Michigan was warned about the British COVID-19 variant, but many ignored it

Respiratory Therapist Eralda Bendaj, 31, talks with a COVID-19 patient as she performs a home oxygen study to check his blood oxygen levels to see if he will need oxygen once he is discharged from Beaumont Hospital in Farmington Hills, Mich. on Dec. 17, 2020.

DETROIT – Local health departments across Michigan started sounding the alarm months ago.

A deadlier coronavirus variant that had first ravaged Britain was now here — in metro Detroit, at the University of Michigan, a state prison in Ionia and rural counties in the Thumb region — with doctors, nurses and public health officials fully aware.

And yet Michiganders — from state prison employees to small business owners and local officials to parents of high school athletes — ignored medical experts’ repeated warnings about the highly infectious variant. They rebuffed stay-in-place recommendations, allowed crowded events to occur and turned a blind eye to defiant behavior, according to thousands of internal health department emails and contact tracing notes from across the state and interviews with those in charge.

All the while, schools and restaurants reopened and mask and quarantine rules were relaxed. Overwhelmed health departments struggled to talk to oftentimes-angry infected patients, battled with school superintendents and parents who wanted a return to youth sports and fought losing battles to institute lockdowns or change state policy.

Michigan became the worst COVID-19 hot spot in the nation, and is among the worst states for the British variant. As of mid-April, it was at a record-high for childhood hospitalizations — an alarming virus situation that the Detroit Free Press, part of the USA TODAY Network, sought to explain by collaborating with Columbia University journalists and researchers who zoned in on the U.K. variant when it first turned up in the state.

Researchers found that the B.1.1.7 variant quickly ran rampant in Michigan, triggering COVID-19 clusters and variant outbreaks at the University of Michigan, multiple high schools, a prison, an insurance company, a day care, a dairy farm, a nursing home and a Grand Rapids hospital.

And that was only the beginning.

The British variant’s warpath in Michigan is documented in internal emails and memos obtained through the state’s Freedom of Information Act, along with interviews with state health officials, the Michigan Department of Corrections and local health departments in several counties.

The documents and interviews show how the U.K. variant, which is approximately 60% more transmissible and 67% more deadly than the original coronavirus strain, spread quickly across Michigan.

As of Wednesday, Michigan has seen 3,020 confirmed cases of the U.K. strain, more than double the number just three weeks ago, according to the Centers for Disease Control and Prevention.

Michigan’s overall COVID-19 numbers have soared to 882,000, with a daily case rate of 74 cases per 100,000 people over the last seven days — the worst in the country, per New York Times data.

Deaths have also gone up: 237 deaths in the first week of April, up 39% from the week before.

In response to this growing crisis, Michigan on Friday extended its current COVID-19 restrictions for one month, requiring mask wearing, limited capacity at most businesses, 50% indoor dining, small private gatherings and testing for youth athletics. Children 2 to 4 are also now required to wear masks.

Journalists and researchers have spent months analyzing the state’s virus data and confidential contact tracing notes, which were obtained by the Brown Institute for Media Innovation’s Documenting COVID-19 project, which is housed at Columbia University.

As the data shows, and as multiple health officials said, many people still don’t want to cooperate with contact tracers, much less wear masks and socially distance. Perhaps especially frustrating for health experts, they say, is that the defiant now include the once-compliant who have grown tired of following the rules, and want to believe the worst is over.

“Look at the numbers — people should not act like it’s not around,” said Dr. Arnold Monto, a renowned University of Michigan epidemiologist who also chairs the FDA’s vaccine advisory committee.

As Monto and many health experts have noted, the latest surge involves an alarming trend.

“This has really moved down to 10- to 29-year-olds,” Monto said, stressing more compliance with masks and social distancing is needed now. “It isn’t very hard to continue to wear a mask. … We have learned how to control this. And with the variants, we’re going to have to work even harder.”

Cynthia Krencicki, 58, of Livonia receives the Moderna COVID-19 vaccination from the Oakland County Health Division Vaccinator Khalia Hill, 40, of Pontiac, Mich. at Suburban Showplace in Novi, Mich. on Jan. 23, 2021.  Krencicki teaches 2nd grade at Ferndale's Lower Elementary and says she is allergic to Penicillin and has to wait 30 minutes in Observation after receiving her vaccine.

