“Forgotten but not gone.” That might be the best phrase to describe the COVID-19 pandemic at the moment, at least in northern Michigan.

On the one hand, many facets of life have returned to normal. But COVID transmission has ticked upwards in July after a relatively quiet June, with the U.S. officially passing 34 million cases last week. And now the rapid spread of the more contagious Delta variant – identified in Grand Traverse County for the first time this week – is raising big questions about vaccination rates, herd immunity, fall 2021 back-to-school policies, and more.

Last Friday, CDC Director Rochelle Walensky reported that the U.S. was seeing an average of 26,000 new COVID-19 cases per day – a 70 percent increase from the week before. Also up nationally from the week before were COVID hospitalizations (by 36 percent) and deaths (by 26 percent).

In northern Michigan, numbers are still low but climbing. According to Wendy Hirschenberger, health officer for the Grand Traverse County Health Department (GTCHD), the department has increased its COVID testing hours in recent weeks because of an uptick in demand, spurred by increasing case activity. The health department’s best week, June 21 to June 27, saw only a single new case in Grand Traverse County. Last week, that number was up to 26.

Nationally and locally, the cases follow a distinct trend: They are disproportionately occurring in people who have not been vaccinated against COVID-19. Speaking at a virtual press conference on Tuesday, Dr. Christine Nefcy, chief medical officer for Munson Healthcare, echoed a statement Walensky made last week: that COVID-19 “is becoming a pandemic of the unvaccinated.”

While Nefcy said Munson is “very happy that our numbers remain low” in the region, she also took a broader view, directing attention to other parts of the country “to show why we’re a little concerned about the Delta variant, and [why we’re] watching closely.” Heat maps Nefcy shared showed a correlation between vaccine hesitancy and COVID outbreaks.

“There are some hot spots across the country that have under a 30 percent vaccination rate,” Nefcy said. “We are quite a bit higher than that in northern Michigan. But there is an overlap between being unvaccinated and these outbreaks. Those things we talked about early on in this pandemic – about hospitals being overwhelmed, staff being overwhelmed, running out of equipment – those are some of the stories we are starting to see from some of these places that are suffering outbreaks.”

In Michigan, 57.5 percent of the population eligible to be vaccinated (those 12 and older) have received at least one dose of the vaccine, and 53.5 percent are fully vaccinated. Vaccination rates are even stronger in parts of northern Michigan: Leelanau County leads the entire state with a fully-vaccinated rate of 72.8 percent, while Grand Traverse County has a vaccination initiation rate of 68.9 percent and a completion rate of 65.4 percent. But some neighboring counties are more sparsely vaccinated, including Kalkaska (46.3 percent fully vaccinated) and Missaukee (47.3 percent fully vaccinated).

Those numbers, Nefcy says, aren’t quite good enough.

“When we look at that [concept of] community immunity or herd immunity, we really need over 70 percent of people vaccinated for us to break this pandemic,” she said, adding that “the vast majority of people that are getting hospitalized” in the Munson Healthcare system at this point are unvaccinated. That claim tracks with national trends: Walensky has said that roughly 97 percent of recent hospitalizations due to COVID are unvaccinated patients, as well as 99.5 percent of deaths.

Part of the problem, Nefcy said, is that “options for treatment when people are hospitalized [for COVID-19] remain quite limited.” In other words, treatment of existing COVID-19 cases, particularly severe ones, is much more challenging for healthcare workers than vaccinating individuals against those risks ahead of time.

Also presenting at Tuesday’s press conference, Hirschenberger noted that vaccination rates in the area are the highest among older demographics (50 and older), but fall below the 70-percent threshold for all younger demographics. Particularly low are the vaccination rates for school-aged children – a trend GTCHD is hoping to change before summer runs out.

In Grand Traverse County, 36.4 percent of kids 12-15 have been fully vaccinated, compared to 56.8 percent in the 16-19 age bracket.

“Remember, when kids are heading back to school, it’s going to be a mix of those who are eligible to be vaccinated and those who are not – as well as staff. So, we do want to try to get as many of those groups up to that 70-percent-or-higher threshold as soon as we can,” Hirschenberger said.

Local schools are also starting to look at what their back-to-school policies will be. Northwestern Michigan College (NMC) moved to stage four of its four-stage opening plan this past Monday, citing “an increase in COVID-19 vaccination rates, and updates to state and federal health guidelines.” Under stage four, NMC will be back to face-to-face instruction for the vast majority of courses and will offer a “fully operational campus,” including the reopening of the NMC fitness center.

According to Diana Fairbanks, executive director of public relations, marketing, and communications for NMC, the college will not require the COVID vaccine for students, but will be “working with the GTCHD on offering vaccine clinics for the fall semester and will be offering incentives for students to get vaccinated.” Details on how those incentives will be awarded are still being worked out, but grand prizes will include scholarships covering full tuition and fees for the spring semester, as well as vouchers for housing fees, bookstore gift cards, and more.

Speaking for Traverse City Area Public Schools (TCAPS), Executive Director of Marketing and Communications Ginger Smith says it is “simply too early” for the district to know what its COVID protocols will look like this fall. Smith does confirm that there will be no mandate for students to have the vaccine, but says that other questions – such as whether masks will still be required for students and staff, or what the rules might be for fall sports – will likely be dictated by state guidance. Smith also says TCAPS intends to share details “soon” about the next steps for the UpNorth Virtual online learning program.

Interlochen Arts Academy will be requiring all students, faculty, and staff to be fully vaccinated, barring “medical and religious waivers.” According to Camille Colatosti, provost of Interlochen Center for the Arts and co-chair of the institution’s Campus Health Task Force, that requirement – combined with the strong vaccination rates in Grand Traverse and Leelanau counties – will likely allow Interlochen “to lift or reduce our pandemic-related restrictions and resume most of our pre-pandemic activities, including public performances.”