After over two years of public reporting, the State Profile Report will no longer be produced and distributed after February 2023. The final release was on February 23, 2023. We want to thank everyone who contributed to the design, production, and review of this report and we hope that it provided insight into the data trends throughout the COVID-19 pandemic. Data about COVID-19 will continue to be updated at CDC’s COVID Data Tracker.

The State Profile Report (SPR) is generated by the Data Strategy and Execution Workgroup in the Joint Coordination Cell, in collaboration with the White House. It is managed by an interagency team with representatives from multiple agencies and offices (including the United States Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention, the HHS Assistant Secretary for Preparedness and Response, and the Indian Health Service). The SPR provides easily interpretable information on key indicators for each state, down to the county level.

It is a weekly snapshot in time that:

• Focuses on recent outcomes in the last seven days and changes relative to the month prior
• Provides additional contextual information at the county level for each state, and includes national level information
• Supports rapid visual interpretation of results with color thresholds

Context

COVID-19 is on a rise worldwide. It was first identified in the city of Wuhan in China in 2019 and has now spread into a global pandemic. Michigan is currently the third largest affected state in USA. The state's confirmed cases have been on a rise since early March 2020. In this dire time, it is extremely important to understand the factors affecting the spread of the virus in Michigan, identify susceptible population and predict the trajectory of the infected and dead cases on a daily basis.

Content

Update: April 4, 2020 2:00 PM Eastern Standard Time (EST)

This data currently contains information about COVID-19 confirmed cases (14225) and deaths (540) in Michigan counties. The dataset also includes percentage of COVID-19 confirmed and dead cases by age, gender, race and ethnicity. The information is published by www.michigan.gov on a daily basis at 2:00 PM EST. The results are included as of 10:00 AM every day.

Acknowledgements

Michigan.gov - Coronavirus

Inspiration

1. This dataset will be useful in understanding and predicting the trajectory of the infected and dead cases in Michigan in the coming days.
2. The dataset can also give insight about the most vulnerable age groups in Michigan.

Please consider upvoting if the data is found useful in any way. If there are any improvement suggestions, do let me know.

An interactive dashboard tracking the cases of coronavirus COVID-19 in Michigan. Data from Michigan.gov coronavirus cumulative data.

This dataset provides a single table of historical outbreak data as reported by public health departments to the Michigan Department of Health and Human Services from August 22, 2020 to February 11, 2021. Additional information about the dataset and more current data tables can be found here: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_102057---,00.html.

Reporting of new Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. This dataset will receive a final update on June 1, 2023, to reconcile historical data through May 10, 2023, and will remain publicly available.

Aggregate Data Collection Process Since the start of the COVID-19 pandemic, data have been gathered through a robust process with the following steps:

• A CDC data team reviews and validates the information obtained from jurisdictions’ state and local websites via an overnight data review process.
• If more than one official county data source exists, CDC uses a comprehensive data selection process comparing each official county data source, and takes the highest case and death counts respectively, unless otherwise specified by the state.
• CDC compiles these data and posts the finalized information on COVID Data Tracker.
• County level data is aggregated to obtain state and territory specific totals.

This process is collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provide the most up-to-date numbers on cases and deaths by report date. CDC may retrospectively update counts to correct data quality issues.

Methodology Changes Several differences exist between the current, weekly-updated dataset and the archived version:

• Source: The current Weekly-Updated Version is based on county-level aggregate count data, while the Archived Version is based on State-level aggregate count data.
• Confirmed/Probable Cases/Death breakdown:  While the probable cases and deaths are included in the total case and total death counts in both versions (if applicable), they were reported separately from the confirmed cases and deaths by jurisdiction in the Archived Version.  In the current Weekly-Updated Version, the counts by jurisdiction are not reported by confirmed or probable status (See Confirmed and Probable Counts section for more detail).
• Time Series Frequency: The current Weekly-Updated Version contains weekly time series data (i.e., one record per week per jurisdiction), while the Archived Version contains daily time series data (i.e., one record per day per jurisdiction).
• Update Frequency: The current Weekly-Updated Version is updated weekly, while the Archived Version was updated twice daily up to October 20, 2022.

