizations. In fact, actually, this week our numbers are probably the highest they have been in the delta surge,” Malani told the Free Press. “We have about 260 hospitalized patients with COVID across our seven hospitals in Trinity Michigan.

“There should be … stronger communication around the need for boosters.”

COVID-19 hospitalizations rose 20% in just one week in Michigan — from 2,144 on Nov. 1 to 2,580 Monday — putting a crunch on hospitals that also are treating a large number of patients with other medical conditions.

Traverse City-based Munson Healthcare announced Tuesday that it has now exceeded capacity at its nine northern Michigan hospitals for the first time in its 106-year history, and is operating at “Pandemic Response Level Red.”

That means that physician’s offices, labs, outpatient clinics and hospitals will remain open, but non-urgent surgeries and other procedures may have to be delayed, especially if they require an overnight hospital stay, said Munson spokesperson Dianne Michalek. A temporary pause has been placed on sleep disorder services as well.

“The number of patients we are seeing in our hospitals right now are close to those we experienced during the worst of the pandemic last spring,” Christine Nefcy, Munson’s chief medical officer, said in a statement.

“Now, more than ever, we need our communities to band together with us by getting vaccinated, wearing a mask in public, practicing proper hand hygiene, and avoiding large gatherings whenever possible.”

The timing couldn’t be worse. Colder weather is coming, which means more people are moving indoors, where the virus spreads more easily. And the holiday season is approaching — a time when families and friends gather.

That’s another reason, Malani said, for anyone who’s eligible for a booster to get it now: It takes two weeks after the injection to get the added protection from the shot, which would make eating Thanksgiving dinner with friends and extended family a little bit safer.

For people who are elderly or who have underlying health conditions that put them at severe risk for disease, a booster could give them added protection to prevent them from needing hospital care if they develop a breakthrough infection of the virus.

“The vaccines are really quite effective at keeping people out of the hospital,” Malani said. “They’re really effective at preventing severe disease, hospitalization, ICU (intensive care unit) critical illness, death.

“The people that are not getting vaccines, they’re really … hurting their communities,” he said. They put themselves at risk for contracting the virus, and needing hospital care, adding strain to an already overburdened health care system. And they put their friends and family at risk by potentially spreading the disease.

And in worst-case scenarios, they could die.

“There’s going to be people that are not at the Thanksgiving table, that are not at the Christmas table” because of COVID-19, he said. “That’s what’s going to happen.”

Dr. Dennis Cunningham, medical director of infection prevention for Detroit-based Henry Ford Health System, told the Free Press he was alarmed to see how many people with COVID-19 were admitted over the weekend to Henry Ford’s five hospitals.

“It has us a little bit worried,” he said Monday afternoon. “This was a really sharp increase over the weekend.”

In recent weeks, Henry Ford has typically had about 150 coronavirus patients filling hospital beds. By Monday, the COVID-19 census had jumped to 250 patients.

“The case rate, which is how many new infections there are per 100,000 people, it’s going up across the entire state, especially in southeast Michigan,” Cunningham said. “So I do expect the numbers will continue to get worse for a bit.”

Michigan’s case rate is now 342.5 per 100,000 people — more than double the case rate two months ago, when Michigan saw 152.3 new infections per 100,000, according to the CDC.

The seven-day average of the percentage of positive coronavirus tests — another indicator of community spread of the virus — now exceeds 14% statewide, according to state health department data.

On the west side of the state, the percentage of positive tests is even higher, said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan.

“Last week, it skyrocketed,” he said. “We’ve had many days in the 20s. So something different is happening this time that we just can’t quite describe. But it’s definitely real and we are seeing in our outpatient testing a lot of breakthrough” infections.

Most people who get vaccine breakthrough cases have mild infections, he said, and don’t need hospital care. Of the 281 COVID-19 patients hospitalized across Spectrum Health’s 14 hospitals, 85% are unvaccinated.

“For those (hospitalized with COVID-19) that are vaccinated, they’re at least a decade older on average, and they have many more co-morbidities. So they’re older, sicker people.”

They’re people who need boosters, Elmouchi said.

Many people don’t realize they’re eligible for a booster, Elmouchi said. The shots aren’t just for elderly people or those with immune-suppressing conditions, cancer or heart disease.

“The CDC now extended it,” he said. “If you have a BMI (body mass index) of 25 or greater, which is just mildly overweight, … you qualify” as long as it has been at least six months since your second dose of a Pfizer or Moderna vaccine or two months after a single dose of Johnson & Johnson’s vaccine.

He estimated at least 70% of the adult population would qualify for a booster in Michigan based on the BMI standard and other conditions, such as pregnancy and mood disorders. Smokers qualify, as do people with substance use disorder.

Yet as of Monday, only about 915,000 booster doses had been administered in Michigan. Here’s how the booster distribution breaks down:

• 21.9% of the 75 and older population have gotten a booster
• 35% of those ages 65-74 have had a booster
• 24.3% of people ages 50-64 have had a booster
• 8.2% of people ages 40-49 have had a booster
• 6.7% of people ages 30-39 have had a booster
• 3.6% of people ages 20-29 have had a booster

“Most people think I’m not immunocompromised. I’m not over 65. I’m not in health care. I’m not worried,” Elmouchi said.

Front-line workers are eligible for booster shots, too — even if they don’t have health conditions that would qualify them. That includes first responders, police officers, firefighters, corrections officers, postal workers, health care workers, teachers, along with people who work in grocery stores, public transit, manufacturing and agriculture.

“The message gets very confusing for the average person,” Elmouchi said. “It’s really unfortunate because ultimately, at the end of the day, we all know that everyone who’s eligible for a vaccine would benefit from getting one.

“And then from a booster standpoint, I think it’s very unclear to people how important they are to prevent you from getting sick and missing work or missing … the holidays with your family, and potentially keeping you out of the hospital.”