DETROIT — Michigan shed its last COVID-19 restrictions nearly 18 months ago and, in that time, the public has come to accept a certain number of deaths from the virus as residents look to put the trauma of the pandemic behind them, experts say.
There are a lot of reasons why, analysts said. Public COVID requirements are largely gone. Deaths are significantly fewer: In the past week, Michigan reported 242 COVID-related deaths in seven days, down from the first months of COVID when the state would regularly report more than 150 deaths in a single day.
Media coverage of the pandemic has lessened from the around-the-clock updates that flashed across television and smartphone screens during the early days of the pandemic.
"People are looking for a return to normalcy," said Kenneth J. Doka, a grief expert and senior vice president for grief programs at the Washington, D.C.-based Hospice Foundation of America. "The pandemic had a massive effect economically, politically, wherever you look. There's only so much time we can spend dealing with that stress, so I think what we're experiencing is a great desire to return to normalcy.
"Is it a little premature? Maybe," he added. "The death toll is still ongoing. But a lot has changed since the first days of the pandemic."
Other health measures have, by many standards, faded away over time. People have largely stopped wearing masks and returned to work. Distancing measures that were standard in the initial months of the pandemic are often now only memorialized by stickers on the floor measuring 6 feet apart.
One of the biggest changes is the existence of the COVID-19 vaccine. It has granted people a level of security and, for many, has meant the difference between a major illness and a minor one, said Dr. Joseph Inungu, professor and director of the master in public health program at Central Michigan University.
The vaccine means people are staying alive, Inungu said. People are still getting sick — nearly 3 million people in Michigan have tested positive, and that isn't counting the likely significant number of people who learned of their own positive cases through home tests they didn't report to the state. But hospitalizations are lower as treatments are available at home, and many who have gotten vaccinated are experiencing a mild illness.
For those who have lost loved ones to the virus, the shift in attitudes can be jarring. Deanna Druyor-Wetzel, who estimates she's lost half a dozen family members and several friends to COVID, said it has been strange to watch people stop caring.
Druyor-Wetzel said she lost so many people to COVID at once that one internet commenter told her it was "statistically impossible." Nearly three years removed, the timeline feels a little fuzzy, but in short order in the first six weeks of the pandemic's arrival in Michigan in the spring of 2020, the Taylor resident lost her grandmother and grandfather, a co-worker, a friend of a friend. By the summertime, she lost more distant relatives and family friends, people she had known for a long time. Others were so sick they needed a ventilator to help them breathe when there weren't enough ventilators available.
"There were, of course, no funerals at that point," Druyor-Wetzel said. "We couldn't have a graveside service, so instead my mom's siblings had to stay by the car for the internment. One of her siblings couldn't make it because they were so sick themselves."
Even now, she still worries about the people in her life getting sick. She worries about her husband, Eric, who has lung problems. She thinks about children in school who are getting sick. She thinks about the toll long COVID can take on people, including a relative who couldn't walk after being hospitalized for the virus. She doesn't always wear a mask herself, she said, but she carries a stack with her and will put one on when she needs it.
Others have started leaving masks behind altogether. Jeff VanWashenova, 43, from Detroit, said he was an "avid mask wearer" during the first year of the pandemic and did everything he could to keep himself and others around him safe. But as time has gone on, and he and others have "accepted COVID as part of our lives," he said he has largely stopped wearing them.
"They're a lot more effective when everyone is wearing them," VanWashenova said. "It's hard to fight that fight by yourself."
He points to signaling from the health leaders that indicates that the virus is moving from a pandemic phase to an endemic phase, where, like with the flu, the disease is considered more manageable and tends to come in waves. The Centers for Disease Control and Prevention is starting to suggest people consider wearing masks again as other viruses also circulate.
It's hard to hold on to trauma for a long time, experts say — and they agree, the COVID-19 pandemic has been traumatic.
