Michigan’s definition of coronavirus ‘recovery’ looser than other states

Anthony Moses, 64, of Detroit sits with his wife, Tiffiney Moses, in an upstairs bedroom at their home on Detroit’s west side. Anthony was released from Beaumont Hospital on Monday after 55 days in the hospital battling COVID-19. He's far from recovered, though. He uses a walker and a cane, and Tiffiney and other family members assist him, with making food and personal care. (Ryan Garza, Detroit Free Press)

Not dead.

In the crassest of terms, that’s how the state of Michigan defines the 22,686 residents who have “recovered” from COVID-19 as of May 8.

So in mid-April — when Anthony Moses laid in a hospital bed connected to oxygen, having bled internally, having received multiple blood transfusion, and his kidneys possibly shot forever from the virus — he was, as a data point on the state’s coronavirus scorecard, considered “recovered.”

He was still in bed on his 64th birthday April 19 as his family sang him “Happy Birthday” by phone, unable to see him because of the coronavirus that had nearly killed him.

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And on Monday, he arrived home after his 55-day stay at Beaumont Farmington Hills — 32 pounds lighter and now assisted by his family in the simplest tasks: dressing, walking, even swinging his legs in and out of bed.

“You take for granted that you can get out of bed and walk,” he said.

But Moses said God saw him through the ordeal: “I can’t complain. I’m here.”

As Michigan’s first and worst-hit coronavirus patients leave hospitals and rehab units and head back home, the disconnect between the state’s definition of “recovered” and their everyday life is startlingly clear. 

The Michigan Department of Health and Human Services counts those “who are 30 days out from their onset of illness” as recovered. In other words, unless the state receives a death certificate stating otherwise —  every person who tests positive is considered “recovered” 30 days after the onset of symptoms.

The monthlong period represents two 14-day incubation periods for the virus with a few extra days that allow any death certificates to reach the state’s reporting system, the Michigan Disease Surveillance System, or MDSS, said Lynn Sutfin, health department spokesperson.

The definition is a jarring oversimplification of a virus identified just six months ago in China and may leave survivors with damage that’s complicated and still not fully understood. It also underscores the shortcomings in data collection used to paint a picture of Michigan in its battle against the deadly coronavirus that first appeared in two cases March 10. 

The state’s reporting infrastructure is designed to capture the onset and spread of disease; it isn’t set up to capture recovery data, Sutfin said.

“We realize there are some in [the data] who aren’t at the same level of health as they were, but we don’t feel that they will change the overall numbers much,” she said.

Sutfin noted that there is no universally accepted definition of “recovered” from coronavirus yet. 

The U.S. Centers for Disease Control and Prevention offers guidelines on when to end home isolation and or when health care workers are safe to return to work after an infection. It is still working on an estimate of “recovered” Americans, and will include it and definition of “recovered” on its website soon, according to a CDC in an email to Bridge Magazine.

That leaves Michigan and other states to interpret “recovered.”

Ohio, for example, doesn’t try. With partial data, the picture would be misleading, said Melanie Amato, press secretary​ for the Ohio Department of Health.

 

A COVID-19 infection in March has left him still struggling for breath even after returning to work, said Dr. Samuel Allen, a critical care pulmonologist at Beaumont Health.

There’s no national standard, she said, and insufficient testing means not everyone sickened would be reflected in the data. Though some local health departments are tracking their own recovered cases, the data would be too flawed at a state level.

“It wouldn’t be an accurate description,” of what happened, she said.

Wisconsin tracks “recovered” with a three-point definition: 30 days from onset of symptoms or diagnoses, documentation that symptoms have resolved, and documentation that patients have been released from public health isolation.

Dr. Samuel Allen has faced down the virus more than most, both as a critical care pulmonologist at Beaumont Health and as a patient.

April 5, he said, “was my sickest day on earth,” and he’d spend more than two weeks off the job. 

Although the state’s numbers of COVID-19 cases have plateaued, Allen said he feels no less in the thick of it, and there will be countless more deemed “recovered” in the coming weeks.

“I took five people off ventilators last week. Three ended up back on the ventilators within 72 hours, they were so weak,” he said.

Adding to it the frustration, he said, his own body still struggles in recovery, though he returned to work more than three weeks ago. He’s often short of breath and there’s coughing jags, too.

But he’s lucky.

Others spend days, even weeks, on ventilators. Some patients lose kidney function, leaving the hospital only for another long-term acute care facility, where ventilators and dialysis keep them alive, he said.  Among them recently, was a 38-year-old patient with no life-threatening conditions prior to the COVID-19 infection, Allen said.

Recovered? Far from it, he said.

“They’re through the virus. They’re through their treatment for the virus,” he said. “Now they’re left with the repercussions of the virus and that can take months to heal."

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Comments

Anonymous
Sun, 05/10/2020 - 10:40am

I'm getting a little sick of the executive branch over and over saying that it "isn’t capturing data." The Governor has one job- run the executive department. She's so busy engaged in partisan campaigning and issuing dictates and scolding protesters that she isn't running the executive branch very well. She isn't collecting data, isn't reporting data, isn't regulating and supervising nursing homes and vulnerable populations, the unemployment hotline is mostly broke, and she isn't filing the proper paperwork on time to apply for loans and aid. She is doing a bad job of being Governor.

middle of the mit
Sun, 05/10/2020 - 11:03pm

Are you saying Governor Gretchen should actually put on the jack boots and assert Her authority?

https://www.bridgemi.com/talent-education/michigan-launches-coronavirus-...

I give you the conservatives response to your response that the Governor should have taken!

You want her to regulate, but then whine and cry that your freedumbs are being trampled on!

When you figure out how it is that you non medical experts think that society should respond to this...............

let us know.

