‘I consider this our fourth increase’

DETROIT – A Beaumont Health expert gave a worrying update about COVID and hospital trends in Metro Detroit, calls this the “fourth rise” and shares three reasons why he believes the numbers are on the rise again.

Nick Gilpin, an Infectious Diseases Physician and Medical Director of Infection Prevention for Beaumont Health, held a virtual briefing Thursday (November 11) to discuss what he sees in Metro Detroit.

Fourth COVID climb in Metro Detroit

“Over the last four to five days, we’ve seen a significant increase in our hospital’s COVID numbers,” Gilpin said. “We currently have around 397 – almost 400 COVID patients across our hospitals.

“With about 400 COVID patients in our hospitals right now, I consider this to be our fourth COVID increase.”


Gilpin said the first increase occurred in March / April 2020. Beaumont Health topped about 1,300 patients during this increase.

“It was by far our most crushing wave,” he said.

Several months later, in the fall and winter months, the second wave came. Gilpin highlighted the period between November 2020 and January 2021, saying the hospital system peaked with about 700 COVID patients.

In the short period between April / May 2021, a third increase saw Beaumont Health peak with about 800 COVID patients, according to Gilpin.

“It was the wave that was predominantly driven by the new delta variant,” he said.

Gilpin said there was a stretch over the summer where COVID numbers dropped, community positivity dropped, and life seemed to return to normal.

“Everything felt good,” Gilpin said. So, in the last few months, I would say from around the end of August / beginning of September, we have experienced this slow burning – this slow, constant increase, with a very low slope – of increases in COVID patients at our hospitals, and that number has gone up over the last few months (from) a very slow slope to in the last week or so, a very sharp increase to where we are at the moment. “


While hospitals are seeing fewer COVID patients right now than in previous increases, Gilpin said he is “very concerned” about the trajectory of this wave.

“This fourth wave, which we are in right now, could take the form of becoming a four or five month long affair,” he said.

Metro Detroit COVID trends

Gilpin said COVID trends in the Metro Detroit community seem to reflect what Beaumont officials see in their eight hospitals.

“Figures across the state jumped about 30% in the past week, and community positivity – the percentage of tests positive in the tri-county Metro Detroit area – has also risen and is now around 11.5%,” Gilpin said.

That percentage signals that Metro Detroit is officially in a period of “significant to high” community COVID transmission, he said.

RELATED: Michigan has the highest COVID case rate in the United States. And admissions are rising


For reference, in the summer, the percentage of positive tests in the area was below 3%, according to Gilpin.

He said Macomb County is about 12-13% positivity, Oakland County is about 8-9% and Wayne County is about 5%.

“When you put it all together, Metro Detroit is about 11% or so,” he said. “That’s an incredibly high number.”

Vaccinated vs. unvaccinated in hospitals

Gilpin was asked how many of the COVID patients in the hospitals have been vaccinated.

“What we have seen is that in general, about 65-70% of all our COVID patients in the hospital are unvaccinated at any given time,” Gilpin said. “This applies to every COVID patient who enters the hospital. That number is also about the same for our intensive care patients.”

Gilpin said as of Wednesday, with about 400 COVID patients at Beaumont hospitals, about 260 were unvaccinated and about 115 were fully vaccinated.

“I can tell you, I’ve looked at these numbers in more detail: Most of the patients who come in who are fully vaccinated – there is usually an explanation for this,” Gilpin said. “The explanation is typically that the person either has chronic medical conditions that put them at greater risk, which means that the vaccine may not be as effective in this population – for example, immune compromising conditions, older age – or these may be people who became vaccinated very early in the pandemic and they may experience some declining immunity. “


He said declining immunity is what led to recommendations for the third booster shot.

Also, as the proportion of the general population becomes more and more vaccinated, the proportion of COVID hospital patients who are vaccinated will naturally increase because there are simply more people who fit into that category, Gilpin explained.

Metro Detroit ‘becomes a hotspot’

Metro Detroit’s percentage positivity is currently more than double the rate experts see across the country, according to Gilpin.

“Metro Detroit is once again becoming a hotspot,” he said.

Now that transmission is so high in the area, Gilpin said it is as important as ever to follow precautions such as to make and take distance.

Why are COVID cases rising in Metro Detroit?

Gilpin began his comments on the increase by saying that no one knows for sure what is driving the increase in COVID numbers. But as an expert in infectious diseases, he has some theories.

“It’s probably a combination of things,” Gilpin said. “To begin with, it is certain that we still have a significant proportion of the unvaccinated in the community.”


He said figures from Beaumont experts as well as medical officials from the state of Michigan confirm that this increase is mainly driven by people who have not received the COVID vaccine.

Although Michigan is a state where the vaccine is readily available, many people have decided not to get the shot, Gilpin said.

“We know that cooler weather that we have experienced over the last few weeks creates conditions that are more favorable for the virus to transmit,” Gilpin said. “Not only because temperature and humidity tend to favor transmission, but also because behaviorally, when it gets cold, we all start gathering indoors again, and that means more transmission options.”

The third factor in this increase is a national narrative that COVID is in decline, Gilpin said. It creates a false sense of security because while that may be true for many regions of the country, it is “certainly not our experience” in the Midwest, he said.


“I think some signals that things are starting to get better have led to some more relaxed attitudes,” Gilpin said. “We are seeing relaxed behavior in terms of masking, physical distancing. We are seeing more and more large gatherings taking place and we know that these are the conditions that are going to create more transmission.”

How to flatten the basket

During previous increases, there was a drastic increase in cases followed by a drastic decrease due to certain mitigation strategies, such as shutdowns and government mandates. But this increase is different, Gilpin believes.

The virus is spreading more gradually this time, and strategies (such as the vaccine) are in place to slow the spread.

“We have things in place that we know can flatten that curve effectively without having to resort to the techniques we’ve used in the past,” Gilpin said. “What I personally want to see is that I want to see more people taking common sense approaches.”


Vaccines for children

Gilpin said hospitalizations are “definitely up” for children in the state of Michigan, including at Beaumont hospitals.

The biggest coincidences right now in Michigan are happening among school-age children – between the ages of 10 and 18, according to Gilpin.

“A lot of it is because there is still a significant portion of the population that has not yet been vaccinated,” Gilpin said.

He also said most new COVID outbreaks across the state occur inside schools.

“It’s not even close,” he said. “So you have schools that run a large portion of outbreaks.”

Many children do not get seriously ill from the disease, but some of them do, and they can all spread it to others, Gilpin warned.

“They can still spread COVID to their teachers,” Gilpin said. “They can spread it to their households, and then it just becomes a way for the virus to spread more.”

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