At the end of last week, COVID-19 statistics for St. Joseph County stood at 1,752 infections to date, including 28 cases resulting in death. The numbers, displayed on the Branch-Hillsdale-St. Joseph Community Health Agency (BHSJ)’s coronavirus webpage, mark a rapid increase since early October. They also reflect a statewide and national trend of fast-rising cases. In light of the trend, the Michigan Deparment of Health and Human Services (HHS) issued new orders in a Governor’s press conference Sunday evening.

Although there has not yet been a week in which there have not been new cases since the pandemic first reached the county last spring, the recent, rapid climb began roughly a week and a half before Watershed Voice’s last report on October 20. At that time, the total case count was 1,083 with 15 deaths countywide.

Despite a lull in case growth that occurred over the summer, the count of new cases per day has over the past several weeks eclipsed late winter and early spring numbers, which is when growth was last at a peak. On November 6, BHSJ reported it was receiving up to too new cases per day in the three counties it represents and serves, which it said “is at least five times more than we were seeing each day during the summer.”

Friday’s BHSJ statistics indicate about one out of every 35 county residents has tested positive for the virus since it first arrived last March. The October 20 rate was one out of every 65 people. Because many of the new, positive cases have come in during the past week, it is likely there will be a concurrent, further spike in the death count, since deaths from the virus often occur during the latter part of the first week or during the second week of symptoms.

The growth in St. Joseph County reflects rapidly-rising case numbers in most other parts of Michigan and many parts of the United States, especially in the Midwest. Several sources have reported that West Michigan hospitals are approaching their capacity due to an influx of COVID-19 patients.

In response to the rising numbers, HHS announced new orders providing additional restrictions Sunday evening. The orders force the closure of high schools, colleges, and some businesses including movie theaters, bowling alleys, and casinos. High schools and colleges must proceed with online or virtual instruction formats only.

The orders also require restaurants to cease indoor dining, although take-out and outdoor dining are still permitted. Retail shops, hair salons, gyms, pools can remain open with some restrictions in place. Schools including preschools, kindergartens, elementary schools, and middle schools can also remain open. The orders take effect this Wednesday. They are set to remain in effect through December 8, but may be extended at that time.

Gatherings are affected by the orders, including Thanksgiving celebrations around the state. For the duration of the order, gatherings are limited to two households at a time, and HHS said it encourages families to pick a single household to interact with over the next three weeks.

Other parts of the order pertain to organized sports, which HHS said are limited to those “meeting extraordinary standards for risk mitigation,” but that “all other organized sports must stop.” In response to the order, the Michigan High School Athletic Association announced it is suspending fall and winter sports tournaments.

The restrictions come despite protestations from some Republican lawmakers in the state having to do with whether the State Legislature had input on the restrictions. In Sunday’s press conference, Governor Gretchen Whitmer said her office has been in contact with lawmakers, who she said offered little more than advice and guidelines. She said the Supreme Court’s September ruling on health orders provided that orders issued through HHS are consistent with powers granted to the agency by the State Legislature.

Last week, BHSJ announced it has added a number of its own operational measures in response to the spike. On Thursday, it announced that it had placed a “Coping with COVID-19 Tool Kit” on its website, with the intent of providing information on what residents should do in the event that they either test positive or must quarantine due to exposure to an infected person. It also includes information to assist with delivery of groceries and medications, finding testing sites, and accessing mental health resources. The agency regularly provides other tips for things like shopping, attending deer camp, and other activities on its Facebook page.

Because of the increased cases, BHSJ said, “even with our staff working at full tilt, we are not able to investigate or notify close contacts as quickly as we’d like. You might not get a call right away. That’s why we need everyone’s help to follow isolation and quarantine precautions.” In order to help manage the situation in light of capacity limitations, BHSJ announced last Wednesday that it is prioritizing its contact tracing and notifications according to several risk factors.

The agency is thus encouraging residents to be proactive in getting tested if they have been exposed to infected persons. BHSJ also said that people who are infected or who have been exposed should begin quarantining themselves promptly and remain quarantined without interruption for a minimum of 14 days. Even if confined to their own residence, and with or without symptoms, infected persons should also isolate from others, the agency said.

Also, BHSJ said, those who are infected should begin notifying their close contacts, and it encourages them to contact their employers for tracing purposes as well. The agency specifies that close contacts are those who have been within six feet or less of an infected person for at least fifteen minutes at a time within a period of 24-hours. The agency said this applies whether face masks have been used or not.

The spike in cases has prompted a number of measures by different organizations and agencies around the county. Last week, the St. Joseph County courts system announced it is suspending all jury trials for the remainder of the year. A number of public agencies and boards that began returning to in-person meetings in August and September have returned to meeting online.

Several school districts around the county have temporarily closed school buildings after reported positive cases, turning instead to virtual learning options. Glen Oaks Community College has steadily taken more and more comprehensive measures. Last Thursday, it announced it has suspended all in-person instruction except labs.

In order to continue managing heavy demand, HHS has continued to revise the way testing for the virus is prioritized. Highest priority goes to those showing symptoms who are hospitalized patients, healthcare workers, first responders, or workers and residents in congregate care facilities, which can include nursing homes and assisted living facilities, homeless shelters, and incarceration facilities, among others.

Prioritized next are asymptomatic people who are either preparing for surgical procedures or who have been exposed to infected persons, as well as persons showing symptoms of infection, which can include cough, shortness of breath, fever, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and sore throat. Also included are asymptomatic people in designated high-risk professions or those living or working in congregate care facilities.

Despite the fact that COVID-19 has resulted in nearly one million deaths worldwide to date, and that it is different from a number of diseases that can often appear to have similar symptoms, some scientists and medical professionals have learned more about the disease since it first emerged. This is helping to inform how doctors treat the virus, which has resulted in death rate that is slightly reduced from what it was early in the pandemic. Computer models and various other forms of research, including vascular research, are helping experts to better understand what the disease does inside the body. Several companies are also cautiously optimistic about the current state of vaccine development.

Nevertheless, and in the meantime, as case and death counts continue to rise, public health officials continue to advise precautions they have advocated since the spring to help limit the spread of the disease. BHSJ, HHS, and other local and state officials and agencies continue to support precautionary measures including social distancing, masking, and remaining at home. To whatever extent possible, they encourage people to stay home and limit their contact with others by telecommuting, conducting meetings and other activities virtually, and having groceries delivered.

Where contact with others is necessary, HHS continues to require face masks indoors, as well as minimum social distancing of six feet. Masks are also required outside in cases where people are six feet or less from others who are not members of their households.

Public health officials say masks help prevent the spread of COVID-19 by limiting the amount of the virus that infected people exhale into the air, thus protecting others from the wearer more effectively than they actually protect the wearer. According to most public health experts, masks are the most effective means to mitigate the spread of the virus in public, an assertion that it supported by measured statistics. For more on how that works, Watershed Voice recently published this guide.

Dave Vago is a writer and columnist for Watershed Voice. A Philadelphia native with roots in Three Rivers, Vago is a planning consultant to history and community development organizations and is the former Executive Director of the Three Rivers DDA/Main Street program.