Important note: The counts reflected during a given time period in this dataset may not match the counts reflected for the same time period in the archived dataset noted above. Discrepancies may exist due to differences between county and state COVID-19 case surveillance and reconciliation efforts.

Confirmed and Probable Counts In this dataset, counts by jurisdiction are not displayed by confirmed or probable status. Instead, confirmed and probable cases and deaths are included in the Total Cases and Total Deaths columns, when available. Not all jurisdictions report probable cases and deaths to CDC.* Confirmed and probable case definition criteria are described here:

Council of State and Territorial Epidemiologists (ymaws.com).

Deaths CDC reports death data on other sections of the website: CDC COVID Data Tracker: Home, CDC COVID Data Tracker: Cases, Deaths, and Testing, and NCHS Provisional Death Counts. Information presented on the COVID Data Tracker pages is based on the same source (total case counts) as the present dataset; however, NCHS Death Counts are based on death certificates that use information reported by physicians, medical examiners, or coroners in the cause-of-death section of each certificate. Data from each of these pages are considered provisional (not complete and pending verification) and are therefore subject to change. Counts from previous weeks are continually revised as more records are received and processed.

Number of Jurisdictions Reporting There are currently 60 public health jurisdictions reporting cases of COVID-19. This includes the 50 states, the District of Columbia, New York City, the U.S. territories of American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the U.S Virgin Islands as well as three independent countries in compacts of free association with the United States, Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Palau. New York State’s reported case and death counts do not include New York City’s counts as they separately report nationally notifiable conditions to CDC.

CDC COVID-19 data are available to the public as summary or aggregate count files, including total counts of cases and deaths, available by state and by county. These and other data on COVID-19 are available from multiple public locations, such as:

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

https://www.cdc.gov/covid-data-tracker/index.html

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html

https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/surveillance-data-analytics.html

Additional COVID-19 public use datasets, include line-level (patient-level) data, are available at: https://data.cdc.gov/browse?tags=covid-19.

Archived Data Notes:

November 3, 2022: Due to a reporting cadence issue, case rates for Missouri counties are calculated based on 11 days’ worth of case count data in the Weekly United States COVID-19 Cases and Deaths by State data released on November 3, 2022, instead of the customary 7 days’ worth of data.

November 10, 2022: Due to a reporting cadence change, case rates for Alabama counties are calculated based on 13 days’ worth of case count data in the Weekly United States COVID-19 Cases and Deaths by State data released on November 10, 2022, instead of the customary 7 days’ worth of data.

November 10, 2022: Per the request of the jurisdiction, cases and deaths among non-residents have been removed from all Hawaii county totals throughout the entire time series. Cumulative case and death counts reported by CDC will no longer match Hawaii’s COVID-19 Dashboard, which still includes non-resident cases and deaths. 

November 17, 2022: Two new columns, weekly historic cases and weekly historic deaths, were added to this dataset on November 17, 2022. These columns reflect case and death counts that were reported that week but were historical in nature and not reflective of the current burden within the jurisdiction. These historical cases and deaths are not included in the new weekly case and new weekly death columns; however, they are reflected in the cumulative totals provided for each jurisdiction. These data are used to account for artificial increases in case and death totals due to batched reporting of historical data.

December 1, 2022: Due to cadence changes over the Thanksgiving holiday, case rates for all Ohio counties are reported as 0 in the data released on December 1, 2022.

January 5, 2023: Due to North Carolina’s holiday reporting cadence, aggregate case and death data will contain 14 days’ worth of data instead of the customary 7 days. As a result, case and death metrics will appear higher than expected in the January 5, 2023, weekly release.

January 12, 2023: Due to data processing delays, Mississippi’s aggregate case and death data will be reported as 0. As a result, case and death metrics will appear lower than expected in the January 12, 2023, weekly release.

