For nearly a week in early June, Ionia County recorded no new COVID-19 cases. With a small uptick late last week that streak came to an end amid both expanded testing in nursing homes and in the community. At the same time, while statewide numbers for new COVID-19 cases have been falling, the state has been ramping up contact tracing capacity. We reached out to Ionia County Health Officer Ken Bowen to learn more.
The state has begun moving from primarily mitigating the epidemic to avoid overwhelming health care system capacity to containing new cases. This has lead to a changed emphasis from tactics like broad stay at home orders and business closures to more targeted restrictions on places where people are in close proximity and especially on contact tracing. Prior to the past few months, contact tracing was a public health term not in the common vernacular. According to Mr. Bowen the principle is elementary detective work.
“When we are notified of a positive case,” said Bowen, “we contact that individual. We ask the individual who they have been in close contact with while they were symptomatic and for up to two days before the start of symptoms.” After entering all this data into a database used by the Michigan Department of Health and Human Services (MDHHS), “Health Department staff reach out to and monitor “high risk” contacts,” Bowen said, “for example, those who already have symptoms of their own or work with vulnerable individuals. The rest are contacted and monitored by volunteers with the Michigan Department of Health and Human Services. Contacts must be monitored for 14 days after their contact with the confirmed case.”
As of this writing (6/23) Ionia County has 171 confirmed cases of COVID-19 and has recorded 4 deaths. However, the county is geographically sandwiched as it were between Kent County which has 4221 cases and 121 deaths and Ingham County which has 816 cases and 21 deaths. Many of Ionia County residents live along or near the I-96 corridor connecting the Grand Rapids and Lansing communities. Given the close connection between Ionia County and their neighbors what has made the difference in keeping Ionia County’s numbers so low? According to Bowen, “the stay-at-home order worked. Now we have to be vigilant with regard to masks and social distancing to keep the numbers down.”
Earlier on in the epidemic, releases from the Ionia County Health Department consistently contained the admonition that community spread is occurring, but in recent weeks that messaging has changed to emphasize contact tracing efforts. That doesn’t mean that community transmission is not occurring says Bowen, “but we are in a period of reduced transmission compared to a month or two months ago. Whether we stay there depends on how careful people choose to be.”
While statewide, COVID-19 has disproportionately affected the elderly, stats from the Ionia County Health Department show that the largest proportion of cases are actually in the 20-29 age range. “We had a large workplace outbreak in April and May,” at Herbreuck’s Poultry Ranch facilities Bowen said, “that affected younger, working-age individuals and their immediate families.” That outbreak included 63 cases (with more in Herbruck’s facilities in Eaton, Ingham, Kent, and Montcalm Counties) making up more than 1/3rd of all the cases in Ionia County to date.
Another demographic of concern has been prisons. State policy has been to count COVID-19 cases and deaths occurring in the Michigan Department of Corrections (MDOC) as separate from the counties the prisons are in. While Ionia County houses four state prisons, they are treated essentially as a separate entity in state statistics and the Ionia County Health Department referred all questions to MDOC.
In late May, the Michigan National Guard assisted MDOC in testing every single prisoner across the state identifying nearly 4000 infected prisoners. That effort identified only four cases to date in Ionia County prisons and no staff or officers have tested positive according to MDOC spokesperson Chris Gautz. “When prisoners test positive for COVID, they are immediately transferred...to a special unit in another part of the state at a prison that specifically houses just COVID positive prisoners. So there are currently no COVID positive prisoners in Ionia. As soon as the four tested positive, they were moved out right away.”
According to a report from the federal Center for Medicare and Medicaid Services, nearly 30% of all deaths from COVID-19 in Michigan have occurred in nursing home or long term care facilities. Governor Whitmer recently ordered ramped up testing of all nursing home residents and staff. Asked if that could lead to a spike in new cases being identified in the county, Bowen said that the felt that monitoring and testing has been adequate.
Moving forward, as cases continue to trend downward, the responsibility for what happens next continues to rest with every citizen doing their bit. “Stay vigilant,” says Bowen, “we’re all tired of the rules and it is easy for all of us to pretend that COVID is gone, but it is not gone. Be serious about social distancing when in public, and wear a mask when you can’t maintain social distancing. If you are sick, stay home. If you think you need to be tested, contact your doctor.”
Up to date information on COVID-19 is available from the Ionia County Health Department, State of Michigan, and the Centers for Disease Control.
PHOTO: State of Michigan