Order expands mask requirement to children ages 2-4 as recommended by American Academy of Pediatrics

From the MDHHS

On Friday, April 16, the Michigan Department of Health and Human Services (MDHHS) extended its Gatherings and Mask epidemic order. The Order—which preserves the strongest public health order in the Midwest—is designed to balance day-to-day activities while controlling the spread of COVID-19 and saving Michiganders’ lives. It includes expansion of mask requirements to children ages 2 to 4 to further protect the state’s residents.

Although progress has been made, it is crucial that Michiganders continue to mask up and socially distance as the state takes steps to get back to normal. 

Expanding the mask rule to children ages 2 to 4 requires a good faith effort to ensure that these children wear masks while in gatherings at childcare facilities or camps. It takes effect April 26, 2021. This addresses the increase in cases among younger Michiganders and follows recommendations from the American Academy of Pediatrics and Centers for Disease Control and Prevention guidance.

“Michigan continues to implement smart health policies and mitigation measures to fight the spread of COVID-19,” said Elizabeth Hertel, MDHHS director. “This includes the requirement to wear a mask while in public and at gatherings, limits on indoor residential social gatherings larger than 15 people with no more than three households, and expanded testing requirements for youth sports. Additionally, the most important thing people can do right now is to get the safe and effective COVID-19 vaccine to protect themselves and their families, and help us eliminate this virus once and for all.”

As of April 16, 29.5% of Michigan residents 16 and older had been fully vaccinated for COVID-19 and 44% had received at least a first dose.

“More than 5.5 million doses of the safe and effective COVID vaccines have been administered in Michigan, and we are well on our way to vaccinating at least 70% of Michiganders ages 16 and up,” said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health at MDHHS. “However, I continue to be incredibly concerned about our state’s COVID-19 data. We are still very much fighting this pandemic and seeing concerning trends in new cases and hospitalizations. Michiganders need to be using every tool in our toolbox right now to get these cases and hospitalizations down. Just because something is open and legal does not mean you should be doing it. We all must continue doing what works to slow the spread of the disease by wearing masks, washing our hands, avoiding crowds and indoor gatherings, and making plans to get the safe and effective COVID-19 vaccine as soon as possible.”

MDHHS had been closely monitoring three metrics for stabilization or declines over the past several weeks.  Michigan’s metrics have been increasing for the past few weeks, although the rate of increase is declining. The presence of more infectious variants, such as the B 1.1.7 variant, threatens progress in control of the epidemic and MDHHS will be monitoring data closely. In recent days:  

Positivity rate: had increased for eight weeks but has seen a recent 5-day decline to 17.1%. However, this metric remains up 390% from the mid-February low and remains above the December peak of 14.4%.

Statewide case rate: This metric has increased over the past eight weeks to 613.9 cases per million. The rate is more than 475% higher than the low in mid-February but remains below peak of 737.8 cases per million on Saturday, Nov 14.

Hospital capacity: The percent of inpatient beds dedicated to those with COVID-19 is now at 18.8%. This metric peaked at 19.6% on Tuesday, Dec. 4, and is up 373% from the February low.

“Nurses are exhausted. Many hospitals are close to 100% capacity. RNs around the state are being put in the impossible situation of having to decide which patient to attend to. Nurses are working up to 18 hours at a time, often without breaks,” said Jamie Brown, president of the Michigan Nurses Association. “We are begging for everyone in the community to do their part. Stay home. Wear a mask. Get a vaccine when you are able. We are barely able to keep our heads above water. We are in crisis. We need our communities’ help.” 

“We know that wearing a mask significantly reduces the spread of infection and should be part of the comprehensive strategy to reduce COVID-19—including for children age 2 and up,” said Michigan Chapter of the American Academy of Pediatrics (MIAAP) President Dr. Matthew Hornik. “Use of masks does not restrict oxygen in the lungs even in children, it is recommended to wear a mask with layers to filter droplets effectively.” 

The order extension is through May 24. An infographic that highlights order requirements can be found on Michigan’s COVID-19 website.

The latest information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus. To learn more about the COVID-19 vaccine, visit Michigan.gov/COVIDVaccine.  

Restaurant capacity opened to 50 percent as of Friday, March 5th

The Michigan Department of Health and Human Services (MDHHS) updated two of its epidemic orders Tuesday, allowing for increased capacity limits at various venues such as restaurants, exercise facilities, retail stores, casinos, and entertainment venues; larger residential and nonresidential gatherings; and expanded visitation opportunities at residential care facilities. 

The order said restaurants could now open to 50 percent capacity (up from 25 percent), and increased the curfew one hour from 10 p.m. to 11 p.m. While that’s some progress, Michigan is still far behind it’s neighboring states of Wisconsin, Illinois, Indiana and Ohio—none of whom have a restaurant capacity limit.

