Health Department Update

Berrien County Health Department Health Officer Nicki Britten, left, and Berrien County Undersheriff Chuck Heit address the media concerning the declaration of a state of local emergency in Berrien County during a news conference Thursday, March 26, in the Berrien County Conference Room. - Photo by Don Campbell

BENTON TOWNSHIP — The number of confirmed cornavirus cases in Berrien County reached 629 on June 1 while the death toll stood at 52.

The Berrien County Health Department also reported 193 presumed cases of COVID-19, and 483 recoveries.

State-wide numbers on June 1 were 57,532 cases and 5,516 deaths.

Watching the COVID-19 case count go up each day doesn’t give the full picture of what’s hap­pening in Berrien County, health officials said Friday, May 22.

Nicki Britten, health officer for the Berrien County Health Department (BCHD), said during the department’s weekly news con­ference that they’ve been keeping an eye on the data closely because everyone is think­ing about opening the state back up.

“What we’ve been watching for are trends in the number of confirmed cases, the per­centage of our tests that positive, and what’s going on with deaths and hospital admis­sions,” she said. While confirmed cases, deaths and hospi­tal admissions have all increased recently, the percentage of tests coming back positive has decreased significantly in the last 11-12 days, according to Britten.

“That’s good news and an important num­ber to watch, because as our capacity to detect COVID goes up, we want to see the percent of cases go down,” she said.

Britten said the number of confirmed cases is growing, and will keep growing over the next several weeks, because of more testing being done.

“We know if we test a few hundred people in a day, we’re likely to find some asymp­tomatic carriers,” she said. Britten said a contributing factor, and an important part of the data, is the increase of cases, deaths and hospitalizations from transmission happening in the county’s long-term care facilities, like nursing homes and assisted living facilities.

“This is a really tragic thing when it gets into these facilities. It can be really challeng­ing,” she said. “When you have people who are very vulnerable to serious illness, and even death from a COVID infection, living in close quarters, it’s easier for transmission to occur and to have some pretty devastating results.”

The state’s long-term care facility data is being updated, but as of May 19, there were 122 cases in four different facilities in Ber­rien County.

Britten said the health department is continuing to work with these facilities, and the facilities are dealing with it appropriately, but as transmission is seen out in the community, it will still impact the congregant facilities like nursing homes, jails and homeless shelters.

“We haven’t seen any clusters in our jails or homeless shelters, but there have been some deaths of nursing home residents and that is contributing significantly to the cases we’re seeing, and the hospitalizations and deaths,” she said.

Undersheriff Chuck Heit said during the news conference that the Michigan National Guard came to voluntarily test all the Berrien County jail inmates this week. He said while they tested most inmates this week, jail staff are still taking a symptomatic approach by testing anyone who is sick and isolating them.

Britten also reported during the news conference that there is now a fourth COVID-19 testing site open in Berrien County at the Rite Aid in Bridgman. To get tested there, visit www.riteaid. com.

To be tested by Spectrum Health Lakeland, call 833-559-0659; to be tested by InterCare, call 855-869-6900; and to be tested by Walmart, visit www.MyQuestCOVID Test.com.

Gatherings over holiday weekend

Heit and Britten took a moment during the news conference to talk about Memorial Day weekend.

Heit said he’s received many questions about the county’s parks, specifically.

“While it remains open, it won’t be the Silver Beach people are used to,” he said. “For one thing, with the water levels the way they are, there’s just not as much beach as there was, so that’s going to make social distancing harder.”

Heit said a deputy will be stationed down there to monitor if things get too crowded.

“I know they’re already looking at capacity of vehicles at 50 percent,” he said.

In addition, the restrooms remain closed, as well as the playgrounds and volleyball courts. The food court will be open, but will be set up for social distancing.

Heit said while gatherings of up to 10 people are now legally allowed, social distancing is still the best defense against spreading COVID-19.

“And if you have several different gatherings of 10 people, that increases the risk of spreading the disease around to multiple groups of people,” he said.

Britten said it’s all about risk reduction, especially for people with underlying health conditions like hypertension and diabetes.

