Alan Vierling, president of Lansing's Sparrow Hospital in Ingham County, said it appears "right now, we're on the front end of a surge." .

"The admissions are for sure going up — going up with people who are not vaccinated, so it's very consistent with what you see on the national news.

Twenty-seven counties have “substantial” spread — a weekly case rate of between 50 and 99.9 per 100,000 people, a positivity rate between 8% to 9.99%, or both.

But at Beaumont Health, the state’s largest system, a physician said people should probably return to universal masking when they are going to stores or gathering indoors in large groups.

Fishbain expressed concern that vaccinated people can spread the delta variant, but he said vaccination remains “very, very good.” Just 0.06% of Beaumont’s vaccinated patients have tested positive, he said.

While infected children tend not to get sick or as sick as adults, he said, they could spread the virus to vulnerable people.

The Michigan Health and Hospital Association has received anecdotal evidence from its hospitals of slow growth in hospitalizations and test positivity, said John Karasinski, a spokesman for the association.

"Getting vaccinated and wearing masks when we are inside and close together will always be a smart thing to do as long as COVID is around — and COVID will be around for a while," she said. .

In Oakland County, where the positivity rate from July 21-27 was about 3.7%, officials said Monday there are no plans to put a mask mandate in place despite the "substantial" transmission risk designation by the CDC.

"Oakland County Health Division reminds all residents, vaccinated and not vaccinated, that wearing a mask while in public indoor spaces and social distancing, in addition to immunization, are the most effective means for limiting the spread of the virus," county spokesman Bill Mullan said

State of Michigan data put Ingham County in the “moderate” transmission category, said Madison Van Epps, a spokeswoman for the Ingham County Health Department

On Monday, the Michigan Department of Health and Human Services also urged people who attended the Muskegon Bike Time motorcycle event in mid-July to get tested