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Michigan now has quadruple Ohio’s coronavirus cases: What’s causing the difference?

 Michigan now has nearly four times as many coronavirus cases as neighboring Ohio, reaching 14,225 on Saturday while Ohio’s grew to 3,739.

As Ohio’s coronavirus cases have inched up, Michigan’s have soared, begging the question why two Midwest states are affected so differently and whether quicker restrictions in Michigan could have mitigated the surge. As of Saturday, Michigan had 540 deaths, Ohio 102.
While it might take until after the pandemic to truly understand what caused the stark difference, case numbers indicate the massive metro area of Detroit plays a big role.

More than 80 percent of confirmed cases in Michigan are in the Columbus News Detroit area. In contrast, 15 counties in Michigan’s sparsely populated Upper Peninsula had just 22 cases and two deaths, as of Friday.

Greater Detroit has 4.3 million people, nearly half Michigan’s population and more than double that of Cleveland, Columbus or Cincinnati.

Highly-populated U.S. cities are epicenters for the coronavirus, which spreads through close contact. Metropolitan areas like Seattle and New York, where people live close together, are becoming war zones.

“We know that cities are hit early and hard if you don’t take decisive action,” said Dr. Michael Mina, assistant professor of epidemiology at Harvard T.H. Chan School of Public Health.

Social distancing is a key tool in halting the spread of coronavirus by limiting physical contact, said Dr. Robert Salata, an infectious disease expert with the UH Roe Green Center for Travel Medicine.

“There’s a lot of controversy but most of the data I’ve seen is that the physical distancing makes a difference in reducing case and deaths to the tune of about 20 to 60 percent at best,” Salata said. “In my view this is one of the most important things we can do for infection control at this point.”

Ohio Gov. Mike DeWine and Health Director Dr. Amy Acton gained international recognition for quickly issuing coronavirus restrictions, but Michigan wasn’t far behind. Most of the major social distancing guidelines in the states occurred within a day of each other.

Michigan - stops short of a stay-at-home order on March 22, but advises Michigan residents stay home. Stay-at-home order is issued March 23.

Michigan coronavirus deaths outpace Ohio
In Michigan there have been more than five times as many deaths attributed to coronavirus than in Ohio.Rich Exner, cleveland.com

Michigan, Ohio, per capita coronavirus deaths, cases
On a per capita basis, coronavirus cases and deaths reported to date has been far more severe in Michigan than in neighboring Ohio.Rich Exner, cleveland.com

Salata said Michigan’s presidential primary March 10 could be a possible factor in the state’s elevated cases, because large gatherings of people make it easier for the disease to spread. Ohio canceled in-person voting on St. Patrick’s Day.

While Salata could not comment on Michigan’s approach to social distancing overall, he said a day delay likely would not make a difference.

What do Michigan officials say?

Experts and officials in Michigan have attributed the surge in cases to increased testing, reports cleveland.com’s sister site mlive.com.

“What is happening in this country is most places have very limited testing,” Detroit Mayor Mike Duggan said in a press conference. “The more testing you have, the more infections you find."


I guarantee you the Detroit positives will continue to grow because we are doing far more tests than anybody else.”

But data doesn’t bear out this argument. As of Thursday, more tests have been processed in Ohio than in Michigan, according to COVID19tracking.com, which aggregates testing data. In Michigan, as of Friday, there were 24,637 tests reported. In Ohio, there were 38,375.

What are other factors?

The Detroit metropolitan area is home to a major international airport, one of 11 where federal officials directed planes from China, after the coronavirus was discovered in Wuhan.

Passenger traffic reached 36.7 million people in 2019, according to airport numbers.

Chronic health issues could also make city residents more vulnerable to the coronavirus, Mina said.


Hypertension, diabetes and heart disease all could put patients more at risk for contracting the disease and developing more severe complications.

“There’s no question that there are vulnerable groups both in terms of acquisition of the viral infection and certainly the potential development of severe disease and death. Some of those conditions are seen more often in people who are of lower social and economic status, such as hypertension, diabetes,” Salata said. “That applies to Ohio as well.”

Salata said that the lack of access to medical care for those in poverty could also contribute.

The city of Detroit has a poverty rate of 36.4 percent. Cleveland’s is 34.6 percent, according to recent U.S. Census numbers.

“We know viruses do not discriminate based on location, race, ethnicity, or national origin,” said Jimena Loveluck, health officer with the Washtenaw County Press Release Distribution Services In Columbus Health Department told the Detroit Free Press. “However, viruses like COVID-19 can highlight health disparities that are deeply rooted in our society.

More insight will come when researchers know the extent of the virus’s spread. Testing is limited right now, and many coronavirus cases are asymptomatic, so no one knows how widespread the disease actually is.

Salata said population-based studies would lend more insight into the extent of the virus.

”I think down the line we’ll have the ability to look at the true occurrence of this in the communities and I think that will be an important tool for us to predict, if this becomes cyclical, what to expect in the future."

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