LANSING, Mich. (AP) — Michigan has recorded more than 1 million confirmed cases of COVID-19 since the start of the pandemic, the health department said Sept. 22.

The state crossed that threshold by reporting 6,079 new cases over the last two days. There have been at least 20,781 deaths in Michigan linked to COVID-19.

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“After more than 18 months fighting this pandemic, it is sobering to reach the milestone of 1 million confirmed cases. … I ask everyone who is eligible to be vaccinated as quickly as possible,” said Dr. Joneigh Khaldun, Michigan’s chief medical executive.

Nearly 58% of eligible Michigan residents, 12 and older, are fully vaccinated, according to the health department.

Detroit Mayor Mike Duggan told The Detroit News that he believes a “major wave” of cases is coming this fall.

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“If you combine a surge in patients with the difficulty filling staff,” Duggan said, referring to hospitals, “I think we’re going to have a major problem in Michigan in the next couple of months.”

Less than 50% of eligible Detroit residents are fully vaccinated.

“When the COVID rate starts to climb in this state in the next month or two, you’re going to see what you saw in Florida — the vaccination rate is going to start to climb,” Duggan predicted.

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