The University of Michigan community has undergone one stay-at-home order and another very similar recommendation over the course of the academic year in attempts at slowing the spread of COVID-19. Using data from the Washtenaw County Health Department’s COVID-19 website and the University’s COVID-19 dashboard, The Michigan Daily analyzed various case metrics in hopes of portraying the impact of the two stay-in-place restrictions.
Susan Ringler-Cerniglia, Washtenaw County Health Department public information officer, told The Daily that it is difficult to calculate the efficacy of an order or recommendation.
“You cannot really measure what didn’t happen,” Ringler-Cerniglia said. “Underlying, that is, we do know how this spreads and how often the increase in spread is related to non-compliance.”
Ringler-Cerniglia emphasized that the effectiveness of an order or recommendation largely relies on students following the protocols.
“If a social gathering is not happening … and good COVID prevention protocols are the norm, we see less transmission,” Ringler-Cerniglia said. “It is very difficult for us to know the degree to which students or others are embracing those good prevention strategies, but we do see the impact when they are not.”
Dr. Emily Martin, associate professor of epidemiology at the University’s School of Public Health, helped the University develop COVID-19 surveillance and testing strategies in 2020. She told The Daily the efficacy of a recommendation or order depends on the behavioral changes that students and community members are willing to implement into their routines.
“You want to stop that exponential rise and put an interruption in there,” Martin said. “Now ideally, behavior continues to change and things continue to go back down from that point. It really has to do with enforcement or with other elements of their personal balancing of risk and reward for how they are going to behave when there is a stay-in-place. Most students, even with a recommendation, will make efforts to scale back their behavior in terms of gatherings.”
October stay-in-place order
The October stay-in-place order for U-M students was issued by the Washtenaw County Health Department in conjunction with the University. Undergraduate students were instructed to remain at their place of residence for a period of two weeks, including for the Halloween weekend and football game against Michigan State University, unless they were commuting to work, receiving medical care, attending varsity sports practice, voting or exercising in groups with no more than one other person.
The Daily calculated various statistics on the spread of COVID-19 before, during and after the two-week order. In general, average daily new cases in Washtenaw County increased during and after the October order, but the percentage of cases linked to the U-M community decreased by slightly over two fold during the stay-in-place period and even more so in the two weeks following the order.
For the two weeks prior to the order, there was an average of about 56 daily new cases in Washtenaw County. For the two weeks during the order, there was an average of about 71 daily new cases in the county, compared to an average of 129 daily new cases in the county for the two weeks following the order.
The Daily also calculated how many of the total county COVID-19 cases were affiliated with the University. The stay-at-home order went into effect on Oct. 20 and ended on the morning of Nov. 3.
During the two-week period from Oct. 11 to Oct. 24, cases associated with the University accounted for roughly 77% of the total county cases. In the following two weeks from Oct. 25 to Nov. 7, during which the stay-at-home order was in effect, the University accounted for about 38% of the total cases in the county. Roughly during the two weeks after the order, from Nov. 8 to Nov. 21, the University accounted for around 24% of the total Washtenaw County cases.
Because symptoms often do not appear for days after someone is exposed to COVID-19, it can take approximately two weeks to observe the impact of an order. Statistics from the two-week period following the October 2020 order may therefore be more indicative of the efficacy of the order than those during the two weeks students were told to stay in place.
Several weeks after the October order, the number of daily average positive cases in Washtenaw County began to slightly decline as many students left campus on Nov. 20 to travel home for winter break. As students returned in late December and early January for the Winter semester, the daily averages in Washtenaw County began to rise again.
The B.1.1.7 variant
Following the emergence of the new, more transmittable B.1.1.7 COVID-19 variant in the U-M community even before the semester began, University officials have had less time to react to rising case numbers than during the fall semester. On Jan. 27, just a week into the winter semester, the Washtenaw County Health Department recommended that all U-M students stay in place for two weeks. This move came days after the University announced a 14-day pause of all athletic activity due to confirmed cases of the B.1.1.7 variant.
At the time the recommendation was announced, there were 14 known cases of the new variant in Washtenaw County.
In an email to the U-M community in late January, University President Mark Schlissel explained why it was important for the University to take action against the new variant.
