A week ago, Monroe County had 58 cases of the coronavirus. That’s since tripled to 152.

Saginaw County has gone from 71 cases to 186; Clinton County, from 33 to 82; Hillsdale County, from 19 to 62. All in a week.

Since Michigan confirmed its first COVID-19 cases on March 10, officials have been laser-focused on the numbers in Wayne, Oakland and Macomb counties, which remain the epicenter of the pandemic in the state - with more than 16,000 of the state’s 20,346 confirmed coronavirus cases.

But in the past week, there have been significant surges of confirmed cases outside of the Metro Detroit area.

Coronavirus is "definitely spreading outside of Detroit,” said Emily Martin, a University of Michigan epidemiologist. “It’s kind of tricky because the testing is a lot better in metro Detroit than it is in other areas of Michigan, so there’s probably even more spread than what we’re seeing.”

Dr. Dennis Cunningham, corporate medical director of infection prevention and employee health for the McLaren Health System, said he’s definitely seeing the surge in his hospitals, particularly in Flint.

Genesee County, where Flint is located, went from 249 to 713 cases in the past week.

“I’m cautiously optimistic about things in Detroit” based on hospital admissions, Cunningham said Wednesday. “They aren’t any worse and may be slightly better.

“But Flint continues to have an increasing number of cases,” Cunningham said. “Flint has some more tough days ahead, and I do think it’s going to spread to other parts of the state.”

The growing numbers in more rural parts of the state are also concerning, Martin said. Two big issues especially pertinent for the northern Lower Peninsula and the Upper Peninsula: they are regions already underserved by health-care providers and they have a disproportionate number of senior citizens, an age group especially vulnerable to coronavirus.

“At least in the Detroit area there’s enough healthcare systems that if one gets overburdened, there are others nearby who can help out by taking patient transfers,” Martin said. “We don’t have the same kind of overlap in northern Michigan. There’s not that kind of saturation of available medical care.”

Moreover, Martin said, “the public-health agencies in northern Michigan tend to be spread out over huge geographic areas and have jurisdiction over many counties. So they have big jobs on their hands without the same kind of resources that people might have in metro Detroit.

“Plus they have older populations, and populations that haven’t had great access to all of the health care services that they’ve needed for a long time," Martin said. “That will kind of catch up with you” in a public-health emergency.

Lisa Peacock know those concerns first-hand. She’s the public health officer for the Health Department of Northwest Michigan, which includes Charlevoix, Emmet, Antrim and Otsego counties, and for the Benzie-Leelanau District Health Department.

“We’re very worried" about the increasing numbers, Peacock said. “The stability of the health-care system is our biggest concern.”

On April 1, the six counties that she oversees had a total of 35 confirmed cases of coronavirus. By Wednesday, that had increased to 62. Per capita, the six counties collectively now have a higher rate of confirmed coronavirus cases than Kent or Kalamazoo counties.

Peacock already has gotten a taste of how coronavirus can strain local health-care services. Twenty-nine of the confirmed coronavirus cases in Peacock’s region are in Otsego County, an outbreak traced to a resident who apparently caught coronavirus on an overseas trip and then exposed others at a popular restaurant in Gaylord.

Although 29 cases is a tiny fraction of the numbers seen in metro Detroit, local health officials had to scramble to deal with the Gaylord-area outbreak, Peacock said.

Munson Healthcare has hospitals in Gaylord and neighboring Grayling, and decided to put all the COVID-19 patients in the Grayling facility and the non-COVID patients in the Gaylord hospital, she said. But while Grayling Hospital has 80-some beds, they typically only staff for 20, Peacock said, an example of the limited capacity at northern Michigan hospitals.

The other issue in northern Michigan is that there’s been for very limited testing for coronavirus, Peacock said, making it hard to know the true extent of the spread of the disease.

“In our counties where we’ve had only a handful of cases, we think a lot of that is due to the limited capacity for testing,” Peacock said. “Emmet County had very few cases until we opened a testing facility about a week ago. And once we started doing that expanded testing, we started finding more positives --- which is exactly what you would expect to see.”

The good news for counties just now seeing a rise in coronavirus cases is that the mitigation efforts imposed statewide -- such as the closing of schools and restaurants and the stay-at-home order -- mean it’s likely those areas will see fewer cases than they might have experienced otherwise, Martin said.

“When metro Detroit started have all these cases, the whole state went into a stay-at-home mode -- which is probably going to work out better for the rest of the state," making it more likely community spread of the virus will be minimized, Martin said.

The lack of population density also works in favor of rural counties, making it easier to achieve social distancing, experts say.

Still, officials are worried summer will bring an influx of second homeowners and vacationers who could bring coronavirus with them or become infected after their arrival, putting further strain on the local health-care system.

Health departments representing 31 counties in the northern Lower Peninsula recently issued a joint advisory asking people to reconsider travel to the region and for those who do come to quarantine themselves for 14 days after their arrival.

Because the raw numbers of confirmed coronavirus cases are so much lower in northern Michigan compared to metro Detroit, “people may feel this is a safe sanctuary,” when that’s not true, Peacock said.

“We have very, very, very limited testing capacity and a health-care system that is not prepared for that surge in population,” Peacock said. “Our hospital administrators are begging us to share that message.”

PREVENTION TIPS

In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.

Health officials say you should be staying at least 6 feet away from others and working from home, if possible.

Carry hand sanitizer with you, and use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and when you go into places like stores.

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