Confirmed COVID-19 cases are rising faster in Detroit than they were early on in the U.S. cities hardest hit by the outbreak, raising alarm over whether the city will see the same explosive spread as was seen in Seattle or New York.
On Tuesday, Detroit had recorded 574 cases and 11 deaths from the coronavirus in the 13 days since its outbreak began, with the first reported case on March 11. By contrast, it took New York City, the current U.S. epicenter of the pandemic, 16 days to get to that point, and the Seattle area, another hotspot, 19 days. As of Tuesday, New York City had approximately 15,000 cases and 131 deaths, and Washington’s King County had 1,170 cases and 87 deaths.
Experts agree the spike in cases, up 38 percent from Monday, is concerning. But they’re mixed about whether it’s an indicator of Detroit’s potential trajectory, noting that inconsistencies in testing make it difficult to draw comparisons to other cities. In addition, they say many areas have seen early jumps in their caseloads as more people get tested.
Dr. Teena Chopra, an infectious disease specialist and associate professor at Wayne State University's medical school, predicts that despite those variables, the number of cases will continue to rise sharply in Detroit because residents are particularly vulnerable.
“We will see a big surge; we are already seeing it, but we will see it even more,” said Chopra. “Detroit’s population is extremely high risk because of many factors: high rates of hypertension, diabetes … poor resources, a socially and fiscally underserved population [where] literacy is an issue” and social distancing guidelines may not have reached some residents.
Infectious diseases are known to spread rapidly in densely populated areas where people mingle, but Chopra says low-income areas are also at great risk. Detroiters, for example, are more likely to contract and have severe complications from the flu, she says.
Detroit is the country’s poorest big city, with a third of its residents living in poverty. It's also more sparsely populated than areas that have seen significant spread of the illness.
Detroit health officials and another infectious disease expert say it’s too soon to tell what’s in store.
“We’ll have a better idea in one or two weeks whether the increase means … the virus is actually moving faster or if it’s the result of [all of this] new testing coming out,” said Dr. Emily Martin, associate professor of epidemiology at the University of Michigan's School of Public Health.
Places with a shortage of tests, like Michigan, she added, may produce more positive results because they’re prioritizing testing for only the sickest patients.
As a result, Martin says death rates tend to be a more reliable indicator of the pervasiveness of the illness.
Detroit had recorded 11 deaths as of late Tuesday, the 13th day of its outbreak, whereas the Seattle area crossed that threshold six days after its outbreak began; and New York City in seven days.
Other variables will also play a role in the city’s coronavirus trajectory. Chopra said a statewide shelter-in-place order implemented Tuesday, just two weeks into Michigan’s outbreak, could eventually mitigate the spread, though she believes cases will continue to rise for the next several weeks.
Despite having access to more testing, the number of cases in the Seattle area continues to grow nearly a month into its outbreak. A shelter-in-place order was issued in Washington only Monday.