State: Docs have discretion; order eases burden on morgues
LANSING, Mich. (AP) — Michigan hospitals and physicians have “broad discretion” to decide whether to continue delaying procedures during the pandemic, the state said in new guidance issued in the face of pressure to let providers do more as the curve of coronavirus cases flattens.
Dr. Joneigh Khaldun, the state’s chief medical executive and chief deputy health director, announced the memo Monday, a day after sending it. Six weeks ago, Gov. Gretchen Whitmer restricted all nonessential medical and dental care to ensure that the health care system had enough capacity and equipment to treat COVID-19 patients and to limit the virus’s spread.
The governor’s order remains in effect, but physicians “do have the discretion to be able to determine what care is necessary and urgent for their patients,” Khaldun said.
If clinicians determine in-person contact is necessary, she said, they should take steps such as asking patients to wait in their cars until their appointments and requiring masks. Khaldun encouraged providers to prioritize appointments for the most vulnerable and to consider allowing visits for immunizations.
“Things that were not urgent a few weeks ago may now be urgent more than ever,” she said.
Michigan’s daily report on cases and deaths was partial due to a software issue. The state had more than 4,100 deaths and nearly 44,000 confirmed cases, though the actual number of infections is thought to be far higher because many people have not been tested and people can be infected without feeling sick.
While data in recent weeks is a sign for “cautious optimism,” Whitmer said, she pointed to a rapid rise of cases in western Michigan and rural northern Michigan.
“If we open up too fast, we will have to go through this pain all over again,” she said.
In Detroit, Mayor Mike Duggan said the pace of deaths continued to fall, although there had been at least 248 deaths among nursing home residents, nearly 25% of the city’s total.
Henry Ford Health System in southeastern Michigan had 310 COVID-19 patients, down 30% from a week ago. Beaumont Health, the state’s largest provider, had 447 coronavirus patients and 62 with tests pending, compared to a peak of 1,223 on April 7.
The state reported progress on testing, with more than 11,300 done Friday — a daily record.
In Livonia, seven Catholic nuns have died from health complications aggravated by the virus, said the Felician Sisters of North America. The religious order founded Madonna University and operates Angela Hospice, both in Livonia.
“Some sisters have tested negative; some who have tested positive are recovering in the convent,” spokeswoman Suzanne Wilcox English said.
For most people, the coronavirus causes mild or moderate symptoms. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.
Roughly 50 communities will hold elections on school taxes or other issues Tuesday after others were postponed. They will be primarily mail-based, though one polling place must be open in each jurisdiction.
Secretary of State Jocelyn Benson’s office sent absentee ballot applications to just over 740,000 registered voters in those communities. Turnout was at 20% and will ultimately more than double the average turnout of 12% for May local elections, she said.
The Democrat would not say if the state would automatically mail applications to voters statewide for the August primary and November general election. She said her office will focus for now on making sure people know they can request a ballot from their local clerk.
Republican U.S. Rep. Paul Mitchell of Michigan filed the latest lawsuit challenging the Democratic governor’s orders as unconstitutional, saying she cannot have “full unchecked power to govern by executive fiat.” The GOP-led Legislature may soon sue, too.
A state judge last week rejected a separate legal challenge brought by residents and a business owner.
State Senate Majority Leader Mike Shirkey, a Republican, backed the idea of a veto-proof citizens’ initiative to repeal a 1945 law that Whitmer has cited to keep in place her emergency declaration without a legislative extension. The declaration is the foundation of her stay-at-home and other orders.
Conservatives would need roughly 340,000 valid voter signatures, an even tougher task in a pandemic, so lawmakers who could pass it without the governor’s signature.
State Health and Human Services Director Robert Gordon issued an emergency order to alleviate the burden on hospitals and funeral homes confronting storage issues due to COVID-19 deaths. Changes include a shorter window in which they must contact families, who will have less time to make arrangements for the deceased.
The order also allows for the use of temporary morgues.
Whitmer announced that the state spent roughly $3.3 million buying back liquor from 657 bars and restaurants that sought the financial lifeline. They will be able to buy the liquor again for at least 90 days after the emergency ends.
Associated Press writer Ed White in Detroit contributed to this report.