January 19, 2023: Due to a reporting cadence issue, Mississippi’s aggregate case and death data will be calculated based on 14 days’ worth of data instead of the customary 7 days in the January 19, 2023, weekly release.

January 26, 2023: Due to a reporting backlog of historic COVID-19 cases, case rates for two Michigan counties (Livingston and Washtenaw) were higher than expected in the January 19, 2023 weekly release.

January 26, 2023: Due to a backlog of historic COVID-19 cases being reported this week, aggregate case and death counts in Charlotte County and Sarasota County, Florida, will appear higher than expected in the January 26, 2023 weekly release.

January 26, 2023: Due to data processing delays, Mississippi’s aggregate case and death data will be reported as 0 in the weekly release posted on January 26, 2023.

February 2, 2023: As of the data collection deadline, CDC observed an abnormally large increase in aggregate COVID-19 cases and deaths reported for Washington State. In response, totals for new cases and new deaths released on February 2, 2023, have been displayed as zero at the state level until the issue is addressed with state officials. CDC is working with state officials to address the issue.

February 2, 2023: Due to a decrease reported in cumulative case counts by Wyoming, case rates will be reported as 0 in the February 2, 2023, weekly release. CDC is working with state officials to verify the data submitted.

February 16, 2023: Due to data processing delays, Utah’s aggregate case and death data will be reported as 0 in the weekly release posted on February 16, 2023. As a result, case and death metrics will appear lower than expected and should be interpreted with caution.

February 16, 2023: Due to a reporting cadence change, Maine’s

The single biggest need in the parts of Detroit that have been the hardest hit by the coronavirus is food. That's according to data available in a recently released COVID-19 Dashboard put together by Michigan 211.

The New York Times is releasing a series of data files with cumulative counts of coronavirus cases in the United States, at the state and county level, over time. We are compiling this time series data from state and local governments and health departments in an attempt to provide a complete record of the ongoing outbreak.

Since late January, The Times has tracked cases of coronavirus in real time as they were identified after testing. Because of the widespread shortage of testing, however, the data is necessarily limited in the picture it presents of the outbreak.

We have used this data to power our maps and reporting tracking the outbreak, and it is now being made available to the public in response to requests from researchers, scientists and government officials who would like access to the data to better understand the outbreak.

The data begins with the first reported coronavirus case in Washington State on Jan. 21, 2020. We will publish regular updates to the data in this repository.

As of March 10, 2023, the state with the highest number of COVID-19 cases was California. Almost 104 million cases have been reported across the United States, with the states of California, Texas, and Florida reporting the highest numbers.

From an epidemic to a pandemic The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. The term pandemic refers to multiple outbreaks of an infectious illness threatening multiple parts of the world at the same time. When the transmission is this widespread, it can no longer be traced back to the country where it originated. The number of COVID-19 cases worldwide has now reached over 669 million.

The symptoms and those who are most at risk Most people who contract the virus will suffer only mild symptoms, such as a cough, a cold, or a high temperature. However, in more severe cases, the infection can cause breathing difficulties and even pneumonia. Those at higher risk include older persons and people with pre-existing medical conditions, including diabetes, heart disease, and lung disease. People aged 85 years and older have accounted for around 27 percent of all COVID-19 deaths in the United States, although this age group makes up just two percent of the U.S. population

Reporting of Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. This dataset will receive a final update on June 1, 2023, to reconcile historical data through May 10, 2023, and will remain publicly available.

This archived public use dataset contains historical case and percent positivity data updated weekly for all available counties and jurisdictions. Each week, the dataset was refreshed to capture any historical updates. Please note, percent positivity data may be incomplete for the most recent time period.

Related data CDC provides the public with two active versions of COVID-19 county-level community transmission level data: this dataset with historical case and percent positivity data for each county from January 22, 2020 (Weekly Historical Changes dataset) and a dataset with the levels as originally posted (Weekly Originally Posted dataset) since October 20, 2022. Please navigate to the Weekly Originally Posted dataset for the Community Transmission Levels published weekly on Thursdays.

