The last 30 days marked the worst month for Grand Traverse County since the start of the pandemic, with 1,964 new COVID-19 cases and 28 deaths reported, according to data released Tuesday by health officials. Munson Healthcare also shared vaccination data showing that a majority of the 146 patients currently hospitalized with COVID-19 in Munson hospitals – including those in intensive care or on ventilators – are unvaccinated.

Grand Traverse County Health Department Health Officer Wendy Hirschenberger said the current wave hitting the region is “the largest and most serious COVID surge we’ve experienced in northern Michigan since the pandemic started.” Cases have increased every week for the last three weeks, with the average daily number of new cases in Grand Traverse County reaching 65 for the month. That average was 29 in September and 37 in October. Grand Traverse County’s current testing positivity rate is at 19.2 percent, close to the statewide testing positivity rate of 20 percent. “We do keep reaching new highs, not really in a good way,” said Munson Healthcare Chief Medical Officer Christine Nefcy.

Nefcy said Munson was experiencing “some of the highest numbers” it’s seen in the pandemic for inpatient COVID-19 care, with 146 patients hospitalized as of Tuesday. That is more than double the number of patients who were hospitalized just six weeks ago, when 71 patients were being treated for COVID-19. Eighty-six of the hospital system’s current patients are at Munson Medical Center in Traverse City. Munson released patient vaccination data Tuesday (pictured) showing that of its 146 current COVID-19 patients, 119 are unvaccinated and 27 are vaccinated. Among 61 patients in the ICU, 54 are unvaccinated and 7 are vaccinated. And all nine Munson patients on ventilators are unvaccinated, Nefcy said.

“You can see both in our hospitals as well as in our ICU definitely a predominance of admissions for unvaccinated patients,” she said. Nefcy said the average hospital stay for a COVID-19 patient was 5-7 days, though she noted that range could vary widely depending on the individual status of patients, particularly those requiring intensive care or ventilation. Nefcy said Munson was “not in any danger right now of turning people away,” but said the hospital had taken steps including doubling people up and postponing elective procedures to ensure enough staffed beds remain available for patients.

Nefcy outlined treatment options being offered to COVID-19 patients, including monoclonal antibody treatment provided on an outpatient basis to individuals who aren’t sick enough to be hospitalized but have a high risk of developing serious illness based on their age or health. Within the hospital, a variety of treatments from oxygen to steroids are “relatively common,” Nefcy said. She noted Munson anticipates that “broad authorization” to use oral therapy – or pills – will come in the new year, though she added that supply chain issues could impact the immediate availability of those drugs.

In Grand Traverse County, 72.2 percent of residents have now received at least one vaccine, while 65.7 percent have completed a full series. Grand Traverse County is outpacing the state average in vaccinations in the 5-11 age group, with just under 28 percent of children in that age group having received at least one vaccine locally compared to 16 percent statewide. Hirschenberger said the health department continues to open new vaccination appointments for the 5-11 age group every Wednesday at 10am. Despite a growing number of stories on breakthrough cases, health officials noted that the overall breakthrough rate of COVID-19 infections after being fully vaccinated in Michigan remains low at just two percent. Of those breakthrough cases, only 0.023 percent have resulted in hospitalizations, Nefcy said.

Munson has been busy focusing on its own internal vaccination rates after setting a December 5 deadline for employees to get vaccinated in response to federal mandates for large employers and healthcare providers. Chief Communications Officer Dianne Michalek tells The Ticker that Munson expects to be 99.8 percent compliant with its mandate and had “only 20 resignations across our 9,000-plus employees” due to the vaccine requirement. Some staff, who are still on leave or work part-time or on-call and aren’t scheduled to come in anytime soon, will have their vaccination status confirmed once they’re ready to return to work. “Overall, healthcare workers are used to vaccine mandates for flu, MMR and other reasons and we were really pleased to see the steady uptick in vaccination rates as we approached the December 5 deadline,” Michalek says.

Notably, Munson’s figures include approved exemptions for approximately 800 employees. Though that number represents nearly 10 percent of the hospital system’s workforce, Michalek says Munson “fully expected the number of exemptions to be that high based on what we were hearing from other health systems. From what we know anecdotally, our number of exemptions may be lower than other health systems.” Two separate panels reviewed exemption requests, one for medical reasons and one for non-medical reasons. Michalek says Munson offered an exemption to 100 percent remote workers, “so that and religious reasons make up a large portion of the exemptions granted.” Employees were not allowed to seek exemptions for having natural immunity to COVID-19.

While some of Munson’s exempt employees work directly with patients, Michalek notes “those workers have been treating patients throughout the course of the pandemic. We require daily screenings for symptoms and continue to have strict protocols for PPE. Universal masking is required in all MHC facilities right now.” She adds that “employees who are exempt and still working are no different than the employees who receive exemptions for the flu vaccine every year and are required to wear a mask at all times.”

While court challenges could delay the rollout of federal vaccination and testing mandates for employers, other local organizations besides Munson are preparing for their eventual enforcement. In a November 12 email, Northwestern Michigan College AVP of Human Resources Mark Liebling said the college was “developing a policy and detailed procedure for ensuring compliance” with the new federal regulations. NMC will opt for mandatory testing over mandatory vaccinations, according to Liebling, with employees who don’t provide proof of vaccination required to submit a weekly negative COVID test in order to continue working at the college. NMC’s policy will “clarify what forms of proof or of test results are acceptable, and what consequences will exist for employees who do not comply,” Liebling wrote.

In a follow-up November 22 email, Liebling said that in response to a court order putting a pause on the federal regulation rollout, NMC was in a holding pattern until the litigation is resolved. “We are standing by and intend to take no further action to enforce the ETS (emergency temporary standard) until the legal status and our compliance requirements are clear,” he wrote. Liebling added that NMC’s “top priorities continue to be the health and safety of our community, and minimal disruption to those served by the college while also complying with legal requirements.”