“No one can eliminate the risk, but you can limit your risk by making informed choices as to how you’re going to move about in your life, especially as things reopen,” she said.

Coronavirus Data Dashboard

The Health Department on April 30 released an online-based Coronavirus Data Dashboard today to centralize data related to COVID-19 in Berrien County, which is available at www.bchdmi.org/COVID19.

The dashboard includes information regarding the cumulative number of confirmed and presumed cases of COVID-19 in Berrien County as well as information on those who have recovered from or died as a result of the virus.

This data hub also includes an interactive map of COVID-19 cases by zip code, demographic breakdowns of cases, deaths, and recoveries and charts showing trends in cases over time.

“This data dashboard is an excellent tool to share more information with our community about the cases of COVID-19 in Berrien County,” said Britten. “This data shows us a great deal about the confirmed and presumed cases, but we know that it does not capture the greater numbers of residents who are infected and have not been identified.”

The map of Berrien County shown on the dashboard does not show how or where the virus is being transmitted, nor does it show where individuals were exposed to the disease. The data is indicative of community-wide spread of COVID-19, meaning there is a risk of viral transmission in all areas. Residents are asked to take precautions wherever they live, including staying home as much as possible and only leaving for essential trips. When venturing into public, residents are to maintain a social distance of six feet or more from others, wear a face covering in enclosed public places, and keep up with rigorous hand hygiene.

The data dashboard will continue to be updated daily with information gathered by the Berrien County Health Department and with partnership from Spectrum Health Lakeland. Anyone can access this internet-based dashboard at the link on www.bchdmi.org/COVID19.

Berrien Re-Opens coalition aims for 'best practices'

By Tony Wittkowski

ST. JOSEPH — A coalition of Berrien County organizations repre­senting health care, govern­ment and economic devel­opment are joining forces to assist companies in a restart of the local economy.

The coalition group re­leased a proposed frame­work Thursday, May 7, that’s being referred to as Berrien Re-Opens, which showcases best practices to help com­panies return to business in the wake of the COVID-19 pandemic.

The group consists of lead­ers from the Berrien County Health Department, Berrien County, Kinexus Group, Southwest Michigan Re­gional Chamber and Corner­stone Alliance. “It is important for busi­nesses and workplaces to re­open in a manner that main­tains the health and safety of our community,” said Nicki Britten, a health officer for the Berrien County Health Department. “We continue to monitor data and will be able to identify if we need to adjust course.”

Britten said adherence to the health practices outlined in the plan will provide the best chance of maintaining the flattening of the curve.

The framework has sev­eral components, including businesses creating a pre­paredness and success plan, a workplace coordinator, establishing responsibilities for supervisors and employ­ees, and implementing work­place preventative measures.

Since the coronavirus hit the region in March, Kinex­us Group President and CEO Todd Gustafson said the economic damage has been enormous.

“We are seeing unemploy­ment numbers that we have not seen since the Great De­pression,” Gustafson said.

It’s estimated that the real unemployment numbers in Berrien County are in the 14 to 18 percent range.

Gustafson said key job sec­tors have been hit hard.

Among the 71,000 peo­ple employed in the coun­ty, nearly 19,000 are in the six most vulnerable sec­tors – manufacturing, retail, restaurants and bars, trans­portation, entertainment, and personal services. In some of these sectors, 40 to 50 percent of workers are out of work.

Southwest Michigan Re­gional Chamber President Arthur Havlicek said gaining confidence with consumers will be the key to successful­ly reopening the economy.

“Nearly three-quarters of our economy is driven by consumer spending, which is exactly why we need to highlight best practices for area businesses,” Havlicek said.

The chamber has promoted small businesses with a so­cial media campaign called “Buy Local Berrien!” Cre­ated at the beginning of the outbreak, the group has grown to more than 8,000 members.

Cornerstone Alliance President Rob Cleveland said the area’s strengths in quality of life and tourism will aid in a quicker economic recovery.