Methods for calculating county level of community transmission indicator The County Level of Community Transmission indicator uses two metrics: (1) total new COVID-19 cases per 100,000 persons in the last 7 days and (2) percentage of positive SARS-CoV-2 diagnostic nucleic acid amplification tests (NAAT) in the last 7 days. For each of these metrics, CDC classifies transmission values as low, moderate, substantial, or high (below and here). If the values for each of these two metrics differ (e.g., one indicates moderate and the other low), then the higher of the two should be used for decision-making.

CDC core metrics of and thresholds for community transmission levels of SARS-CoV-2 Total New Case Rate Metric: "New cases per 100,000 persons in the past 7 days" is calculated by adding the number of new cases in the county (or other administrative level) in the last 7 days divided by the population in the county (or other administrative level) and multiplying by 100,000. "New cases per 100,000 persons in the past 7 days" is considered to have transmission level of Low (0-9.99); Moderate (10.00-49.99); Substantial (50.00-99.99); and High (greater than or equal to 100.00).

Test Percent Positivity Metric: "Percentage of positive NAAT in the past 7 days" is calculated by dividing the number of positive tests in the county (or other administrative level) during the last 7 days by the total number of tests resulted over the last 7 days. "Percentage of positive NAAT in the past 7 days" is considered to have transmission level of Low (less than 5.00); Moderate (5.00-7.99); Substantial (8.00-9.99); and High (greater than or equal to 10.00).

The data in this dataset are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.

This dataset is created using CDC’s Policy on Public Health Research and Nonresearch Data Management and Access.

Archived data CDC has archived two prior versions of these datasets. Both versions contain the same 7 data elements reflecting community transmission levels for all available counties and jurisdictions; however, the datasets updated daily. The archived datasets can be found here:

Archived Originally Posted dataset

Archived Historical Changes dataset

Archived Data Notes:

October 27, 2022: Due to a processing issue this dataset will not be posted this week. CDC is currently working to address the issue and will publish the data when able.

November 10, 2022: As of 11/10/2022, this dataset will continue to incorporate historical updates made to case and percent positivity data; however, community transmission level will only be published in the corresponding Weekly COVID-19 County Level of Community Transmission as Originally Posted dataset (Weekly Originally Posted dataset).

Note:

October 20, 2022: Due to a data reporting error, the case rate for Philadelphia County, Pennsylvania is lower than expected in the COVID-19 Community Transmission Level data released on October 20, 2022. This could lead to the COVID-19 Community Transmission Level for Philadelphia County being underestimated; therefore, it should be interpreted with caution.

November 3, 2022: Due to a reporting cadence issue, case rates for Missouri counties are calculated based on 11 days’ worth of case count data in the COVID-19 Community Transmission Level data released on November 3, 2022, instead of the customary 7 days’ worth of data. This could lead to the COVID-19 Community Transmission Levels metrics for Missouri counties being overestimated; therefore, they should be interpreted with caution.

November 10, 2022: Due to a reporting cadence change, case rates for Alabama counties are calculated based on 13 days’ worth of case count data in the COVID-19 Community Transmission Level data released on November 10, 2022, instead of the customary 7 days’ worth of data. This could lead to the COVID-19 Community Transmission Levels metrics for Alabama counties being overestimated; therefore, they should be interpreted with caution.

November 10, 2022: Per the request of the jurisdiction, cases among non-residents have been removed from all Hawaii county totals throughout the entire time series. Cumulative case counts reported by CDC will no longer match Hawaii’s COVID-19 Dashboard, which still includes non-resident cases. 

November 10, 2022: In the COVID-19 Community Transmission Level data released on November 10, 2022, multiple municipalities in Puerto Rico are reporting higher than expected increases in case counts. CDC is working with territory officials to verify the data submitted. 

December 1, 2022: Due to cadence changes over the Thanksgiving holiday, case rates for all Ohio counties are reported as 0 in the COVID-19 Community Transmission Level data released on December 1, 2022. Therefore, the COVID-19 Community Transmission Levels may be underestimated and should be interpreted with caution. 

