December 13, 2020: Roundup & Myth Busting
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Table of Contents
Intro and Disclaimer
QM would like to help you make sense of information being circulated by: 1. Translating data into digestible language, 2. Dispelling misconceptions and linking to evidence, and 3. Curating relevant data, and articles on a weekly basis. Our Round Up/ Mythbusting projects are intended to help our QM family make sense of information being circulated. Taking control of our health as a queer community includes making institutional knowledge accessible to the public.
Disclaimer: Although this information has been evaluated and determined to be accurate by Queering Medicine (QM), we at QM do not want to give the impression that we are the sole gatekeepers of medical knowledge. As a collective, QM members bring professional and personal qualifications that allow us to research and share credible knowledge. Our goals for this weekly round up and myth busting is to translate data into digestible information, dispel misinformation, and curate relevant data for the Lansing queer community. We encourage the community to question knowledge found outside of reputable sources, however, Queering Medicine will gladly help facilitate this process. If evidence or recommendations change, or any inaccuracies are found, we will correct them and explain the changes. If you have any questions about our methodology and sources, or you would like to point out any inaccuracies, please let us know!
Vaccine Update
On Friday, the FDA authorized Pfizer/BioNTech’s COVID-19 vaccine for emergency use in the United States. The authorization, unfortunately, but unsurprisingly, comes with political news. White House Chief of Staff Mark Meadows reportedly had a conversation with FDA Commissioner Dr. Stephen Hahn in which he demanded that the FDA approve the vaccine by Friday or else Dr. Hahn should look for a new job. While Dr. Hahn states that this was not the case and that the FDA was simply “encouraged to continue working expeditiously,” politics continues to interfere with the scientific process and potentially undermines trust in COVID-19 vaccines.
The U.S. is the 6th country to approve this vaccine, coming after Canada, the U.K., Bahrain, Saudi Arabia, and Mexico. An initial 2.9 million doses are set to be shipped out starting next week, with the first shots available in the U.S. on Monday, according to an Army general involved with the vaccine rollout. In total, about 25 million doses are planned to be delivered by the end of the year and 100 million doses of the vaccine by March 2021, per the U.S. government and Pfizer agreement. These doses are also reportedly going to be free to the public, with healthcare workers and elderly people in long-term facilities to be prioritized in the first wave. Since 2 doses of the vaccine are needed for it to be effective, about 50 million people in the U.S. are expected to be vaccinated by that time.
While this is important news, we also wanted to take some time to clarify some information and address concerns regarding the vaccine. To start, many of the side effects that have been reported, such as pain, redness, and swelling at the injection site are common in vaccinations, as are systemic side effects such as fever and headache. These side effects are common in that they are regular responses that our body's immune system has when being introduced to something unfamiliar and mounting an initial immune response - that is to say, they are appropriate things for our body to do when a vaccine works. Out of 21,720 volunteers who received the COVID-19 vaccine in the trial, there were 4 related serious adverse events, indicating that something seriously harmful happening due to the vaccine is quite rare. A total of 6 people died while in the study, 2 being in the active vaccine group and 4 in the placebo group of the trial. None of the deaths, however, were linked to the vaccine or placebo injections.
Another concern that has been brought is the issue of pregnancy and infertility with regards to this vaccine. The reality is that many clinical trials, including this one, do not enroll those who are pregnant or lactating. While the American College of Obstetricians and Gynecologists (ACOG) continues to advocate for trials not to exclude those who are pregnant or lactating, this was unsurprising, given the expedited nature of this vaccine study. Those who are pregnant have been noted to be an at-risk group of complications due to COVID-19, so with regards to vaccination, it is recommended that you speak with your primary health care provider prior to getting the vaccination if you are pregnant or lactating.
In the U.K., two healthcare workers had severe allergic reactions to the vaccines. Both have recovered since those incidents. These incidents prompted regulators to make sure that the history of an anaphylactic allergic reaction to food, insects, or any sort to be checked prior to administering the vaccine. The FDA has also reported that because of these cases, they would increase monitoring for anaphylaxis. They have also stated that side effect monitoring will continue with this vaccine for at least 2 more years.
