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Henry Ford Health System has seen Covid-19 cases soar by 50% in three weeks, putting a major strain on staff and patients at the Detroit-based network of five major hospitals in southeast Michigan.

The state is the latest U.S. hot spot, with a seven-day case rate of more than 600 per 100,000 -- triple the national average. Michigan has more than 3,700 patients hospitalized for Covid, with some overflowing into hallways and conference rooms, according to the Michigan Health & Hospital Association. The vast majority of those who need needing intensive care and ventilators are unvaccinated.

“Our emergency departments and our hospitals are functioning beyond full capacity,” Adnan Munkarah, Henry Ford’s chief clinical officer, said in an interview. “That means our beds are full and we have patients waiting in the emergency department for hours for beds to open.”

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Nearly two years into the coronavirus pandemic, the U.S. is struggling with yet another surge. The nation is reporting more than 90,000 new infections a day, 23% more than a month ago. Eighteen states -- including Wyoming, Pennsylvania, Nebraska and New Hampshire -- have more ICU patients with confirmed or suspected Covid than a year ago. Read more: Covid Rebound in U.S. Is as Bad as Last November’s in Some Spots

White House coronavirus response coordinator Jeff Zients said Monday that the U.S. isn’t headed for Covid-19 lockdown measures like those imposed by some European Union countries in response to recent outbreaks. Vaccines, booster shots, and therapeutics will “accelerate the path out of this pandemic,” Zients said on a conference call.

Still, more than 40% of the U.S. is not fully vaccinated. For those who are, efficacy is waning, and just 18% have received booster doses. Meanwhile, the drawn-out pandemic is taxing hospital ICUs and hospital workforces, resulting in unprecedented labor shortages.

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“We have burnt through a whole generation of health-care workers,” said Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security who specializes in hospital preparedness. “More often than not the reason that the intensive-care units are overwhelmed is they don’t have staff.”

Hospitals have been exploring multiple strategies to boost staff, said Nancy Foster, the American Hospital Association’s vice president of quality and patient safety policy. That includes redeployment from less hard-hit areas within larger hospital systems and using federal workers, she said.

The Department of Defense this week sent a medical response team of about 20 nurses, respiratory therapists and other professionals to help staff the University of Colorado Health’s Poudre Valley Hospital in Fort Collins. In Minnesota, Governor Tim Walz is deploying the state’s National Guard to help fill gaps in skilled nursing.

Michigan had 3,785 hospitalized Covid hospital patients as of Nov. 21, including 784 in ICUs, according to the state hospital association. Governor Gretchen Whitmer, who enacted some of the toughest early restrictions in the U.S. to slow the spread of Covid in 2020, has so far resisted reinstating them. The Democrat said Monday that her administration may provide some guidance ahead of Thursday’s Thanksgiving holiday.

“We cannot wait any longer for Michigan to correct course,” the hospital association said in a statement. “We need your help now to end this surge and ensure our hospitals can care for everyone who needs it.”

Patients will continue increasing over the weeks ahead as the nation enters the annual flu season, the association predicted. The U.S. Centers for Disease Control and Prevention has dispatched a team to investigate a cluster of 528 cases of the flu seen at the University of Michigan-Ann Arbor campus since Oct. 6. About 77% were in unvaccinated people.

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About 54% of Michigan’s population is fully vaccinated against Covid-19, well below the U.S. average of 59%.

“We knew if we didn’t get a high vaccination rate, we would be dealing with another surge,” Henry Ford’s Munkarah said. “And unfortunately, we are living it.”

As of Monday, the unvaccinated make up 72% of Henry Ford’s Covid-infected patients, 86% of Covid ICU patients and 89% of Covid patients on a ventilator. Henry Ford has not yet started canceling elective surgeries or non-urgent care, but that is a possibility, Munkarah said.

“If the numbers continue to climb as we are seeing them, we are going to get to the point where we need to have significant rescheduling of cases and probably slowing down some of the non-emergent or urgent activities,” he said.

Toner said he expects the latest wave of the infection, along with staffing shortages, mean it will take fewer Covid-19 hospitalizations to overwhelm the system. The flu season that is just getting started will cause further stress, he said.

“I think we will see hospitals and ICUs in many places stretched to the limit,” Toner said.