December 22, 2022: Due to an internal revision process, case rates for some Tennessee counties may appear higher than expected in the December 22, 2022, weekly release. Therefore, the COVID-19 Community Transmission Levels metrics for some Tennessee counties may be overestimated and should be interpreted with caution.

December 22, 2022: Due to reporting of a backlog of historic COVID-19 cases, case rates for some Louisiana counties will appear higher than expected in the December 22, 2022, weekly release. Therefore, the COVID-19 Community Transmission Levels metrics for some Louisiana counties may be overestimated and should be interpreted with caution.

December 29, 2022: Due to technical difficulties, county data from Alabama could not be incorporated via standard practices. As a result, case and death metrics will be reported as 0 in the December 29, 2022, weekly release. Therefore, the COVID-19 Community Transmission Levels metrics for Alabama counties will be underestimated and should be interpreted with caution.

January 5, 2023: Due to a reporting cadence issue, case rates for all Alabama counties will be calculated based on 14 days’ worth of case count data in the COVID-19 Community Transmission Level information released on January 5, 2023, instead of the customary 7 days’ worth of case count data. Therefore, the weekly case rates will be overestimated, which could affect counties’ COVID-19 Community Transmission Level classification and should be interpreted with caution.

January 5, 2023: Due to North Carolina’s holiday reporting cadence, aggregate case data will contain 14 days’ worth of data instead of the customary 7 days. As a result, case metrics will appear higher than expected in the January 5, 2023, weekly release. COVID-19 Community Transmission metrics may be overestimated and should be interpreted with caution.

January 12, 2023: Due to data processing delays, Mississippi’s aggregate case data will be reported as 0. As a result, case metrics will appear lower than expected in the January 12, 2023, weekly release. COVID-19 Community Transmission metrics may be underestimated and should be interpreted with caution. 

January 13, 2023: Aggregate case data released for Los Angeles County, California for the week of December 22nd, 2022, and December 29th, 2022, have been corrected for a data processing error.

January 19, 2023: Due to a reporting cadence issue, Mississippi’s aggregate case data will be calculated based on 14 days’ worth of data instead of the customary 7 days in the January 19, 2023, weekly release. Therefore, COVID-19 Community Transmission metrics may be overestimated and should be interpreted with caution.

January 26, 2023: Due to a reporting backlog of historic COVID-19 cases, case rates for two Michigan counties

As of March 10, 2023, the death rate from COVID-19 in the state of New York was 397 per 100,000 people. New York is one of the states with the highest number of COVID-19 cases.

Data published on potential COVID-19 symptoms reported through NHS Pathways and 111 online Dashboard shows the total number of NHS Pathways triages through 111 and 999, and online assessments in 111 online which have received a potential COVID-19 final disposition. This data is based on potential COVID-19 symptoms reported by members of the public to NHS Pathways through NHS 111 or 999 and 111 online, and is not based on the outcomes of tests for coronavirus. This is not a count of people.

COVID-19 incidence, mortality, and vaccination rates by race, age, and sex, Michigan, June 2021.

The coronavirus disease 2019 (COVID-19) has been reported in every U.S. state, with the states of New York, New Jersey, and Michigan reporting the highest number of cases. As of April 27, 2020, there had been 119 cases of COVID-19 connected to a community in New Rochelle, New York. This statistic shows the number of cases of COVID-19 in the United States as of April 27, 2020, by place of contraction. COVID-19 is caused by the coronavirus SARS-CoV-2.

This file contains COVID-19 death counts and rates by month and year of death, jurisdiction of residence (U.S., HHS Region) and demographic characteristics (sex, age, race and Hispanic origin, and age/race and Hispanic origin). United States death counts and rates include the 50 states, plus the District of Columbia. Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file. Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death. Death counts should not be compared across jurisdictions. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington. Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf). Rate are based on deaths occurring in the specified week and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly) rate prevailed for a full year. Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

As of March 10, 2023, there have been 1.1 million deaths related to COVID-19 in the United States. There have been 101,159 deaths in the state of California, more than any other state in the country – California is also the state with the highest number of COVID-19 cases.

