Jon Deming, the chief of Otsego County's emergency medical services, tried to prepare his northern Michigan staff for something nasty, a mass casualty school shooting or a school bus accident.

But COVID-19 is different, he said.

"Never in my life could I ever envision this," said Deming, who's 66 years old and has worked in emergency response for nearly 50 years. "This is just nuts. ... Life was good about two weeks ago."

Deming's home county of Otsego, a tourism destination and rural area that lies toward the top of northern Lower Michigan, finds itself entrenched in the fight against the coronavirus. While Metro Detroit is center stage with 80% of the state's cases, officials in Otsego County say what's happening in their community shows how quickly the virus can spread anywhere.

The county — its seat is Gaylord — has a population of about 24,500. But its 20 confirmed COVID-19 cases through Friday afternoon ranked it behind five heavily populated counties for the most per-capita cases. The top five are Wayne, Oakland, Macomb, Washtenaw and Geneseecounties.

The smallest of the five, Washtenaw, features the University of Michigan and a population of more than 360,000.

While the20 cases in Otsego County might seem small compared with the thousands of cases in Metro Detroit, it would take few serious cases of COVID-19 to overwhelm the health care system in rural northern Michigan, county officials said.

Otsego area COVID-19 patients will primarily be cared for at Munson Healthcare Grayling Hospital, which has 71 beds, said Dianne Michalek, spokeswoman for Munson Healthcare. Should the Grayling Hospital become overburdened, Munson would open COVID-19 units at other facilities in its system, she said.

Otsego County's emergency medical services operation has about 36 employees. One of those employees already has COVID-19 and is on a ventilator in the hospital, Deming said. Two other employees have tested positive but haven't been hospitalized, he said.

In total, five employees have been off work this week because they had symptoms, Deming said Friday. And another employee temporarily left because she has a family and didn't want to risk getting the virus, he said.

Countywide, Otsego had one confirmed case for every 1,233 residents through Friday. Washtenaw had477 cases overall confirmed cases for a per-capita rate of one confirmed case for every 770 residents.

Kent County, where Michigan's second-largest city of Grand Rapids is located, has one case for every 4,830 residents. Ingham County, home to Lansing, has one case for about every 1,923residents.

The situation shows how coronavirus can spread across all areas geographically, said Frank Claeys, Gaylord's police chief who's helping manage the city's response.

“It’s something that doesn’t know any lines," Claeys said. "All it takes is for one person to have it. And there’s easy community transmission of it.”

Virus hits area in six days

The Health Department of Northwest Michigan disclosed the first case of COVID-19 in Otsego County on March 16, six days after the first cases in all of Michigan were reported.

Otsego County's case showed up in state data on March 17, making it one of the first 15 counties to have a confirmed case.

Aaron Pegg of Gaylord had traveled internationally, going on a mission trip to Ethiopia through his church. Pegg has done local media interviews about his experiences and posted Facebook videos, explaining that when he returned home on March 6, he thought he was fine.

Five days later, Pegg said he began feeling symptoms, a fever, a sore throat, body aches and chills. He described it as a "weak flu" in a Facebook video. He went to the emergency room and was tested for COVID-19. On March 16, he found out he was positive.

Pegg said he had basically gotten over his symptoms two days earlier.

"People that I consider brothers and sisters got the virus from me and were able to fight it off," he said in one video. "I am thankful that so far there haven't been any fatalities from the corona-tree that branched out from me. People have not had serious hospitalization from my corona-tree so far. But I will say it's been a burden.

"I am sure that my team members have felt the burden too as being looked at as the people who carried this thing into northern Michigan, a community that we love."

Claeys, the Gaylord police chief, said to his knowledge, no one else who went on the mission trip tested positive for the virus. Dr. Joshua Meyerson, medical director for the Health Department of Northwest Michigan, said there seemed to be multiple clusters of the virus with some people in the county simply not knowing how they got it.

"All of the people involved did everything they were supposed to do," Meyerson said.

The individuals let doctors know they were sick early on, which allowed officials to identify cases earlier, he said.

On March 23, the health department reported that Bennethum’s Northern Inn, a restaurant in Gaylord, was a possible site where there was "significant exposure" to the virus. People who were at the restaurant from 5-8 p.m. March 12 and 8-10:30 p.m. March 14 "should self-monitor for 14 days" from the exposure date, the department said.

The situation in Gaylord shows why people need to follow social distancing measures regardless of where they are in the state, Meyerson said.

"You won't get away from it by coming up here," he said.

Emergency services stretched

Joseph Duff, the city manager for Gaylord, said he was at a loss to explain precisely why Otsego County has more cases than other similarly sized counties in the state.

For example, the two closest counties to Otsego in population are Manistee and Roscommon counties. They each had one and two cases, respectively, as of Friday's state data.

Duff said he couldn't point to a single individual as the reason the virus had spread in the county. But he guessed the spread might have something to do with the regional nature of the area with people coming from surrounding counties to shop at Gaylord's larger retailer.

"We’re just not sure why the reasons are that our numbers are higher than others in our surrounding area," Duff said.

Gaylord is along the Interstate 75 corridor, Dr. Janelle Hendrian, chief medical officer of Munson Healthcare Otsego Memorial Hospital, noted in a statement. People from all over the state, including northern Michigan, stop in the area for food and supplies, she said.

"Due to the nature of our town and wide utilization of our amenities, it is theoretically possible that we have more opportunities for exposure than one would think," Hendrian added.

"We are seeing vacation cottages, that are normally vacant this time of year, fully occupied," she continued. "People are flooding out of the more densely populated cities to the north. Some of these people have come from areas with a large COVID-19 burden."

Regardless of why, the virus is already affecting emergency response in the county. With five employees not working because of symptoms, Deming said the county, which normally runs three to four vehicles to respond to problems per day, is now running two.

Deming said he isn't sure how his employees may have contracted the virus. But he said they've been transporting some "really sick people."

"I’ve got great people," Deming said of his staff. "I’ve just got to get them through this."

cmauger@detroitnews.com