Michigan doc says record-high Covid cases likely undercounted due to Omicron spread

ROYAL OAK, Mich. - Omicron has created a series of new problems for Michigan beyond the historically high number of people its infecting. 

The surge has placed added pressure to an already-beleaguered hospital system in Michigan, which isn't surprising. The strain, shown to be three-to-four times as infectious, can even move through vaccinated people. 

But it's also prompted at-home testing to increase. Any positive tests aren't being recorded by the state, said Beaumont's Dr. Matthew Sims. 

"And now we have omicron, which they're estimating is three or four times more contagious and that's probably an underestimate because, remember, a lot of people right now are testing by at-home testing kits and those don't get recorded.," Sims, who is an infectious disease specialist said Sunday night.

"So anyone who's positive based on an at-home kit is not in the numbers. So there's probably even more omicron out there than we realize."

The Centers for Disease Control and Prevention has adjusted its recommended quarantine period for asymptomatic cases in an effort to better reflect the contagiousness of COVID-19's new mutations. 

But these changes, which were adopted by the Michigan health department in December, also show the trouble that health officials have with communicating the best advice.  

"The pandemic is changing faster than the messaging," Sims said.

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The CDC's new guidance were released around Christmas - a time period when not everyone may have been watching the news. Many might have already returned to their homes for the holidays. How long symptomatic people isolate? If an asymptomatic person still tests positive after the five-day quarantine period, should they continue to self-isolate? What if two tests show two different results?

The pandemic has never been a static issue and experts say best safety practices would always evolve as the health crisis does as well. But contradictions between top officials, miscommunication with the White House, and other peculiar decisions have made that evolution tricky.

Last week, the American Medical Association criticized the CDC for its latest guidance, saying the new recommendations were "not only confusing, but are risking further spread of the virus."

That's because the CDC's original guidance didn't include recommendations people obtain a negative test before ending their self-isolation.

That is, if someone is able to find a test to take in the first place.

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Counties like Wayne and Oakland have reopened drive-thru testing centers to adapt to the increased need. Media reports about a dearth of at-home tests has made it tough for people to find out if they're still carrying the virus

And those that are testing aren't reporting it to the state, which keeps an official record of how many positive cases are being reported. On Friday, the Michigan Department of Health and Human Services announced a daily average of more than 20,000 new cases - easily the highest yet. 

But those numbers are likely still not accurate since they don't include at-home tests. 

More cases may not sharpen the point much more than health officials have already conveyed - Michigan hospitals are in trouble and have needed to make space elsewhere to free up staffing and beds. 

"I think the hospitals are still safe at this point, I think people are going to get the care they need," Sims said "but you can only stretch the system so far."

"Right now, we're still going a pretty good job of providing critical care to patients," he added. "As you know, we're trying to limit elective care. You know if something can wait, hopefully, you know, it should wait."

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Beaumont reported a 40% increase among Covid-positive patients last week. About 62% of those patients were unvaccinated and only 8% had received a booster shot. Henry Ford Health System has seen a similar climb among cases.

It also said last week it had to send nearly 700 employees home due to infection.

Yet, even as the pandemic's fourth surge remains its severest in Michigan, more than 3 million residents have still not gotten their first dose. The COVID-19 vaccine dashboard reports as of Monday, only 63.8% of the state's eligible population had gotten its first dose. 

The disparity is concerning to health officials who are struggling to communicate how someone should proceed following an infection. Convincing a population more skeptical to expert advice to get vaccinated remains an even more persistent barrier. 

"People who are just completely against the vaccine - it's very hard no matter what message you give to convince them that the vaccine is needed. That it's safe, it's effective, that this is what we need to come out of the pandemic," Sims said.