“This plan addresses both the supply side of the equation by getting our workplaces ready, and the demand side of health and safety,” Cleveland said. “A community such as ours is positioned for future growth, and the steps taken over the last two months show our community’s proactive approach to helping local businesses in a time of need.”

Cleveland said all the organizations have been in regular communication since March 13. However, the group came together on a conference call on Monday to discuss how to create a plan of action for businesses looking to reopen.

“There’s information everywhere. We’ve all been very cognizant of it,” Cleveland said. “That was the whole point in trying to deliver a concise message. You don’t want people going to everyone’s different website. All of us want the same things. So we chose to speak from the same voice.”

Being prepared

The Berrien ReOpens plan is based on three lines of defense – limiting the number of people together at a time; sanitizing all areas; and requiring the appropriate personal protection equipment.

Under the plan, companies are recommended to have a plan of action before starting operations.

With the exception of health care workers, first responders and front-line staffers, most workers are considered at low- to medium- risk of exposure to the coronavirus.

The Berrien ReOpens plan also advises that each workplace have a coordinator or a task force in place to stay up to date on federal, state and local guidance, and to incorporate any changes.

“Everyone on the team is part of the plan and the responsibilities of having a safe workspace,” the plan states. “All managers, supervisors and employees are part of the effort to minimize the risk of the virus.”

The Centers for Disease Control and Occupational Health and Safety Administration set several guidelines that were highlighted in the plan.

The safety measures include:

• Frequently washing hands with soap and water for at least 20 seconds. If it is unavailable, use an alcohol- based hand rub with at least 60 percent alcohol.

• Avoid touching the eyes, nose or mouth with unwashed hands.

• Cover all coughs and sneezes appropriately.

• Avoid close contact with people who are sick.

• While there is a community spread of COVID-19, maintain appropriate social distance of 6 feet.

• Team members should also report any symptoms – dry cough, fever and shortness of breath – they are feeling and keep workplace housekeeping and social distancing at all times.

Preventative measures

The Berrien ReOpens plan has put several best practices and measures in place to ensure the health and safety of workers, customers, visitors and the general public.

Several items are suggested under the following categories:

• Minimize exposure from co-workers by educating employees on protective behaviors, and sharing CDC information and providing the proper items.

• Practice social distancing, limiting in-person meetings and promoting remote work.

• Restricting team members who display symptoms of COVID-19.

• Encouraging sick employees to stay home.

• Actively encouraging employees to stay home if they have been in contact with a confirmed or suspected case of the virus.

• Employers will have a communications plan in place and work with the Berrien County Health Department and ensure record keeping.

• Perform increased routine cleaning and disinfection.

• Limit travel.

• Encourage remote work by employees who are at a higher risk.

• Limit visits from vendors and partners in person.

The Berrien ReOpens partnership will provide regular updates as information and conditions on the ground change. The Berrien ReOpen Plan is available at www.BerrienReopens.org.

Dr. Lowell Hamel reflects on battle with COVID-19

By Louise Wrege

BERRIEN SPRINGS — Dr. Lowell Hamel said the community’s overwhelming love and support during his weeks of fighting the effects of COVID-19 made his re­turn to his Berrien Springs home on Monday, April 27, possible.

The disease, Hamel said, nearly killed him.

Hamel, chief operating officer at Spectrum Health Lakeland, had started feel­ing ill near the beginning of April. Then the disease pro­gressed quickly.

“In about a week, maybe a little longer, I went from re­ally a symptom to respiratory failure,” said Hamel, who also has a family practice in Berrien Springs, University Medical Specialties, that is also part of the hospital sys­tem.

Hamel, who had no oth­er underlying health issues, said the team treating him at Lakeland Medical Center in St. Joseph made the right decision to transfer him to Spectrum Health in Grand Rapids when his condition started to rapidly decline. He said the Grand Rapids staff had more experience with the new disease because it hit that area a week before it was first found in St. Joseph.

There, he was placed on a mechanical ventilator for eight days before coming off it on April 23. Hamel said he knew his chances were grim when they put him on the ventilator.