By that time half of us will be sick, a tenth of us will be dead and your business?

Well..you ARE THE PROFESSIONALS THE REST OF US SHOULD BE LISTENING TO!

It WILL be put on you!

Get it yet?

Revere
Mon, 05/11/2020 - 12:30pm

Mit,
You've lost it. What's up?

Anonymous
Mon, 05/11/2020 - 1:30pm

I don't think that I want the Governor to start doing more- I'd just like her to do what she is supposed to do. The State of Michigan already had regulations and policies and oversight and inspections in place to go to nursing homes and senior facilities- she should just do her job. The State of Michigan already had the tools and people in place to collect information from hospitals and doctors- she should just do her job. She shouldn't do more than her job, or try to change her job, or rely on a unique interpretation of a law that hasn't been used in 50+ years to come up with a bunch of new ways to do her job- she should just do her job.

Her failure to do her job- to perform inspections and safety checks in already regulated nursing homes- killed people. Her failure to collect information properly using existing resources and systems led to (and continues to lead to) a serious lack of information about the virus and it's spread. Her failure to run the unemployment office properly has cost people money and made it so that they are unable to pay their bills- she is the executive and she is in charge of that office and (as they say) the buck stops with her- and she is doing a bad job. She failed to properly file paperwork many times, and that cost our state time and money.

The Governor doesn't need to be listened to, she doesn't need to be a dictator, she doesn't need to be a medical expert, she doesn't need to give anyone any sort of response. She should just do her job better. People are dying because she sucks at being a Governor of the State of Michigan.

Anna
Mon, 05/11/2020 - 9:29am

"Recovered" in epidiemiological studies means precisely "not dead" at a specified point in time after having been infected. The point in time is chosen based on the expectation that a patient who was going to die of this specific disease would have done so by that time. The other relevant issue is, when setting up conditions for epidiemiological models is that, in most models, a "recovered" patient cannot further spread infection and is not susceptible to re-infection for some time.

"Recovered" in epidiemiological terms does not mean, and was not intended to mean that the infected person has returned to their previous state of health. The more underlying health conditions, including being older than 60, that a person has, the longer it will take for them to return to their previous state of health. Further, it appears that, as for other viral infections, COVID-19 can cause long-term damage to heart, circulatory system, lungs, and kidneys after the patient has recovered in the technical, epidiemiological sense.

Businesses setting policy on paid sick leave and insurance companies attempting to calculate their potential liability for continuing therapy and supportive care should not base their decisions on the epidiemiological time span assumed for "recovery" until we have much more data about the trajectory of the diease and patient's recovery in the sense more often used in everyday speech.

Anonymous
Mon, 05/11/2020 - 7:45pm

These definitions must change- the European Flu is unlike anything that has ever struck mankind. I now demand that the word "recovered" means what I want it to mean, which is "returned to a previous state of perfect health pre-Trump." Businesses Are Evil, Orange Man Bad, Follow The Science, and other sayings.

Chris
Mon, 05/11/2020 - 7:44pm

I have been looking for the data and statistics for nursing homes and other long term care facilities for weeks!!! NOTHING!! Then I happened upon a list of US States as to data, MICHIGAN REPORTS NOTHING!! I am sooo fed up with the political game from this Governor! The people of Michigan deserve ALL DATA, not just what the Governor decides we get !!!

Chris
Mon, 05/11/2020 - 7:45pm

I have been looking for the data and statistics for nursing homes and other long term care facilities for weeks!!! NOTHING!! Then I happened upon a list of US States as to data, MICHIGAN REPORTS NOTHING!! I am sooo fed up with the political game from this Governor! The people of Michigan deserve ALL DATA, not just what the Governor decides we get !!!

Chris
Mon, 05/11/2020 - 7:45pm

I have been looking for the data and statistics for nursing homes and other long term care facilities for weeks!!! NOTHING!! Then I happened upon a list of US States as to data, MICHIGAN REPORTS NOTHING!! I am sooo fed up with the political game from this Governor! The people of Michigan deserve ALL DATA, not just what the Governor decides we get !!!

Marlene Augst
Tue, 05/12/2020 - 6:55am

This country rolled over for a computer model. And the people who are I'll WERE ALREADY ill or old and I'll. This was overreach and refusal to look AT ALL THE DATA, and she placated to her base at the expense of the ENTIRE MID AND NORTHERN MICHIGAN economies. We aren't her base and she could careless about North of 69.

Marlene Augst
Tue, 05/12/2020 - 6:55am

This country rolled over for a computer model. And the people who are I'll WERE ALREADY ill or old and I'll. This was overreach and refusal to look AT ALL THE DATA, and she placated to her base at the expense of the ENTIRE MID AND NORTHERN MICHIGAN economies. We aren't her base and she could careless about North of 69.

Kathleen
Fri, 05/15/2020 - 3:41am

I have read other articles here but this was the worst. The headline is wrong, many states have less wait time to claim "recovered"

The comments below are obviously from rural Michigan Trump supporters who will sing a different tune when covid19 makes it up or over to you. I'm from Livonia and we have the 2nd highest cases and deaths. Does anybody care about Livonia? We were 38th in CARES help.

TRUMP HAS DIVIDED US EVEN WHEN UNITY WAS REQUIRED. Remember 9/11... we put the US back in USA with Pres.Bush consoling us and bringing us together. TRUMP is calling for Pennsylvania to open when they're still climbing in deaths. I don't like Biden either but Whitmer did the right thing and she has to close everything so we don't drive up north and infect you by accident. .Michigan will be in the history books as an example of the right way to handle a pandemic, Wisconsin will not. TRUMP IS FECKLESS and that is a FACT!