U-M raises red flag

It was Jan. 24 when the University of Michigan issued an alert that a cluster of students had tested positive for the B.1.1.7 variant.

University of Michigan students walk around campus in Ann Arbor on Tuesday after Washtenaw County Health Department issued a Stay in Place order for undergrad students because of the rising number of COVID-19 cases on campus.

The urgency and dire potential of the new variant wasn’t lost on the school community as it sought to get word out that 14 cases of the U.K. variant were confirmed at U-M that day.

U-M medical professor Dr. Carl Schmidt forwarded an email about the cluster to Wayne County public health officials with an ominous note: “I hope you’re vaccinated,” Schmidt wrote. “This is about to get as bad as it’s ever been.”

Screenshots of emails

According to internal emails, the Washtenaw County Health Department considered a stay-in-place order on campus following pressure from local leaders.

“Our community does not understand the severity of the situation,” County Commissioner Sue Shink wrote to local health officials at the time, arguing for a tougher response.

“We are talking about reopening restaurants and schools when the new, more contagious variant is gaining a foothold in our community and will likely render those reopenings foolish or impossible,” Shink wrote.

Two months earlier, Washtenaw County had issued a two-week stay-at-home order for undergraduate students as it sought to curb an uptick in COVID-19 cases at U-M. This time, however, would be different.

Three days after Shink emailed health officials, the county opted not to issue another lockdown order for U-M. Rather, after consulting with the state health department’s legal team and Michigan Attorney General Dana Nessel’s Office, the county issued a list of recommendations to the larger community to stay home and avoid public gatherings.

Washtenaw County officials said that since the B.1.1.7 variant was detected elsewhere in Michigan, they “carefully considered” what a lockdown would accomplish.

“In other words, the potential public health benefits must outweigh the possible negative impacts of additional restrictions,” said Washtenaw County spokeswoman Susan Ringler-Cerniglia.

Nessel’s office pointed to another possible reason a shutdown was avoided: the potential for a lawsuit.

“We offered our insights as to the various legal arguments being advanced in lawsuits against the State challenging (state) epidemic orders,” the office said in a statement. “That said … we did not advise Washtenaw County against issuing an order, nor would we since it is not our role or province.”

Screenshots of emails

U-M said questions about why a public health order wasn’t issued when the U.K. variant first surfaced on campus should be directed to the health department. It also said that during the pandemic, it has “followed and continues to follow guidance from both the local and the state health departments.”

Three weeks after the county scuttled a public health order, a resident in the Ann Arbor area sent photos to the health department of athletes at a school indoor track meet. Many in attendance, including the athletes, were not wearing face coverings in violation of the state’s mandatory mask rule.

Washtenaw’s environmental health director Kristen Schweighoefer wrote back: “I’ll add this to the growing to-do list of complaints.”

Around the same time, in February, a separate complaint was emailed to Washtenaw County officials, this one describing how off-campus apartment residents were congregating without masks at Super Bowl parties and in common areas.

In response, Washtenaw’s medical director, Dr. Juan Marquez, wrote to his colleagues: “Is there any additional education/reinforcement of the mask mandates that can be done for residential buildings?”

The environmental health director’s response was straightforward: “If they are violating our local gathering order, I can investigate and possibly issue a civil infraction. But it typically has been issued to a particular person or persons. I’d need a lot more detailed info.”

Screenshots of emails

No Super Bowl party tickets were mentioned in future correspondence.

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Variant rips through prison

In early January, a prison employee at the Bellamy Creek Correctional Facility in Ionia took back-to-back coronavirus tests over two days. One came back positive, the other negative.

The Michigan Department of Corrections allowed her to go back to work.

The B.1.1.7. variant was detected in January at the Bellamy Creek Correctional Facility, where it quickly spread to more than 150 inmates and staff.

Meanwhile, the employee’s county health department tried calling to let her know of the original positive test, but couldn’t reach her.

Weeks later — after being exposed to the new, more transmissive U.K. variant by a co-worker and feeling sick — the same employee got tested again. It came back positive.

That time, her test result was randomly chosen by the Michigan Department of Health and Human Services for genomic sequencing and was confirmed to be the B.1.1.7 variant. Her local health department again tried to reach her by phone, but failed. When someone did finally speak to her, she was “not forthcoming with information” and “took a lot of prodding” to get her to provide even a few details.