“I went to sleep with the countdown, thinking there was not much chance I was going to be conscious again,” said Hamel in a phone interview on April 28.

Even though he’s now home, Hamel said he’s not out of the woods yet and has several weeks of therapy to go through before he, hopefully, can get back to a regular routine.

“There’s still things that could go wrong,” Hamel said. “I celebrate whatever extra days I have. There are times when someone who does well starts to do poorly again.”

Hamel said he believes he has survived so far because of his strong nuclear family, the community’s prayers and support, and the diligence of hospital staff to not be afraid to try different things to save the lives of patients with this new, terrible disease.

The problem is that COVID-19 does not respond to standard care.

“The treatment is just so different from what we do for successful treatments for other lung issues,” he said. “That’s part of, for me, what’s remarkable. This team (at Spectrum Health) is innovating and learning and trying and measuring and adjusting and doing things that are unprecedented.”

While on the ventilator, he said they had him laying on his stomach up to 20 hours a day several of the days, which doctors have discovered allows the parts of the lungs not as damaged by the virus to do their work.

“The way COVID damages the lungs, it has a gravity nature to it,” he said. “It damages the lower parts of the lung. Even sitting up is not as effective.”

Normally, people on ventilators are kept on their backs. And there’s good reason for that.

He said people in respiratory failure feel like they are drowning and want to be on their backs or partially sitting up. They definitely do not want to be on their stomachs. He said much more sedation is required to keep them comfortable. And sedation carries its own risks.

“Imagine being operated on for eight days,” he said.

Even turning a patient over like that is risky. He said it usually takes one to two people to turn patients, even those on ventilators. But when patients are on their stomachs, he said it takes eight people to negotiate the turning.

“In the midst of catastrophic failure of the respiratory system ... they turned me while I was conscious and had me sit at the edge of the bed and stand up while intubated, with protection and support,” he said. “You just don’t do those things and yet, here you do.”

Hamel said he was conscious enough “to sometimes contribute and sometimes resist.”

“Mercifully, in the end, I was sedated enough not to recall the whole horrible experience,” he said.

Hamel said his family not only gave him emotional support, but because several of them have medical degrees, they were able to really dig in and research what was working and what wasn’t working around the world, regarding COVID-19. His medically trained family includes his twin brother, Dr. Loren Hamel, who is president of Spectrum Health Lakeland, along with his wife and one of his daughters, who are both ICU nurses.

Hamel said a team of 40 or more people, including many of his family members, met every day on Zoom to compare notes on how he was doing and on what new research they may have found.

“I feel so overwhelmed and blessed,” he said.

Hamel also was one of the first patients at Spectrum Health to receive a transfusion of convalescent plasma from someone who had recovered from COVID-19 – a treatment used more typically long ago, before vaccines were made available for other afflictions. Hamel said the hope is that the antibodies from the plasma can help boost the immune system of the actively sick person.

But, as one of his family members said, it was a move carrying long odds – a “moon shot.”

Hamel said there has been no large study done to see if the plasma helps. He explained that there are many variables, including the patient’s immune system and the quality of the antibodies. When patients recover after receiving the plasma, he said nobody knows yet if this is a universal or individual response – or even if it had anything at all to do with the recovery.

In addition, Hamel said his blood type is rare, so finding someone to donate plasma with the proper blood type was a problem.

But it all came together and he said his recovery has been remarkable, so far.

“The rate of improvement from Thursday to Thursday, from being intubated and extubated ... has been like a rocket,” he said.

Hamel said his therapists thought he would need a week or two more of recovery before returning home. But with the support of his family, he made it back home and is now working on thanking all of the people who supported him while he was ill.

Hamel said that what makes the fight against COVID-19 so remarkable is that all of the researchers worldwide are looking for better treatments and/or a vaccine. And medical staff are sharing what works and what doesn’t work.

Michigan has benefited from the experience of other places in the world that started treating the virus in December and January and sharing their knowledge, he said. The first COVID-19 death in Michigan didn’t happen until March.

Hamel explained that since he was taken off the ventilator, he has received hundreds of texts and messages from well-wishers.

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