By Jon King /

As Michigan’s COVID-19 hospitalizations reach a new high, exceeding the previous record for the fifth straight time, health officials say they are concerned that one of the factors driving the increase is school-based outbreaks.

46 new outbreaks were reported last week at K-12 schools in Michigan, among 511 ongoing outbreaks in the state. While none of those outbreaks are currently reported in Livingston County, they have been in the past, and health officials say they will likely appear again, especially if schools don't take proactive measures, including mandating masks and abiding by quarantines, to halt the spread of the virus.

With only 42% of school districts mandating masks, the state health department reports that case rates among children are higher in counties where school districts do not have mask policies. None of the school districts in Livingston County have mask policies, while alsoadopting a policy of not requiring quarantines for exposed students who are not showing any symptoms, or asymptomatic. However, health authorities say relying on the presence of symptoms is not an accurate measure of infection.

Dr. John Carethers is chair of the department of internal medicine at U-M Health. “Asymptomatic spread occurs,” he said. “And we learned this through some of the early studies from the nursing home, from the Seattle area, when the outbreak occurred that people did on many of the patients who ultimately got COVID did not have symptoms sometimes as long as 3, 4, 5 days after testing positive, they looked at samples before they even got symptoms. And so there is true asymptomatic spread.”

That being the case, Dr. Carethers says the community spread of COVID is definitely connected. “The thing that we understand, even in children, even though children as a whole don't get as sick as adults as a whole, they can still spread the virus and keep in mind, children are exposed to teachers, janitors, parents, in the schools and at home. This is not a political statement. It's a public health statement, based on the science at hand.”

When the new quarantine policy was announced, Livingston County Health Department Director Dianne McCormick said the primary basis for the revision request made by the superintendents was that “no notable increases in school-related COVID-19 transmission were found during a pilot, which reduced the distance for determining student close contacts from 6 feet to 3 feet during the month of October.” McCormick noted that more than 10,000 county students have been excluded from in-person learning since the beginning of the school year “of which a majority has not developed COVID-19 from exposure in the school."

But state health authorities are concerned that factors like the Delta variant have not been adequately considered, as it is much more transmissible and leads to worse clinical outcomes.

More than half of the children who are hospitalized in Michigan with COVID-19 have no reported underlying conditions. In addition, the outbreaks have resulted in a rise in cases of multisystem inflammatory syndrome (MIS-C) in children, a condition in which multiple organ systems become inflamed or dysfunctional. There are 183 cases statewide, with 71% of the children in the ICU and five deaths.

On Friday, the Michigan Department of Health & Human Services released new quarantine guidance for schools in which they recommended local health departments and schools work together to quickly isolate COVID-19 cases among students and staff, identify close contacts of those cases and adopt quarantine policies that reduce the risk of transmission in schools while allowing in-person learning.

"When evidence-based prevention measures are utilized," it states, "such as vaccination and masking, students exposed to COVID-19 cases may not have to quarantine at home and can stay in the classroom"

While severe COVID illness has so far largely not affected Livingston County, St. Joseph Mercy Livingston Hospital Associate Chief Medical Officer Dr. Varsha Moudgal worries that will likely change if more people don't get vaccinated and take common-sense precautions. She hopes they can break through the misinformation barrier and get across to the public that the health care system they have relied on to keep themselves and their children healthy, has not suddenly taken a turn away from that mission.

“For generations now, we’ve always allowed science to guide our path forward,” she said, “and patients have placed trust in their physicians to give them the best possible advice of how to proceed when they’re ill. I would just urge the community to place that same trust in us and allow us to do our job and give you the guidance needed. I recognize that it’s very difficult when there’s a plethora of voices out there that have different things to say, but I would say go back to what you trust and believe. Go back to your physicians, go back to science and allow us to help you.”

Photo - AP/Ted Warren