So the Barry Eaton District Health Department sent someone to her home. And not too long after, the infected prison employee broke her silence. Her 81-year-old mother was hospitalized with the virus, and she called the health department herself.

Eaton County health officer Collette Scrimger said the woman was “very cooperative” in that call, and was willing to have her two daughters, ages 16 and 20, tested for the virus.

Two weeks later, her mother would die of COVID-19.

In the ensuing weeks, coronavirus variant cases and clusters would crop up across the region — some connected to the Bellamy Creek prison and some without any known source. The state health department and prison system would impose tough new measures to control the spread of the U.K. variant, including daily testing for all staff and inmates, stopping all inmate transfers and limiting inmate movement.

But the variant had already spread like wildfire.

Within 10 days of the tougher safety measures, at least 157 new variant cases were found among Bellamy Creek inmates and staff — including many who refused to tell their employers and local health departments about their positive test results.

“The majority of patients are not forthcoming with information,” said Ionia County Health Officer Ken Bowen, one of multiple health officials who reported lack of cooperation by persons infected with the variant.

The Michigan Department of Corrections said it instructs its 1,300 employees to provide information to contact tracers and local health departments, but that it has “no control over our employees when they are off the clock.”

At the Bellamy Creek prison, meanwhile, local and state health departments became locked in a back-and-forth over how they could realistically collect specimens and conduct contact tracing with unwilling prison employees.

Screenshots of emails

On Feb. 12, state health official Fatema Mamou asked her counterparts in Ionia to confirm that patients were isolating appropriately. The health department was re-checking for exposure to other people, and collecting specimens from close contacts for testing and sequencing.

The response was grim.

“I expect very few contacts will be willing to provide specimens,” Bowen, the local health official, wrote her back. “Many cases still refuse to even give contacts.”

Screenshots of emails

But even with better compliance, Michigan local health departments say they are limited in what they can do to control the fast-moving spread of the variants.

“Short of a nationwide lockdown,” Bowen said, “I don’t know what authorities at any level could have done better, although I am sure in hindsight some things will emerge.”

Variant escapes prison, spreads quickly

Outside the prison walls, confirmed coronavirus variant clusters started to pop up across the state, spreading quickly through different counties.

By April 1, another 74 cases of the B.1.1.7 variant were identified in Oakland County, which contains parts of metro Detroit, eventually sounding alarms at hospitals across the area as they hit critical capacity levels.

Michigan’s COVID-19 hospitalizations ballooned by 470% — from 709 in February to more than 4,000 in mid-April.

“Our COVID-19 numbers are climbing higher and faster and it’s very troubling and alarming to see this,” said Beaumont Health CEO John Fox, who oversees the state’s largest hospital system. The number of COVID-19 patients at Beaumont has skyrocketed in this latest surge, from 128 in late February to more than 800.

“To flatten the curve again, we all need to work together now,” said Fox, urging people to wear masks and socially distance. “We need everyone’s help immediately.”

Hospitals in the metro Detroit region in mid-April were at or nearing capacity, with many COVID-19 units ranging from around 75% to 100% full, according to the Michigan Department of Health and Human Services.

Among the leading culprits, experts believe, are the coronavirus variants: The U.K. strain is the most prevalent in Michigan, with more than 2,640 cases. There also are nine cases of the South African variant, and nine cases of the Brazilian variant in Michigan.

“The new COVID-19 variants are more contagious. The patients we are seeing are younger and some are sicker and in need of intense medical attention,” said Dr. Nick Gilpin, Beaumont’s medical director of Infection Prevention and Epidemiology.

Gilpin said he has witnessed another troubling phenomenon: younger patients waiting longer to get care, thinking they can beat the virus.

“By the time they come to the hospital, we’re seeing intense illness with pneumonia, blood clots and severe lung injury,” Gilpin said. “This trend does not seem to be slowing down.”

Schools, sports a growing concern

In late February, a variant outbreak struck Grand Ledge High School following a basketball game with another school as 11 students got infected. The cases were reported five days before the school was slated to begin partial in-person instruction, with 50% of students going to class two days a week.