“There is much less margin for error with the more contagious B.1.1.7 COVID-19 variant, so strict adherence to preventive measures takes on even greater importance,” Schlissel wrote. “U-M public health and medical professionals agree that now is the time to implement these additional temporary measures before spread of this more infectious version of COVID-19 threatens to overwhelm our ability to address the virus.”
Martin said that with recent studies regarding the transmission rate of the new variant, it was important to act quickly to contain its spread.
“From a public health response perspective, you really have less time to react when you start to see an increase or clusters with the variant,” Martin said. “It can burn out of control much faster than what we were dealing with in the fall. That’s why you’re going to see broader measures potentially in response to smaller signals of information.”
Martin said containment of the variant on campus has been considerable, but she would have liked to see a larger decrease in overall cases.
“The B.1.1.7 cases on campus have definitely stayed fairly contained,” Martin said. “We know the variant has not been widespread on campus. But there have been a lot of cases on campus in general. At the same time, the restrictions were not as successful as we have seen in the past with stemming cases overall on campus.”
January stay-in-place recommendation
The Jan. 27 recommendation and the order from the fall semester differ in several ways. Since there is no enforcement system pertaining to recommendations, those who violated the recommendation did not face fines and other punishments as they did with orders.
U-M officials have said the January recommendation was a precautionary measure. In contrast, Ringler-Cerniglia said that in the fall, with a higher density of students in Ann Arbor, the public health system was “strained” and had to act accordingly.
“In the fall, there were a number of orders and the situation at that time was quite a bit different in terms of public health capacity,” Ringler-Cerniglia said in a recent interview with The Daily. “The cases were increasing very rapidly and a capacity to investigate both from the University’s team as well as from the health department team was maxed out.”
Again, The Daily analyzed data to determine if cases rose, fell or remained the same in light of the recommendation. While the daily average number of cases in the county increased throughout the fall stay-in-place order, similar data from the winter recommendation does not show a clear trend.
For the two weeks prior to the Winter recommendation, there was an average of about 74 daily new cases of COVID-19. During the two-week recommendation period, there was an average of about 92 daily new cases. Cases fell slightly for the week following the recommendation, with an average of 63 new cases daily.
As with the fall stay-in-place order, The Daily also calculated the percentage of county cases associated with the University for the January recommendation. The Daily found that unlike October’s order, January’s recommendation was followed by an increase rather than a decline in the total percentage of cases in Washtenaw County attributed to the University.
The stay-at-home recommendation began on Wednesday Jan. 27 and lasted until 11:59 on Sunday Feb. 7.
During the two weeks prior to the recommendation, from Jan. 10 to Jan. 23, the University accounted for roughly 33% of total Washtenaw County cases. For roughly the two weeks in which the stay-at-home recommendation was in effect, from Jan. 24 to Feb. 6, this number rose to 48%. During the week of Feb. 7, immediately following the stay-at-home recommendation, the University accounted for 67% of all Washtenaw County cases.
University spokesman Rick Fitzgerald wrote in an email to The Daily Feb. 17 that the increasing percentage of total cases in the county coming from U-M students is due to a decline in cases in the rest of the Washtenaw County community.
“What this suggests is that students are largely infecting other students,” Fitzgerald wrote. “We continue to see no evidence of spread in the classroom or any of our other spaces that have been engineered for social distancing and where masking is required.”
No weekly data could be obtained regarding the total number of Washtenaw County cases that are linked to the B.1.1.7 variant. However, the University announced on Feb. 16 that 43 students have now contracted the variant.
Stay-in-place strategies have proven to be fairly effective in other places. Usually termed a “circuit breaker” or “pumping the brakes,” these techniques are used in scenarios where the public health system can not keep up with investigation and contact tracing, Martin said.
Washtenaw County reflects state-wide trends in new weekly positive cases
While weekly COVID-19 cases in Washtenaw County before, during and after the October stay-at-home order increased, so did COVID-19 cases across Michigan. Similarly, while weekly COVID-19 cases in Washtenaw County decreased before and after the January stay-at-home recommendation was implemented, state-wide cases did as well.
Future orders and recommendations in Washtenaw County may become a regular occurrence, according to Martin. She said they may be used when positivity rates are increasing and contact tracing is strained.
Daily Staff Reporter Nadir Al-Saidi can be reached at email@example.com.
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