Justin Winslow, the President and CEO of the Michigan Restaurant and Lodging Association (MRLA) is glad to see the restrictions loosening but thinks the duration of the order is too long. “We welcome the governor’s decision today to expand restaurant, banquet and meeting space occupancy and consider this change critically important, but the six-week duration of this Order is concerning and significantly too long to adapt to rapidly changing metrics around this virus. We are hopeful that this DHHS Order represents a paradigm shift in the administration’s overall approach to the hospitality industry, accepting that the dramatically reduced hospitalization rate and increased vaccine distribution mean our most vulnerable populations are protected and that reopening should advance in a timely manner,” he said in a statement.

“While we are disappointed about the length of the Order, given the fragile state of the hospitality industry and improving outcomes, we are committed to working toward collaborative and consistent – emphasis on consistent – progress towards the full reintegration of the industry as Michigan moves more fully into a new phase of this pandemic.”

Governor Gretchen Whitmer reminded people that even though some limits are expanding, she wants Michiganders to still mask up and socially distance as the state slowly reopens.

“As we continue our vaccine rollout and make steady progress against the virus, we are taking additional incremental steps to re-engage to ensure we are protecting our families and frontline workers and saving lives,” said Whitmer. “Michigan is a national leader in the fight against COVID-19, and our fact-based, data-driven approach will help our state rebuild our economy and resume normal day-to-day activities. As always, mask up, maintain social distancing, and wash your hands. We all have a personal responsibility to slow the spread of the virus so we can end this pandemic together. One of the most important things Michiganders can do is make a plan to get the safe and effective vaccine when it’s available to you.”

“More than 2 million doses of safe and effective COVID-19 vaccine have been administered and a third vaccine will soon be arriving here in Michigan to help us end the pandemic in our state,” said Elizabeth Hertel, MDHHS director. “We continue to monitor the data closely, and, based on current trends we are taking another step toward normalcy. We urge Michiganders to continue doing what works and wearing a mask, washing their hands and avoiding crowds.”

MDHHS had been closely monitoring three metrics for stabilization or declines over the past several weeks. As with other states, Michigan’s metrics are mixed. In recent days:

• Hospital capacity dedicated to COVID-19 is now at 3.9%. This metric peaked at 19.6% on Tuesday, Dec. 4.
• Overall case rates: After declining for six weeks, this metric is plateauing at 91.2 cases per million. The rate is similar to what we were at the beginning of October.
• Positivity rate: is now at 3.7% having increased slightly from last week (3.5%). This metric is similar to where we were at the beginning of October.

With all residents at skilled nursing homes having been offered their first dose of COVID-19 vaccine and a vast majority having had their second dose, the Residential Care Facilities Order goes into effect immediately. The order encourages communal dining and group activities for residents and allows indoor and outdoor visitation in all counties regardless of county risk level. Visitation is allowed as long as the facility has not had a new COVID-19 case in the last 14 days and all indoor visitors ages 13 and older are subject to rapid antigen testing. Testing will help keep residents, staff and families safe while allowing for visitation and an increased quality of life for residents. Adult foster care homes licensed for 12 or fewer residents, hospice facilities, substance use disorder residential facilities and assisted-living facilities are encouraged to implement visitor and staff testing protocols.

Visitors will be required to wear face masks or other personal protective equipment when required by the facility at all times. In general, visitors will need to maintain six feet from residents.

“While we continue to have virus very present across the entire state, our improvements in case numbers, test positivity, and vaccinations mean we can move forward with reopening in an incremental way,” said Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy for health. 

Changes to the Gatherings and Mask Order go into effect Friday, March 5, and remain in effect through Monday, April 19.

Capacity changes include:

• Restaurants and bars are allowed to be at 50% capacity up to 100 people. Tables must be six feet apart with no more than six people per table. There is now an 11 p.m. curfew.
• Indoor non-residential gatherings where people interact across households are permitted up to 25 people, allowing public meetings and other small indoor gatherings to resume.
• Outdoor non-residential gatherings where people interact across households are permitted up to 300, allowing larger outdoor events to resume.
• Indoor entertainment venues are allowed to be at 50% capacity, up to 300 people.
• Exercise facilities are allowed to be at 30% capacity with restrictions on distancing and mask requirements.
• Retail is allowed to be at 50% capacity.
• Casinos are allowed to be at 30% capacity.
• Indoor stadiums and arenas are allowed have 375 if seating capacity is under 10,000; 750 if seating capacity is over 10,000.
• Outdoor entertainment and recreational facilities may host up to 1,000 patrons.

Indoor residential gatherings are now limited to 15 people from three households, while outdoor residential gatherings can include up to 50 people.

The epidemic order continues to temporarily pause other venues and activities where participants have close physical contacts and are not consistently masked, like water parks. As before, employees who work in jobs that cannot be performed from home can continue to go to work, while employees who can work from home should continue to do so.