Macomb L'Anse Creuse's Olivia Chadwick attempts a layup against Detroit Renaissance in the first half of the Michigan high school girls basketball state quarterfinal game on Monday, April 5, 2021, in West Bloomfield.

But within days, the outbreak exploded to include dozens of students, at least two coaches and nine parents or siblings who attended the game.

More outbreaks followed.

The football team at Olivet College got hit. So did Thornapple Kellogg and Eaton Rapids high schools, along with a day care, a towing company, a sheet metal contractor and an e-tax office in Eaton County.

As health officials across the state strategized on how to deal with out-of-control outbreaks in schools and on youth sports teams, one Saginaw health official reported that school superintendents in late March were fighting to relax quarantine for sports teams from 10 days to seven.

The health officials didn’t bend and stuck to 10 days.

Screenshots of emails

At the same time, another medical officer from St. Clair County said people there were pushing to relax social distancing guidance from 6 feet to 3 feet, similar to Ohio — though health officials refused, noting the county had been notified of a fifth variant case at a junior high school and a 19.3% positivity rate.

School sports have also turned into a sore spot for medical experts given what the data shows. Since January, the state has seen at least 1,091 COVID-19 cases involving K-12 sports, which resumed following a “let-them-play’ crusade led by scores of parents and students over the winter. Basketball, hockey and wrestling saw the most infections.

“We are concerned about youth sports,” said Dr. Monto, the University of Michigan epidemiologist who has been closely following the latest surge.

Michigan health officials, meanwhile, caution that the data doesn’t reflect the complete picture of outbreaks in Michigan, as many people are still uncooperative with contact tracers.

“Many factors, including the lack of ability to conduct effective contact tracing in certain settings, may result in significant underreporting of outbreaks,” MDHHS spokeswoman Lynn Sutfin wrote in an email to the Free Press.

Meanwhile, Gov. Gretchen Whitmer, who has faced immense criticism by businesses and Republican critics over her prior lockdown orders, is taking a different approach to this latest surge: She is hoping vaccines and personal responsibility can replace government mandates and help bring down the numbers.

Just weeks ago, health experts, including the CDC director, called on Michigan to institute more stringent regulations — though Whitmer has argued ramping up vaccinations is the way to go instead.

Since December, 3.4 million Michiganders have gotten at least one dose of a coronavirus vaccine, and roughly 2.3 million have been fully vaccinated — about 27.5% of the state’s goal of immunizing at least 70% of Michiganders ages 16 and older, state data shows.

“We’re in a different moment. Every one of us has the ability and knowledge to do what it takes, and it’s on all of us to do it,” Whitmer said recently after touring a mass vaccination site at Eastern Michigan University. “And that’s why we are just imploring people — take this seriously.”

Stay-put orders ‘would have helped’

Dr. Matthew Sims, an infectious disease specialist with Beaumont, said the average COVID-19 patient age he has seen is between 30 to 50, with a few in their mid-20s — a phenomenon he credits to how the vaccine was rolled out: Elderly people got it first, though now everyone in Michigan ages 16 and older can get the vaccine.

Dr. Matthew Sims, director of infectious diseases research at Beaumont Health.

Sims cites COVID-19 fatigue as a major reason for the accelerated spread of the virus in Michigan — that and the comfort brought by the vaccine. He said people who got their first dose relaxed their guard a bit, allowing the virus — especially the variant strains — to spread farther and faster than it would have otherwise.

“I keep telling people, there is no magic bullet for COVID,” said Sims, who questions why the third surge is being handled differently than the previous ones in Michigan.

Specifically, Sims believes sporting and other events where the virus can spread quickly should have been stopped before we got to this point.

“It would send a message that shows, ‘OK, this really is still going on,’” said Sims, adding that with previous surges, lockdowns were effective. “We really need to start shutting down again, but there are (legal) factors I can’t speak to.”

Still, even without a lockdown, Sims noted, Michigan isn’t fully protected because other states have different protocols.

“The spring break surge is about to start,” Sims warned. “People who visited big crowds and beaches will be coming back. … Even if Michigan institutes a state-level shutdown order, plenty of other states won’t.”

Kyra Senese and Eric Fan of the Stabile Center for Investigative Journalism, Columbia Journalism School, contributed to this report.

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