Driven by a combination of factors — including colder weather; more indoor social gatherings; pandemic fatigue; and low compliance with non-pharmaceutical public health interventions, like social distancing — there has been what the Livingston County Health Department says is an immense surge in community transmission of COVID-19, reaching numbers higher than during the first wave in the spring.
In a report released by the LCHD, this widespread community transmission has placed tremendous strain on public health capacity throughout Michigan, stretching well beyond capacity limits. This strain has resulted in decreased ability for local public health to effectively conduct and keep up with the increased demand for case investigation and contact tracing.
In this time of widespread community transmission and strained public health capacity, vulnerable populations are again a great concern as we enter this second wave of COVID-19.
Below are the areas of concern the LCHD outlined in its release:
Nursing homes
While transmission of COVID-19 has not yet been widely observed in Livingston County nursing homes due to effective infection control practices, such as regular testing, there is great concern about this population. Nearby counties have recently begun reporting outbreaks in nursing home facilities due to transmission from community-acquired COVID-19 in staff members. The Livingston County Health Department (LCHD) continues to work closely with long-term care nursing facilities in Livingston County to provide support and guidance to effectively safeguard our most vulnerable residents.
Schools
The LCHD said that the risk for in-school spread increases with widespread community transmission. Many staff members and students infected with community-acquired COVID-19 have consequently exposed large groups of individuals in both public and private school districts. This in-school exposure has led to large groups of quarantined staff and students. While the risk of in-school transmission remains low in Livingston County, the practice of in-person instruction is at risk due to increasing numbers of quarantined students and lack of teachers to provide instruction.
As we look toward the upcoming holiday season, LCHD strongly encourages residents to help reduce the risk of community transmission by social distancing, wearing masks, practicing hand hygiene, and gathering only with household members.
Case Count
Over the past two weeks, there were 797 total cases (average of 56 cases per day). This is 123% higher than the previous two weeks, which demonstrates a significant increase in the number of total cases in Livingston County.
There are two classifications of cases that make up the total number of COVID-19 cases; confirmed cases and probable cases. The case count above includes both.
● Confirmed cases are people who had a nasopharyngeal COVID-19 PCR test that was positive.
● Probable cases are people who have COVID-19 symptoms and are close contacts of someone who has COVID-19, but did not have a PCR test done. If someone has a positive rapid COVID-19 antigen test (as well as COVID-19 symptoms and/or are a close contact of a COVID-19 case), they are still a probable case, because they did not have a COVID-19 PCR test done. The COVID-19 PCR test is the most sensitive COVID-19 test and is most likely to correctly diagnose an active COVID-19 infection.
Hospitalizations
Over the past two weeks, there were 7 new hospitalizations. The previous two-week period had 17 cases with a new hospital admission.
Deaths
Over the past two weeks, there was one death. In the past two-week period, there were two deaths.
Positivity Rate
The current positivity rate in Livingston County is 7.5%, which has more than doubled over the past month. The rate is slightly lower than the overall state of Michigan (8.1%). The total number of tests (denominator) remains stable over time indicating significantly increased transmission in the community.
The positivity rate shows what percentage of all COVID-19 tests that were done have come back positive over a certain period of time. The positivity rate depends on the number of COVID-19 cases in a community and the total number of tests that were done. The rate can be high if there are more COVID-19 cases and there is increased spread of COVID-19 in the community; it can also be increased if there are not enough tests being done in the community. A goal that has been adopted across health departments is for the positivity rate to be less than or equal to 3%.
Epi Curve
Livingston County is experiencing significant growth in the number of cases of COVID-19, and is now considered to be in a second wave.
While there was a temporary plateau in mid-October, leading to hope of slowed growth and transmission. However, this period of slowed growth was brief, as the epi curve is now most consistent with exponential growth starting in early October.
Livingston County is still in the growth phase with the most recent case count of 215 per million. This is the highest incidence to date and places Livingston County in the highest risk category, “E,” as seen on the MI Safe Start Dashboard. This growth resembles most other counties in Michigan.
An epi curve is a way to visually show the onset of cases in a community during an outbreak. It shows us how many COVID-19 cases had the onset of symptoms on each day over a period of time. It is a way to illustrate the spread of COVID-19 in the community and how the number of cases has been trending.
Sex
Over the past two weeks, there have been a similar percentage of males and females affected by COVID-19. Males account for 52%; females for 48%.
Age
The distribution of ages of individuals with confirmed or probable COVID-19 shows similar distribution between 30-70 years, with an average age of 44 years.