Vaccine distribution and administration is imminent for healthcare workers and those living in long-term care facilities, and will then proceed to the general public. Monitoring will be continued at all levels, but so far the data has been promising. It is also important to note, however, that the vaccine has only been proven in this trial to provide immunity for 2 months. While it may be longer, the data is not yet available. As folks start to get vaccinated and this process continues, it will be essential to continue practicing proper hand hygiene, social distancing, wearing masks, and listening to and following public health measures. If you have any other questions, concerns, or comments, please send them our way and we will do our best to get them answered with whatever information is available!
More information
Michigan Vaccination Plan Released
The Michigan Department of Health and Human Services announced Friday that it would follow the CDC recommendations for vaccine prioritization. Note that phases may partially overlap (e.g., Phase 1B may start before Phase 1A is completed):
Phase 1A includes paid and unpaid persons serving in health care settings who have direct or indirect exposure to patients or infectious materials and are unable to work from home, as well as residents of long-term care facilities.
Phase 1B includes workers in essential and critical industries, including workers with unique skill sets such as non-hospital or non-public health laboratories and mortuary services.
Phase 1C includes people at high risk for severe COVID-19 illness due to underlying medical conditions, and people 65 years and older.
Phase 2 is a mass vaccination campaign for all adults.
Within Phase 1A, prioritization is broken down as follows:
1A Priority One: Keep critical health care infrastructure open and functioning (i.e., hospitals, critical care units, and emergency medical response systems) through vaccination of staff who perform direct patient care and work in critical areas including:
Group A: Emergency medical service providers, including medical first responders
Group B: General medical floor
Group C: Emergency department
Group D: Intensive care units
1A Priority Two: Prevent outbreaks and protect residents in long-term care facilities.
Group A: Vaccinate workers who have direct contact with large number of vulnerable residents.Note this would include staff who come in and out of the buildings.
Skilled nursing facility staff
Psychiatric hospital staff
Homes for aged staff
Adult foster care centers staff
Assisted living facility staff
Home health care workers caring for high risk clients with large patient loads (e.g. people with a tracheostomy/ventilator at home)
Group B: Vaccinate vulnerable residents in long-term care facilities
Skilled nursing facility residents
Psychiatric hospital patients
Homes for aged residents
Adult foster care centers residents
Assisted living facility resident
1A Priority Three: Keep necessary health care infrastructure functioning.
Group A: Vaccinate workers with direct patient contact who conduct high risk procedures (e.g., dentists, endoscopy, dialysis)
Group B: Vaccinate other workers who have direct patient contact, including outpatient, urgent care, ambulatory care, and home health care.
Group C: Vaccinate workers who have indirect patient contact with specialized skills critical to health care system functioning (e.g. hospital and public health laboratories, pharmacy).
Phase 1B will include:
K-12 school and child-care staff with direct contact with children
Some workers in 16 sectors of Critical Infrastructure Protection Program, including Chemical; Communications; Dams; Emergency Services; Financial Services; Government Facilities; Information Technology; Transportation Systems; Energy; Food and Agriculture; Health Care and Public Health; Nuclear Reactors, Materials and Waste; and Water and Wastewater Systems
Homeless shelters, corrections facilities (prisons, jails, juvenile justice facilities), congregate childcare institutions, and adult and child protective services
Workers with unique skill sets not covered above, such as non-hospital laboratories and mortuary services.
Phase 1C will include:
Group A: Individuals age 65 years and older
Group B: Individuals 18-64 years with COPD, hypertension, chronic kidney disease, heart disease, diabetes, obesity or other conditions that puts them at high risk of negative COVID-19 outcome. (Note that pregnant women are currently not recommended to receive the COVID-19 vaccine.)
Phase 2 will include “All individuals who did not otherwise fit into the earlier groups for whom the vaccine is recommended.”
