College coronavirus outbreaks ‘gravely concern’ Michigan public-health officials
It’s been a rough couple of weeks for Linda Vail, head of the Ingham County Health Department.
Since Sept. 1, her agency has logged more than 1,300 cases of coronavirus. That’s 41% of total cases the county has recorded since the beginning of the pandemic. And there’s no end in sight: The county had more than 600 new cases last week.
The vast majority of the recent cases are linked to Michigan State University students. Almost all MSU classes are online this semester, but that hasn’t stopped students from returning to East Lansing this fall and living an active social life, pandemic or no.
Case investigations of new coronavirus show a consistent pattern of source of infection, Vail said wearily. “It’s social gathering, social gathering, social gathering, social gathering. Parties. People hanging out. Big social gatherings. Small social gatherings. Indoors. Outdoors.
“People are saying, ‘Well, we kept to only 10 people indoors, or only 25 outdoors,’ but it’s like, you’re not wearing masks or social distancing, and so it’s really great that you kept your number down to 10, but you’re all still in each other’s faces,” Vail said.
“Are we surprised there are a bunch of cases? No, we are not,” Vail said, adding it was inevitable as young people from across the state and country moved into communal living quarters in late August.
But she is stunned by the sheer numbers.
“A thousand cases in two weeks?” she said. “This is a crisis.”
She’s not the only public-health official feeling that way.
Outbreaks at Michigan Tech and Ferris State universities have blown up the coronavirus case numbers in Houghton and Mecosta counties. Isabella County, home of Central Michigan State University, declared a public health emergency in August.
Last week, Ottawa County, home of Grand Valley State University, issued a two-week stay-at-home order for GVSU students That came two days after Vail ordered a mandatory quarantine for people living in 23 fraternity and sorority houses and seven large rental houses near MSU.
Ingham County orders mandatory quarantine for 23 Greek houses near MSU campu
Recent coronavirus outbreaks at Michigan colleges and universities have resulted in more than 4,000 coronavirus cases as of Sept. 10, according to a state report released last week.
“We knew that (the reopening of schools) was going to probably increase our cases,” said Marcia Mansaray, deputy director of the Ottawa County Health Department. Her county has had almost 1,000 new cases since Sept. 1. That’s a third of the county’s total cases since March.
“But honestly, I think we were caught a little off guard at how big it got at Grand Valley as fast as it did, and I think Grand Valley was, too, because they were making every effort” to control the virus, she said. “There was testing and doing all these preventive measures in place for that not to happen. But it did.”
Role of college officials
For the most part, public-health officials credit university and college officials with taking the proper precautions to minimize coronavirus outbreaks.
“School officials have been very cooperative,” said Adam London, head of the Kent County Health Department, which is monitoring outbreaks at Aquinas College and Davenport University in Grand Rapids. “They’ve been tremendous partners of ours throughout the summer and in planning for school to resume.
“As far we’ve seen, the challenge really hasn’t been lack of planning by the schools, even with a tremendous increased risk in the face-to-face learning environment,” he said. “The challenge that we’ve seen so far has been the behavior and the activity of the students outside of the classroom.”
Michigan State went as far as moving most of their classes online and encouraging students to stay home this semester, Vail said.
But what made a big difference in East Lansing, in her estimation, was a failed vote by MSU’s Interfraternity Council to put a moratorium on social events during the pandemic. The resolution required a two-thirds majority and failed by one vote. By comparison, such a moratorium is in effect at University of Michigan, which has had far fewer cases of coronavirus so far.
The Interfraternity Council votes were “kind of signal” to the general college community, Vail said. “When fraternities basically say no social gatherings, that signals to the rest of the university that we’re not partying. And when MSU (fraternities) are, like, We’re going to have social gatherings,’ the rest of the university is, ‘We’re going to have parties.’ “
Compounding college students’ penchant for parties is a growing resistance to contact tracing, with those testing positive for coronavirus refusing to provide names and contact information for those they might have infected, multiple health-officers said.
“One problem we’re running into is, young adults don’t want to tell us where they’ve been or who they’ve been in contact with,” said Marcus Cheatham, who heads the Mid-Michigan Health Department, which covers Clinton, Gratiot and Montcalm counties. “This kind of culture is evolving where people are actively defying their local health department.”
On average, Ottawa County residents reached by contact tracers have four close contacts they might have infected, Mansaray said. “I would expect students to have at least that, but many have told us they don’t have any.”
Some university and colleges actually have been helpful in that regard by threatening to take disciplinary action against students who refuse to participate in contract tracing.
“Grand Valley is taking a lot responsibility” in this area, Mansaray said. “No. 1, they set up a complaint line and they’re taking all the questions and concerns. They also have put in a disciplinary policy so that if you are not compliant with the rules, it goes on your permanent academic record and if that happens enough times, you can be expelled from the university, you can lose your housing.
“Some of the apartment complexes are joining in with that, and we may revoke your lease and you’re out,” she said. “So there has been some great partnerships there.”
MSU also has made coronavirus rule compliance part of their Student Code of Conduct, Vail said. “So when they don’t cooperate, I hand over their names and the notes of what they refused to do.”
But colleges and universities could do more, said Dr. Karen Kent VanGorder, a Lansing family doctor and chief medical and quality officer for Sparrow Health System.
“Universities could say, ‘We’ll defund’ ” organizations that hold social gatherings, she said. “We will fine. We will force you to withdraw from college. We will do whatever we can to curtail those activities off campus.”
