‘Like wildfire’: How COVID-19 became one of Michigan’s top killers from The Detroit News

COVID-19 trailed only heart disease and cancer in the number of deaths directly linked to health conditions in Michigan last year, detailing the devastating and sudden damage the virus prompted across the state.

Michigan reported its first cases on March 10, 2020 — a year ago Wednesday — and the first death from the virus occurred in February 2020, according to the state health department. From February through December 2020, COVID-19 is considered the underlying cause of death for 11,182 people, six times more than the deaths tied to pneumonia and flu, according to data from the state Department of Health and Human Services.

During the past year, the coronavirus crowded hospitals, induced the use of refrigerator trucks to cope with surging numbers of cadavers and meant even gatherings for burials had to be limited.

“COVID was spreading through the population like wildfire,” said Nigel Paneth, a professor of epidemiology, biostatistics and pediatrics at Michigan State University. “There’s never been an infectious disease out there like this since the flu of 1918.”

Tim Schramm, owner of Howe-Peterson Funeral Home & Cremations Services, remembers the early days of the pandemic vividly. His locations in Taylor and Dearborn went from serving an average of 45 to 50 families per month to serving 50 families a week for a more than a 10-week stretch.

“That’s the first thing that strikes me, that people — good people, people who were loved — died alone,” Schramm said. “And the pain that the survivors had to feel — the guilt, the anger of not being able to be there — that’s what stands out to me.”

The state Department of Health and Human Services considers the coronavirus the underlying cause of death for 11,182 people in Michigan in 2020. Underlying cause means the health condition was what gave rise to the chain of events leading to the death, according to the department.

According to the most recent complete data set, from February through December 2020, heart disease was the underlying cause for 23,233 deaths. Cancer was the underlying cause for 18,354 deaths. Of the 106,391 total deaths tracked in the mortality data from February through December, 10.5% were attributed to COVID-19.

Dr. Teena Chopra, an infectious disease specialist in Detroit and a professor at Wayne State University, said the fact that COVID-19 was novel — meaning it hadn’t been identified previously — meant no one had built up immunity and helped make it so deadly. 

The virus also ravaged a vulnerable population, the elderly, Chopra said. 

About 73% of the deaths linked to the coronavirus in Michigan were individuals 70 or older, according to state data. About 35% of the deaths were people who lived in long-term care facilities, where the virus could spread from at-risk person to at-risk person. 

“It attacked the most vulnerable people,” Chopra said. 

 Chopra works in Detroit, which was one of the hardest-hit cities in the initial weeks of the pandemic in the United States. A year later, she still remembers a conversation she had with the principal of her daughter’s school. The school had a diversity celebration days before Michigan announced its first cases of COVID-19. 

 “I told him this might be the last celebration,” recalled Chopra, referring to the school year that still had months remaining. 

 Chopra was right. 

Michigan revealed its first cases of COVID-19 on March 10. Two days later, Gov. Gretchen Whitmer announced a shutdown of all K-12 school buildings.

Even before March 10, at eight-hospital Detroit Medical Center, Chopra had already begun hearing about coronavirus symptoms and an increase in respiratory illness. But testing wasn’t occurring because there weren’t supplies to do it, she said.

Current state numbers show there were 376 COVID-19 cases in which the onset of symptoms occurred before March 10.

The coronavirus was the underlying cause of death for 469 people in March 2020, according to Michigan’s mortality data. Those numbers ballooned in April and May as the first wave slammed Michigan, testing the capacity of hospitals. April 2020 was the deadliest month with 3,442 COVID-19 deaths — more than cancer at 1,644 and heart disease, 2,562.

In the first months of the pandemic, Michigan was among the top 10 states for both cases and deaths linked to the virus. Now, Michigan is 14th highest for overall cases and ninth for overall deaths, according to data from the federal Centers for Disease Control and Prevention.

For cases and deaths per capita, Michigan is 43rd and 20th, respectively.

The state’s rate of deaths in comparison with cases is higher than most other states. Michigan is behind only New York City — broken out separately from the state of New York — New Jersey, Massachusetts, Connecticut and Pennsylvania.

Generally, these are states that were hit early on in the pandemic before there was widespread testing to confirm cases, meaning there likely were many more cases in the states in the spring than numbers indicate.

‘Almost like a call center’

There are parts of 2020 that Stephen Kemp would like to forget. April, in particular.

The Southfield funeral director worked around the clock that month as his regular monthly volume quintupled almost overnight. Some days seemed to have more deaths than hours.

“Our phones were almost like a call center. The major funeral homes in the city were overrun and they weren’t taking any calls,” said Kemp, president and CEO of Kemp Funeral Home & Cremation Services.

Within weeks, Kemp had ordered a 31-foot refrigerated truck for overflow. It would stay there through the summer and into October as families waited on death certificates from doctors too overwhelmed to sign them, cremation permits from crematoriums too busy to grant them and burial authorizations from relatives who were themselves hospitalized, quarantined or dead.

“For me, spiritually, it was very difficult,” said Kemp, who considers his work in southeast Michigan a type of ministry. “I felt, initially, that nobody was hearing us, nobody was seeing us.”

Michigan publicly reported its first death from COVID-19 on March 18, 2020: a man in his 50s at Beaumont Health, a Southfield-based system of hospitals that is Michigan’s largest.

“This is an unprecedented situation in Michigan and across the country right now,” said Dr. Nick Gilpin, Beaumont Health’s medical director of infection prevention and epidemiology, at the time.

The first wave of the virus in Michigan slammed Metro Detroit with Wayne County initially ranking among the top counties nationally for COVID-19 cases.

As of Saturday, 5,859 COVID-19-linked deaths have been in Oakland County or Wayne County — 37% of the statewide total. The two counties have about 30% of Michigan’s population.

For the first time in Michigan history, the state in April activated its mortuary response team or MI-MORT, a mass fatality response team to help medical examiners with victim identification and disaster recovery.

When the group was activated in late April, hospitals in Wayne, Washtenaw and Monroe counties had 165 unclaimed COVID-positive decedents that were transported to the response team’s undisclosed collection site. Over the next 28 days, the team received another 60 bodies of COVID-positive decedents, said Schramm, who is commander for the response team as well as owner of Howe-Peterson in Dearborn and Taylor.

They were able to reunite families and help make funeral arrangements for all but nine unclaimed bodies, whose funerals the team arranged on their own, Schramm said.

“I remember those days vividly,” Schramm said of the 75-day onslaught. “As fast as it started — it literally started like someone flipped a light switch on March 17 — it stopped abruptly May 12.”

Spreading like wildfire

As of Tuesday — 364 days after Michigan reported its first COVID-19 cases — the state had confirmed 15,699 deaths linked to the virus and 598,968 infections.

The deaths represent about 2.6% of the confirmed cases. However, there were likely many infections that went undetected, according to health experts.

The human toll of a 1% to 2% fatality rate may feel low when dealing with a disease that affects few people. But that hasn’t been the case with COVID-19, where a huge infection rate has meant more deaths across the nation, said Paneth, the Michigan State University epidemiologist.

“That is a horrendous mortality rate for an infection that’s spreading through the entire population,” he said.

Michigan, and the nation as a whole, likely won’t have a full understanding of the state’s full tally of cases and deaths and what most contributed to the infections and deaths for several months, if not years, Paneth said.

“After the pandemic is over, there will be a lot of dissecting of what happened,” he said.

Read, “‘Like wildfire’: How COVID-19 became one of Michigan’s top killers” from The Detroit News.

Learn more about Teena Chopra, MD, MPH.