Michigan COVID-19 Vaccination Interim Prioritization Guidance:
Michigan COVID-19 Restrictions Extended
Michigan's restrictions related to COVID-19 (limitations on public gatherings and businesses, mask requirements, etc.) have been extended by the Michigan Department of Health and Human Services. The increased restrictions went into effect on November 18th and were initially set to expire on December 8th, but the ongoing surge in cases has made an extension necessary. The rules are now set to remain in effect through at least December 20th, but will likely need to be continued beyond that date, as the surge is expected to continue and will likely worsen due to people traveling and socializing for Thanksgiving, Christmas, and other winter holidays.
Restrictions include:
Indoor dining at restaurants and bars is prohibited
High-school and college classes must be conducted remotely
Theaters, arenas, casinos, bowling alleys, and other indoor entertainment and amusement venues are closed
Retail stores are limited to 30% of capacity and must set up lines for entry and checkout to maintain 6 feet of distance between patron
Group fitness classes are prohibited
Organized sports are prohibited unless all participants and venues comply with MDHHS athletic testing requirements, and spectators are not permitted
Indoor gatherings are limited to no more than 10 people and they must come from no more than two households
Indoor gatherings at non-residential venues are prohibited
Outdoor gatherings are limited to no more than 25 people and they must come from no more than three households
Businesses that provide certain services (e.g., hair styling, massage, exercise facilities, etc.) must keep records of all patrons to facilitate contact tracing
Face masks must be worn at all gatherings, including social settings and businesses, and businesses must deny entry to patrons refusing to wear masks while gathered
More information
"Gretchen Whitmer says Michigan COVID ‘pause’ will go at least 12 more days"
https://www.bridgemi.com/michigan-health-watch/gretchen-whitmer-says-michigan-covid-pause-will-go-least-12-more-daysMDHHS "Gatherings and Face Mask Order" https://www.michigan.gov/coronavirus/0,9753,7-406-98178_98455-546790--,00.html
"Michigan Gov. Whitmer extends COVID-19 pause through Dec. 20"
https://www.detroitnews.com/story/news/politics/2020/12/07/whitmer-administration-covid-pause-to-continue-december-20-pandemic/3858317001/
Ventilation Systems May Spread COVID-19 Over Greater Distances Indoors
Scientists in South Korea are suggesting airflow be taken into consideration when researching and developing COVID-19 precautions for indoor spaces. Using data from the South Korean government's COVID-19 tracking system, the scientists identified a restaurant where people more than 6 feet from an infected individual became infected themselves. One individual infected in the restaurant was 20 feet from the person who had COVID-19 and was only in the same room for approximately 5 minutes. However, some restaurant-goers who were closer to the infected individual had not contracted the virus. The researchers wanted to understand how that was possible, so they analyzed the airflow within the restaurant.
They found that the airflow produced by the air conditioning units carried air from where the person with COVID-19 had sat to the areas of the restaurant where others had been infected. The airflow patterns matched the infection pattern in the restaurant. Their data suggest the equipment that moves air, such as air conditioning units, can increase the distance traveled by exhaled droplets containing the virus.
These data add to a growing concern that restaurants are a significant factor in increasing COVID-19 spread, and that other indoor spaces may also present significant risks. The authors point out that their study is limited to an analysis of an observed scenario. Other scientists suggest it is also limited by focusing on one possible scenario when more interactions may have occurred outside the restaurant. Further analysis in controlled studies are necessary to fully understand the role of airflow in spreading the virus
More information:
Ingham County Passes 10,000 COVID-19 Cases
On Tuesday, it was announced that Ingham County has now had more than 10,000 COVID-19 cases. The surge in cases has been rapid: As of Friday, the total had reached 10,576, while one month ago it was 6,198, and two months ago it was 4,074. 141 people in the county have died from COVID-19 so far, and the average is currently over 10 deaths per week and rising.