The vaccine rollout in the U.S. Since the start of the pandemic, the world has eagerly awaited the arrival of a safe and effective COVID-19 vaccine. In the United States, the immunization campaign started in mid-December 2020 following the approval of a vaccine jointly developed by Pfizer and BioNTech. As of March 22, 2023, the number of COVID-19 vaccine doses administered in the U.S. had reached roughly 673 million. The states with the highest number of vaccines administered are California, Texas, and New York.

Vaccines achieved due to work of research groups Chinese authorities initially shared the genetic sequence to the novel coronavirus in January 2020, allowing research groups to start studying how it invades human cells. The surface of the virus is covered with spike proteins, which enable it to bind to human cells. Once attached, the virus can enter the cells and start to make people ill. These spikes were of particular interest to vaccine manufacturers because they hold the key to preventing viral entry.

With the surge of COVID-19 cases in the United States in the early months of the pandemic, the availability of hospital resources became a concern. To reduce the strain on health systems, it is important to decrease the number of COVID-19 patients requiring hospital care. Since most patients with COVID-19 only develop mild symptoms, remote monitoring and assessment of symptoms of COVID-19 patients at home may help reduce preventable hospital utilization, morbidity, and mortality. Henry Ford Allegiance Health in Jackson, Michigan implemented a nurse-led, telephone-based, active management protocol for patients that tested positive for SARS-CoV-2 at their drive through testing site and who were self-isolating at home. The objective of this retrospective study was to assess the effectiveness of the protocol in reducing hospital utilization by patients who tested positive for SARS-CoV-2 between March 23, 2020 and May 31, 2020. The study included a total of 293 patients, with 154 patients in the pre-implementation group and 139 patients in the post-implementation group. Although the difference in the 30-day probability of hospital utilization between the study groups was not statistically significant, there was a reduction seen in the post-implementation group. The protocol also allowed ongoing assessment of COVID-19 patients with limited in-person interactions, thereby reducing the risk of infection for health care workers. With the increased use of telemedicine, this protocol could be used as a guide for other health systems looking to improve access to care for COVID-19 patients without increasing hospital utilization.

BackgroundCOVID-19 has had a disproportionate impact on racial and ethnic minorities compared to White people. Studies have not sufficiently examined how sex and age interact with race/ethnicity, and potentially shape COVID-19 outcomes. We sought to examine disparities in COVID-19 outcomes by race, sex and age over time, leveraging data from Michigan, the only state whose Department of Health and Human Services (DHSS) publishes cross-sectional race, sex and age data on COVID-19.MethodsThis is an observational study using publicly available COVID-19 data (weekly cases, deaths, and vaccinations) from August 31 2020 to June 9 2021. Outcomes for descriptive analysis were age-standardized COVID-19 incidence and mortality rates, case-fatality rates by race, sex, and age, and within-gender and within-race incidence rate ratios and mortality rate ratios. We used descriptive statistics and linear regressions with age, race, and sex as independent variables.ResultsThe within-sex Black-White racial gap in COVID-19 incidence and mortality decreased at a similar rate among men and women but the remained wider among men. As of June 2021, compared to White people, incidence was lower among Asian American and Pacific Islander people by 2644 cases per 100,000 people and higher among Black people by 1464 cases per 100,000 people. Mortality was higher among those aged 60 or greater by 743.6 deaths per 100,000 people vs those 0–39. The interaction between race and age was significant between Black race and age 60 or greater, with an additional 708.5 deaths per 100,000 people vs White people aged 60 or greater. Black people had a higher case fatality rate than White people.ConclusionCOVID-19 incidence, mortality and vaccination patterns varied over time by race, age and sex. Black-White disparities decreased over time, with a larger effect on Black men, and Older Black people were particularly more vulnerable to COVID-19 in terms of mortality. Considering different individual characteristics such as age may further help elucidate the mechanisms behind racial and gender health disparities.