She also suggested that universities and colleges should simultaneously take a pro-active approach in sponsoring activities that do follow social distance guidelines, such as outdoor movie nights.
“It’s not realistic to tell college kids not to socialize,” Kent VanGorder said. “What we should be doing is enabling people to get together in a way that is safe.”
Risk of community spread
Some have questioned why the college outbreaks are a big concern, considering that most young people have mild cases of coronavirus.
Doctors say that while young adults are at very low risk of dying of coronavirus, the long-term health consequences are unclear.
“As a mother and a family doctor, my biggest concern is, what are the long-term ramifications of this viral illness that we don’t know a lot about yet?” Kent VanGorder said.
It appears that coronavirus, like some other viruses, can cause “downstream vulnerabilities” in people’s health, she said. “What’s going to be the normal course of events once the body is forever changed by having had coronavirus? That could be the important piece for young people.”
The other big issue: Public-health officials are “gravely concerned” college outbreaks will spill over into the general population, London said. “It’s only a matter of time.”
“It’s impossible to keep college students, or any portion of our population, isolated in a vacuum, separate from the rest of the population,” he said. “And when they go to the store, or when they go to work, or when they go anywhere in the community, they’re carrying that virus potentially to people who are far more vulnerable and likely to suffer more serious consequences.”
It’s also an issue as K-12 schools monitor community transmission rates in determining whether to begin or continue in-person classes.
In fact, spiking coronavirus numbers among young adults in Clinton County led St. Johns Public Schools to delay the resumption of in-person classes by a week.
“The numbers have gotten so bad that they blew through the criteria” for a safe reopening, Cheatham said at the time. “So now we have outraged parents who are aware their kids aren’t learning; we have people who can’t access the Internet and so their kids can’t go to school virtually.
“We have the worst possible situation where it’s almost like our community is making war on our schools,” he said.
Worries about the spillover from GVSU cases was what led Ottawa County to issue its stay-at-home order, Mansaray said.
“We’re aware of at least one school district that has had a case that resulted from a contact at Grand Valley,” she said. “And we know there are 80 additional cases throughout Michigan that are linked in some way to Grand Valley students. So it’s spreading.
“Once it elevates our case metrics, there are certain things that happen, like our courts need to shut down and our K-12 schools may need to go virtual. Then the parents of those students might not be able to go to work,” she said. “And there’s this ripple effect of what could happen with hospitalizations and deaths. I mean, we don’t even want to think about that, but we have to.”
Vail makes a similar point, using Ingham County as an example of how when cases spike up, more deaths are often the end result. In the case of Ingham, the county reported only 29 coronavirus deaths through the end of June and there were no deaths reported in July. Then in August, there were 10 deaths in Ingham, which followed a spike in coronavirus cases linked to Harper’s Bar in East Lansing.
While none of the deaths have been linked to the Harper’s Bar outbreak, Vail said it’s likely the deaths were an indirect result.
“The increase in transmission in this community eventually went from people who caused the increase in transmission, to maybe another person that they knew and then to maybe another person they didn’t know,” she said. “And eventually, there are 10 anonymous people (to the original carriers) who are now dead.”
A matter of time?
University of Michigan has yet to experience a large-scale outbreak of coronavirus.
But Susan Ringler-Cerniglia, spokeswoman for the Washtenaw County Health Department, said it may be just a matter of luck and timing.
“I’m not personally convinced that we won’t see that,” she said. “Something that we often forget is how long outbreaks can take to manifest themselves.”
The reality is that the “virus is still circulating. Nothing has really changed about that,” she said. “I can’t say that students here aren’t socializing, because we certainly get lots of reports of it.
“So we don’t yet have an explosion of cases, for lack of a better term,” she said. “Is that because of other differences? I doubt it. We still have congregate living. We still have young people getting together. Are they really doing that much better at compliance? Probably not. Which leads me back to the concern about timing — we just haven’t seen it yet.”
Dr. Jennifer Morse is the medical officer for Isabella and Mecosta counties, where she’s dealing with the outbreaks at Central Michigan University and Ferris State.
Especially at CMU, “their rates are really slowing down,” she said. “But I think at some point, people will get complacent and we might well see spikes again. It’s just likely to happen. I worry about the cold weather, when we’re all stuck inside again. How that’s going to go?”
Vail said she’s sympathetic to the plight of college students.
“This is not a normal college experience,” she said. “It’s sad. It’s unfortunate. But it’s also temporary.
“If we could all decide we’re going to follow the guidelines — we’re going to wear marks, we’re going to social distance, we’re going to keep our gatherings to the limit,” it could bring the current outbreaks under control, she said.
“It doesn’t have to be that way for long, if we can all just basically do some strict adherence for a fairly short period of time,” she said. “I think if we get three to four weeks of strict adherence, it would do wonders.”
Staying on the current course will not end well, Vail added.
“If you, MSU students, want to have a spring semester where you actually can come back to campus, where you actually do get to enjoy Spartan basketball, this is not the way to do it,” she said. “It’s not going happen if we can go at it this way.”
COVID-19 PREVENTION TIPS:
In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.
Health officials say you should be staying at least 6 feet away from others and working from home, if possible.
Use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and carry hand sanitizer with you when you go into places like stores.
Michigan Gov. Gretchen Whitmer has also issued executive orders requiring people to wear face coverings over their mouth and nosewhile in public indoor and crowded outdoor spaces. See an explanation of what that means here.
Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.
For more data on COVID-19 in Michigan, visit https://www.mlive.com/coronavirus/data/.
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