More information
"Ingham County surpasses 10,000 cases of COVID-19"
https://www.wlns.com/news/ingham-county-surpasses-10000-cases-of-covid-19/"Ingham Hits 10,000 Covid-19 Cases; 48823 Now Leads Case and Death Counts"
https://eastlansinginfo.news/ingham-hits-10000-covid-19-cases-48823-now-leads-case-and-death-counts/
COVID and the Holidays
According to Dr. Fauci, holiday travelers should do their best to try to quarantine every time they travel. It is also important to keep track of changes to risk levels in your state/county and the places you are planning to travel to and from. According to CNN, the Saturday after Thanksgiving “more than 91,000 Americans were hospitalized with the virus on the highest daily number yet in hospitalizations due to the virus.” It is becoming more clear that travel during the holidays is a large risk for spreading the virus that causes COVID-19. We encourage our QM family to consider staying home this holiday season, and at the very least having clear communication and expectations on how to keep one another safe.
What was learned from Thanksgiving?
People who do not currently live in your home, such as college students who are returning home from school for the holidays, should be considered to be part of different households. In-person gatherings that bring together family members or friends from different households, including college students returning home, pose significantly greater risks.
High or increasing levels of COVID-19 cases in the area where the gathering is occurring, as well as in the areas where attendees are coming from, increase the risk of infection and spread among attendees. Most states in the United States are either in the Severe outbreak or Active or imminent outbreak level, meaning that the virus is widespread and risk of exposure and infection is high in most locations. https://covidactnow.org
Airports, bus stations, train stations, public transport, gas stations, and rest stops are locations where contact with surfaces that may have traces of the virus is high and the risk of being around someone who is infected is high.
Location matters. Indoor gatherings pose the greatest risk, particularly in places with poor ventilation. Examples include small enclosed spaces with no outside air, or faux outdoor sitting areas like those under tents.
Time is of the essence. Risk of exposure increases the longer you are at an event or are around people who are not in your immediate household. The 6 foot and 15 minute rule is currently being disputed; the distance may actually need to be longer and the time may actually be shorter (e.g., being within 20 feet of someone for 5 minutes may create a significant risk of transmitting the virus).
Number of people is critical. As your invitation list gets longer, your risk of spreading the virus rises (both the risk of someone infected being present, and the number of people that an infected person may pass the virus along to).
What your attendees do before they see you impacts you and the others you invite to your gathering. We do not have control over what others do before entering our home or being in shared space with us. It is important to recognize the large variability we are seeing in the use of masks and social distancing amongst individuals.
What folks do during the gathering matter. The more measures in place, such as mask wearing, social distancing, and handwashing, decreases risk compared to gatherings where fewer or no preventive measures are being implemented.
What are the recommendations for the upcoming Holidays?
At minimum: wear a mask, wash your hands regularly, social distance, and limit the number of guests.
Considerations:
Virtual gatherings are the safest!
Have instructions on how you plan on keeping safe clearly communicated (send a text, email, or call before your event)
Spaced seating. Set up the gathering space ahead of time with chairs and tables arranged to maximize the distance between people.
Food and Drink
Use disposable plates, cups, and cutlery when possible
Bring your own food or have a plan on how to safely serve food (e.g., one person wearing a mask and gloves)
Space items out, and avoid crowding of people as they are being served food
Travel and Overnight Stay
Wear masks at all times (when not eating) inside the house
Ventilate rooms, if possible
Overnight guests should sleep in a separate area
Monitor guests for symptoms
Have a plan in case someone becomes ill
Return from travel
Quarantine for 14 days (doing so before travel is also strongly recommended)
Launder all your clothes and masks that you used for travel
For full explanation follow this link: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html
Communication is key. Be intentional with how you talk to your loved ones about the precautions they are taking. Be clear with expectations and be honest about who you have been around and whether or not you have been wearing a mask.
While it is best for everyone to stay home for the holidays, the CDC notes that the following individuals in particular should avoid gatherings:
People with or exposed to COVID-19
Do not host or participate in any in-person gatherings if you or anyone in your household
Has been diagnosed with COVID-19 and has not met the criteria for when it is safe to be around others
Has symptoms of COVID-19
Is waiting for COVID-19 viral test results
May have been exposed to someone with COVID-19 in the last 14 days
Is at increased risk of severe illness from COVID-19
Do not host or attend gatherings with anyone who has COVID-19 or has been exposed to someone with COVID-19 in the last 14 days.
