GRAND RAPIDS, Mich. (AP) — The number of COVID-19 patients at a major hospital network in western Michigan is up 40% since Nov. 1 as a fall surge pounds the state, officials said Tuesday.

Spectrum Health reported 367 COVID-19 patients at its hospitals, a “dramatic” increase in recent weeks, said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan.

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A common thread among many: no vaccination.

The seven-day test positivity rate was 22.6%, the highest since the pandemic began in 2020, Elmouchi said.

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The state health department on Monday said it was the first time in more than six months that Michigan hospitalizations had crossed 3,000.

“Everybody is seeing this massive uptick,” Elmouchi said of Michigan health care providers.

The state reported a 70% first-dose vaccination rate among people 16 and older. About 63% of those 12 and up are fully vaccinated.

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