ESCANABA — While many pandemic-weary Americans have declared the COVID-19 crisis to be over, it may be too soon to throw away your masks and hand sanitizer, as cases are beginning to spike in Delta County.

“We are seeing that rise in the numbers,” said Carrie Polley, director of nursing for Public Health, Delta & Menominee Counties.

The Centers for Disease Control and Prevention has designated Delta County a “high” community level area for the virus, based on new COVID-19 hospital admissions, the percent of staffed inpatient beds occupied by COVID-19 patients, and the total new COVID-19 cases that are reported to officials.

Neighboring Schoolcraft County has also earned the “high” designation, as have Marquette, Mackinac, Luce and Chippewa counties. Menominee, Dickinson, Iron, Gogebic, Alger and Keweenaw counties are considered “medium,” and the remaining U.P. counties are all considered “low” by the CDC rating.

One of the major issues facing the CDC, PHDM and any of the other entities that track COVID-19 infections is the way testing for the virus has changed. Gone are the days of sick individuals lining up in cars at hospitals or temporary military testing sites. Now, a test can be completed at home in a matter of minutes — with the results ending up in the trash just as quickly.

“We wouldn’t know for sure now the ones that are testing at home and maybe never reporting it and just staying home. We wouldn’t know those numbers, so I can’t predict how high they are,” said Polley.

Because such a large portion of COVID-19 testing is going unreported, the number of infections is likely much higher than the CDC’s community levels indicate. That means getting a clear picture of the status of COVID-19 infections may mean looking elsewhere, and some of the most telling data about the spike in COVID-19 infections in the Delta County area comes from an unlikely source — poop.

The Escanaba Wastewater Treatment Plant is one of only 20 sewersheds in the state and two in the Upper Peninsula that monitor wastewater for the presence of SARS-CoV-2, the virus responsible for COVID-19, through the Sentinel Wastewater Epidemiology Evaluation Project, also known as “SWEEP.” The project samples wastewater for two of the genes that are present in the virus and quantifies how many people are believed to be infected based off the amount of viral DNA detected. While data is delayed due to the nature of the reporting platform, as of May 18, the watershed had three consecutive weeks of virus detection with the 15-day trend showing a 1,000% or more increase in the amount of virus detected.

The SWEEP dashboard does not specify the exact percentage increase or decrease of 15-day trends, but groups the changes into ranges. Any increase of 1,000% or more falls in the highest detection category, suggesting a sharp increase in COVID-19 cases, locally. The previous 15-day period for the Escanaba Wastewater Treatment Plant, which ended May 9, also saw a 1,000% or more increase from the prior period.

Looking at where infections take place any more specifically than the entirety of the Escanaba Wastewater Treatment Plant’s service area — which serves an estimated 12,600 people, according to SWEEP — requires relying on reporting from infected individuals. Still, the reported numbers indicate there are certain locations where infections are localized.

Like SWEEP, the state’s data on long-term care facilities is delayed, but for the week of May 18, seven skilled nursing facility patients were reported as being COVID-19-positive in Delta County. The patients were split between Christian Park Healthcare Center and Bishop Noa’s skilled nursing facility. In the prior week, only one infection was recorded at a Delta County skilled nursing facility.

Healthcare staff have also seen an increase in infections. Twelve staff members from Delta County skilled nursing facilities, homes for the aged, and adult foster care centers were infected the week of May 18 — double the six cases seen in skilled nursing facility staff the week prior. Neither Menominee nor Schoolcraft counties have reported any resident or staff infections in long-term care facilities in the last month.

No outbreaks linked to schools have been reported in Delta, Schoolcraft or Menominee County either, though this may be due to the way infections related to schools are reported. Students and staff who were exposed to COVID-19 outside of school grounds and who are not thought to have spread the disease on school grounds are not included. There are also minimum levels of infection required for reporting to occur, which in some cases are as high as 10% of the students, teachers and staff within a core group. Hospitals are also required to report the number of infected patients they are treating. At OSF St. Francis Hospital, there were five COVID-19 patients as of May 16, one of which was in intensive care.

So how is PHDM managing the increase in cases? Besides continuing to recommend residents practice social distancing and good hand-washing techniques, the health department is offering COVID-19 shots weekly. To schedule a shot, call 906-786-4111 for the Delta County office, 906-863-4451 for the Menominee County office, of visit phdm.org to make an online appointment.