Helpful links:
East Lansing Police Department Criticized for Lack of Transparency
East Lansing's Study Committee on an Independent Police Oversight Commission expressed concerns in a meeting earlier this week on issues relating to transparency regarding complaints and discipline of officers. According to one member of the Human Rights Commission, the police department has become increasingly limited in the information released regarding complaints over time, and the ELPD has failed to provide the requested information to the HRC on multiple occasions, including details of complaints against officers and body camera footage to be reviewed.
"Presentations to Police Study Committee Outline ELPD Complaints, ‘Uphill Struggle’ for Transparency"
https://eastlansinginfo.news/presentations-to-police-study-committee-outline-elpd-complaints-uphill-struggle-for-transparency/
Is it COVID-19 or the Flu?
COVID-19 and the flu are both contagious respiratory illnesses, meaning that they both affect your breathing and lungs when you’re sick. Since respiratory illnesses present with similar symptoms, it can be difficult to tell one from another. Below are several important similarities and differences between COVID-19 and the flu.
Similarities
Both COVID-19 and the flu can spread from person-to-person mainly by respiratory droplets. Respiratory droplets are created when an infected person coughs, sneezes, or talks.
Both COVID-19 and the flu can spread to others by people before they begin showing symptoms.
Both COVID-19 and the flu transmission can be reduced by physically distancing, wearing a mask that covers your nose and mouth, washing your hands often with soap and water for at least 20 seconds, and cleaning and disinfecting frequently touched objects.
Both COVID-19 and the flu share common symptoms such as fever or feeling feverish/chills, cough, difficulty breathing, tiredness, sore throat, runny or stuffy nose, muscle pain or body aches, headaches, and, more commonly seen in children than adults, vomiting and diarrhea.
Differences
Unlike the flu, COVID-19 spreads more easily.
Unlike the flu, COVID-19 causes more serious illnesses in some people.
Unlike the flu, COVID-19 can affect a person’s sense of smell or taste.
Unlike the flu, COVID-19 can take much longer to develop symptoms. Symptoms can appear as early as 2 days after infection or as late as 14 days after infection.
Unlike COVID-19, the flu has several FDA-approved vaccines that are readily available to the general public. While a COVID-19 vaccine was recently granted FDA emergency approval, it is not expected to be available to the general public for months, but will be available to healthcare personnel and people living in long-term care facilities soon.
The only way of knowing whether someone has COVID-19, the flu, or another respiratory illness is through testing. If you suspect that you may have COVID-19 and need testing, contact your primary care physician, an urgent care facility, or the Ingham County Health Department at 517-887-4517. You may also use Michigan’s testing site finder. If either you or someone you know has emergency warning signs of COVID-19 (trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, bluish lips or face), seek emergency care immediately.
More information
QM Public Health Crisis Round-Up Team (in no particular order):
Mauricio Franco (he/him/his), M.S.- Global Medicine, Fourth-year medical student.
Andrew-Huy Dang (he/him/his), B.S. Microbiology, Fourth-year medical student
Wyatt Shoemaker (he/him/his), Fourth-year medical student.
Antonio Flores (he/him/his), Third-year medical student, B.S. Public Health Sciences.
Daniel Pfau (they/them/theirs), Neuroscience PhD, Biological Sciences MS, Homeschool Teacher.
Francis Yang (he/him/his), M.S.-Global Medicine, Second-year medical student.
Kryssia Campos (she/her/hers), Second-year medical student.
Alessandra Daskalakis (she/her/hers): Second-year medical student, B.S. Biology, B.A. Comparative Literature
Vanessa Burnett (she/her/hers) M.P.H; Health Equity Consultant, Michigan Public Health Institute
Wilfredo Flores (he/him/his), fourth-year PhD candidate in Writing and Rhetoric, M.A. Technical Communication
Grey L. Pierce (they/them); M.A., Cognitive Psychology; Assistant Director, Michigan State University (MSU) Usability/Accessibility Research and Consulting; Project Manager, State of the State Survey, MSU Institute for Public Policy and Social Research