As of Tuesday, numbers released by the state show there have been more than 40,000 COVID deaths across Michigan. Nearly 3 million people in Michigan have tested positive, and that isn't counting the likely significant number of people who learned of their own positive cases through home tests they didn't report to the state. Since nearly 3 million people in Michigan have tested positive in a population of just over 10 million people, according to the Census Bureau, it means nearly a third of state residents has tested positive at one point.
The virus also looks different now. The wide availability of vaccines means that a lot of people aren't getting as sick if they're getting sick at all, which has allowed them to shake some of their fears about the worst parts of the illness, experts said.
"Now, the people most affected are often the people who are not vaccinated or maybe have specific health issues," CMU's Inungu said. "That can make it easier for people to push that off, to blame people who get sick — 'Oh, I can sympathize, but he had diabetes or he was obese.' That has contributed to the acceptability of deaths."
It's similar to the pattern Inungu has seen with other diseases, including HIV, which was once seen as a death sentence. HIV treatments available today mean people can still live long lives, including even reducing the risk of spreading it to others, Inungu said.
It's a valuable change, he said, but also one that has meant people now feel that they can blame those who still do get infected on poor lifestyle choices in the same way they can COVID.
"People come to a sort-of acceptance, based on what they think is right," Inungu said. "That is the pattern over and over."
Across the state, more than 69% of people have gotten at least one shot of a COVID-19 vaccine, the state reports. But it is hard to say if that's enough to protect everyone, Inungu said. The number of people who need to be immune to a disease can vary from one illness to the next, but the Mayo Clinic says that for COVID-19, around 94% of the population needs to be immune to "interrupt the chain of transmission."
It also does not help that even people who are vaccinated can still get sick and spread the virus, Inungu said. But the vaccine has undeniably weakened the epidemic, he said, and people should be encouraged to continue to be vaccinated and get any necessary booster shots.
Data on vaccination shows that many of the people who have gotten at least one shot got it relatively early on, though. State data show that while 69.1% of people have at least one dose of vaccine as of Dec. 1, that's only an additional 2 percentage points more people than on April 12. That's about 223,000 additional vaccinated people.
But the virus isn't going away and is contributing to care issues. During a Michigan Health and Hospital Association news conference Tuesday, public health experts from across the state said they expect the virus to continue to circulate, especially in the winter months, and encouraged people to get vaccinated.
“We know that the virus continues to mutate and we know that we still have a fair number of our population that are not up to date on their vaccines," said Dr. Rudolph Valentini, chief medical officer at Children's Hospital of Michigan in the Detroit Medical Center system. "I think that we will continue to see COVID. I know people who are still getting it.”
In addition, COVID is contributing to capacity issues at Michigan's hospitals, which are seeking emergency funding to deal with a labor shortage and a lack of beds. Diseases like RSV, which is especially dangerous for infants and older adults, and the flu, which state officials say is up around the country, are filling beds and intensive care units around the state. An upswing in COVID cases would worsen the situation.
“We are not out of the woods yet with regards to COVID," University of Michigan Health system Chief Operating Officer Anthony Denton said at a Tuesday news conference. "... But this morning, I'm looking at our reports we have 41 COVID patients in our hospital. That's an increase just over three weeks ago.”
“We are expecting COVID-19 to circle back," Valentini said.
Medical officials are urging residents to get vaccinated against COVID and the flu to make the situation more manageable.
"Influenza cases are on the rise in Michigan, and the situation is expected to worsen over the next several weeks," Dr. Natasha Bagdasarian, chief medical executive for the Michigan Department of Health and Human Services, said in a statement. "The flu vaccine is the best way to protect yourself and your families against the anticipated surge of influenza."
Druyor-Wetzel said she's sought out every vaccination and booster she can get to prevent illness from striking her own home. She admits she probably thinks about COVID differently others might.
She points to the old adage about how it takes a village to raise a child, suggesting it also takes a village to prevent illness and to look out for one another. Druyor-Wetzel said she's devastated that people can be so flippant about the virus.
"It kills me when people are so silly about wearing masks," she said. "Sometimes people will ask me about it, and I'll tell them the truth: I lost a lot of people all at the same time."
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(Detroit News staff writer Hannah Mackay contributed to this story.)
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