In addition to the dashboard that we reviewed in our last blog, the State of Michigan publishes a wide variety of additional data and public use datasets about COVID-19. Just above the dashboard, there are six options for exploring additional data. Clicking on one of the links takes you to a new page.
This page includes statewide hospital capacity and available personal protection equipment data, spread out among five tables. It’s updated on weekdays and participation by hospitals varies daily. For example, in the week of September 4-12, the participation rate in hospital capacity reporting ranged from 72%-80% and in PPE availability reporting ranged from 67%-70%. It’s important to pay close attention to the dates on each table reported on this page because they are not all updated simultaneously and occasionally a table will be significantly more outdated than the other tables.
The first table includes statewide hospital capacity reporting by emergency preparedness region. This can help highlight overall hospital capacity as well as ICU bed occupancy. Understanding the total numbers, as the state reports, can be helpful for understanding the scope of availability in each region. The numbers can also be contextualized into percentages to help understand the scale of availability (similar to understanding coronavirus data on a per capita basis). For example, as of September 22nd, both of the Metro Detroit regions had adult ICU occupancy rates of 77.9% (Region 2N and 2S), compared to the Upper Peninsula’s occupancy rate of 65.5% (Region 8). It also helps us to understand overall availability. There are nearly 1,000 adult ICU beds available in the six counties that make up Regions 2N and 2S, but only 58 adult ICU beds in fifteen counties in the Upper Peninsula. These numbers can be further analyzed by comparing them to population size or spatially to understand average distance from care for certain populations.
The second table includes metrics specific to COVID-19, including the number of current hospitalized adult and pediatric patients with confirmed or suspected cases of COVID-19, the number of ventilated patients, adult ICU COVID-19 cases, and the number of emergency room visits the day before related to COVID-19. These numbers can be used with the previous table to understand how many hospital or ICU beds are currently being used by COVID-19 patients versus patients with other ailments. For example, in the entire state, there were 540 confirmed or suspected COVID-19 patients hospitalized as of 9/22, which is 3.2% of the current hospital census. However, COVID-19 cases comprise 6% of current ICU admissions, which indicates that people are still becoming very sick relative to other illnesses in the state.
It’s important to remember that this data has significant reporting lags and does not include reporting from every hospital in the state. Depending on where the hospitals that don’t participate in reporting are located, the data could be skewed in either direction. If the hospitals are predominately in outbreak locations and not reporting because they’re overwhelmed with caring for covid patients, the numbers reported are undercounting current cases. On the other hand, if the hospitals are not reporting because they have nothing to report, our sense of the situation could be overrepresenting the prevalence of coronavirus hospitalizations in the state.
Understanding trends in hospital bed availability can help people make more informed decisions about the risks that they take in their social interactions as we learn to live during a pandemic. The fifth and last table on this page provides hospital or network-level information about bed occupancy, which provides even more detailed, local information for Michiganders.
Tables three and four on this page provide information about PPE in hospitals. These include gowns, masks, eye protection, and gloves. The first table provides statistics for total available count by preparedness region and the second table provides hospital network-level estimates of how many days of PPE they have on hand. The State notes that this data rapidly changes and so it is not reasonable to expect it matches what is on hand at the hospital at any given moment. However, it does give us a reasonable picture of how the State and our local hospitals are doing and maintaining their supplies and could raise early alarms that a region is in danger of not being able to protect its frontline healthcare workers.
Long Term Care Facilities
Michigan recently updated the process for nursing facilities to report coronavirus data to the Michigan Department of Health and Human Services. Currently, the data is being validated by MDHHS, but we can still learn about the data that is being collected and reported.
The first table displays cumulative cases, recoveries, and deaths for residents and staff. The second table reports cumulative case and death counts for residents and staff by facility name. Michigan residents can use this data to stay apprised of changes in the facilities caring for their elderly relatives, and ensuring that the communication between the facility and those in its care is accurate. The preliminary data indicates that nursing home residents account for 6.5% of Michigan’s cases and 30% of the total deaths, which is a reminder of how important it is for families to advocate for safe and thoughtful procedures in the facilities they’re using.
This data is pulled from notes such as chief complaints, triage notes, and clinical impression for 132 emergency departments (EDs) and 51 urgent cares across the state. While it is not inclusive of all EDs and urgent cares, it helps give a picture of the proportion of emergency visits with coronavirus symptoms. It’s important to note that these symptoms are also related to other illnesses, like the flu, but the data helps give a sense of the impact that the pandemic is having on emergency care capacity.
Since this data is collected from doctor’s notes, which are filled out during visits and already reported to the State’s health surveillance system, it is one of the few data sources that stretch back from before the pandemic, which can help contextualize the impact of the pandemic on emergency rooms in comparison to a normal flu season. Michigan started reporting the proportion of visits with coronavirus symptoms on 1/1/2020 and continues to update it regularly. The tables also include the proportion of visits by age group.
This page reports the total number of recovered COVID-19 cases in the state. Michigan reports an individual as recovered after 30 days from the onset of their symptoms. For example, the number of people reported as recovered on September 18th represent cases that were identified with an onset of symptoms on or prior to August 19th. The state removes someone from the number of cumulative recoveries if they die after 30 days from onset.
Local health departments report new and ongoing outbreaks to MDHHS weekly. Outbreaks are identified as 2 or more cases with a link in place and time, which indicates a shared exposure. The tables are broken down into “new” and “ongoing” outbreaks for each preparedness region. These tables can help Michigan residents understand the relative risk of an outbreak in different settings. For example, as of September 17th, 25% of outbreaks occurred in long term care facilities, 14% in K-12 school settings, and 5% in healthcare settings. The outbreak settings also include office environments, restaurants, bars, retail, religious services, detention facilities, and more.
This data is not cumulative so it’s not possible to understand absolute risks from these different settings. And as community spread increases or decreases, certain activities will be more or less likely to be the source of an outbreak. However, this data can give Michigan residents an idea of what their emergency preparedness region is experiencing in terms of outbreaks and help inform decisions for virtual education, shopping, or other activities.
This page reports new and ongoing outbreaks at K-12 and college campuses in Michigan. It identifies the name and address of the school as well as the number of cases and whether cases are affecting staff, students, or both. This data provides additional context to the previous data about new and ongoing outbreaks. Since an outbreak is identified as 2 or more cases, there can be a wide variety in the size of outbreaks. From the data reported on 9/21, many K-12 outbreaks have only 2-6 cases with one school having more than 20. On the other hand, college undergraduate outbreaks are more likely to be much larger, including at Ferris State (57 cases), Michigan State (533 cases), and University of MIchigan (151 cases).
Underneath the dashboard on the home page, there are five downloadable datasets of data visualized in the dashboard. We’ve already talked at length about how this different data is useful. The datasets include cumulative cases and deaths by county, daily cases and deaths by county, demographics for cases statewide, testing by county, and diagnostic tests by result and county. These datasets can make data manipulation easier for more in-depth analysis.