April 19, 2020: Roundup & Myth Busting
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!
Claim: More evidence to support shoes acting as a carrier for the virus that causes COVID-19; some evidence that it could travel further than 6 feet as airborne particles
Researchers concluded that the virus that causes COVID-19 travels on shoes after sampling areas of the ground for evidence of the virus in locations where there were no COVID-19 patients, leading to further support that particles can survive from living on “fomites” (carriers) such as shoes. The virus travels as an airborne contaminant, where it eventually lands on the ground. Researchers also concluded that the virus that causes COVID-19 could travel as far as 13 feet after seeing that 1/12 tests (8.3%) taken from air samples at a Chinese hospital ward tested positive for COVID-19. Although the 13-foot figure is eye-catching, there is more information that needs to be worked out to further validate this number - and the fact that there was only 1 of 12 instances where the virus that causes COVID-19 was detected airborne means that this number should be met with scrutiny. Furthermore, because there is no data on how much of the virus it takes to potentially infect someone, we (and the researchers) cannot confidently say that COVID-19 poses a significant risk for people at 13-feet away, although this does present evidence that the virus could travel that far (8.3% of times, potentially).
The most important piece from this study is likely the affirmation that COVID-19 can travel on shoes and be tracked into the home.
Claim: A study claims hydroxychloroquine improves COVID-19 patient outcomes. (FALSE)
Verdict: FALSE. The original study does not pass the scrutiny of experts. A new study is considered better suited to determine if hydroxychloroquine improves COVID-19 outcomes. This new study suggests hydroxychloroquine treatment has no effect on COVID-19 outcomes. In it, the researchers examined hydroxychloroquine treatment and COVID-19 outcomes. Researchers looked at COVID-19 patient records. Some patients had been given hydroxychloroquine and some had not. The two patient groups had similar COVID-19 outcomes indicating hydroxychloroquine had no effect. Importantly, this study was based on data made available from hospitals and was not a clinically controlled trial.
Information on the original study: https://cnn.it/2wNJVrB
New study: https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf
Myth: PrEP or other HIV medications (lopinavir/ritonavir combination) can prevent me from catching COVID19. (FALSE)
The intended purpose of Pre-exposure prophylaxis (or PrEP) is to prevent HIV (Human Immunodeficiency Virus). Lopinavir and ritonavir are medications used in treatment regimens for people living with HIV. These drugs prevent that virus from replicating. Although SARS-CoV-2 is also a virus, the way in which it spreads and replicates is different from HIV. How?
HIV replicates inside of immune cells (T-cells). COVID-19 does not infect T-cells.
The virus that causes Covid-19 uses the ACE2 (Angiotensin Converting Enzyme 2) receptor to enter cells. These receptors are predominantly found in lung tissue.
Distinction between prevention of infection and treatment of infection
There are current research efforts being made to test the effectiveness of antivirals as a means of preventing infection. Other trials are researching whether antivirals can be used for treatment of COVID-19 after infection has occurred.
Many features of the virus have not been discovered yet, thus we are unsure what other cell types it can infect.
Researchers in China tested the effect of a lopinavir/ritonavir combination in COVID-19 patients, and the drugs did not affect how long it took for patients to experience clinical improvement, nor did they have any effect on the rate of death.
More on PrEP and use of antivirals
More on Pets: There have been no additional reports of pets or other animals being infected by people with SARS-CoV-2 (the virus that causes COVID-19).
Recommendations have not changed as of 4/19/2020. These recommendations include proper hygiene practices when handling pets and animals as they can still carry various germs. When maintaining social distancing measures, these should pertain to your pets as well, such as keeping them at an appropriate distance from other people and pets as they can still carry the virus on them, even though they are not infected, just like any surface. Also, if you suspect or know you have the virus that causes COVID-19, to protect your pet, avoid contact with your pet.
Fact: Higher smoking, cancer, and HIV rates in the queer community put individuals at a higher risk for worse COVID-19 outcomes
Higher rates of smoking, cancer, and HIV in the LGBTQ+ population mean a higher potential for being infected with COVID-19 and worse COVID-19 outcomes, according to leading queer-affirming health organizations. As mentioned in previous posts, and by other activist and public health leaders, these risks are directly linked to systemic oppression- such as homophobia, transphobia, racism, classism, etc. Quitting smoking -(while anything can be addicting, smoking has other factors that increase the challenge for most people when compared to a video game, due to nicotine, etc.), making better eating habits, and increasing physical activity - is difficult for many. If you feel that kicking the habit is right for you at this time, you can call 1-800-QUIT-NOW or 1-855-DEJELO-YA (Spanish) to speak with a coach about strategies to quit smoking. Most health insurances cover smoking cessation products, including nicotine patches, medication, or lozenges. There are tremendous health benefits for quitting smoking, and these benefits can be seen in as little as 24 hours. It is important to note that for some people, now may not be the right time to balance the potential increased stress of quitting smoking with other stressors in their lives, and this is understandable as well. We will cover more information about cancer and HIV prevention in future weeks.
Helpful recommendations: What to Do if You’re Trans and Need to Go to the ER
One of the healthcare challenges (even before the pandemic) for queer people, especially trans and non-binary people of color, has been accessing affirming care services in urgent and emergency settings. The responsibility for creating safe environments of care should never fall on marginalized communities. We recognize for many, self advocacy is critical; so we are sharing some recommendations from reliable sources.
Consider bringing an ally with you to the emergency room (ER) or doctor’s office (during this pandemic, specific facility restrictions will need to be followed).
Bring a phone charger — allies can still be present when you have to talk to doctors or nurses by calling in if your local hospital or clinic is not permitting visitors, but allows cell phone use.
Bring a detailed list of prescriptions, medical history, physician contact information, and any records of surgeries — having this information on-hand can ease stress and speed up check-ins.
“It’s always going to be scary when you encounter a health care provider that you don’t know is okay with [you being trans], I’ve gone in for unscheduled care or seen a new primary care provider and have been like, I hope they’re okay with this.” Dr. Nick Gorota, trans ER doctor and a primary care physician at Lyon-Martin Health Services in San Francisco
“One thing that I find has really helped a lot of times is a pronoun pin.“Or even, sometimes, a kind of written statement to be able to just help people —and to not exhaust [yourself] by trying to say something over and over and over again.” Dallas Ducar, clinical lead for mental health services at the Massachusetts General Hospital Transgender Health Program
Some additional items to keep in mind/have available:
Medical: Any prescription medications (such as hormones) or assistive devices (ask for a 14-day supply)
If you take hormones prescribed by a doctor, ask your doctor for an extended prescription so you can keep a bigger supply with you.
Copies of prescriptions – make sure to save these, especially for injectable medications!
Syringes, alcohol swabs, etc. for any injectable medications
Other medical devices or supplies (such as dilators)
Phone numbers for Lambda Legal, NCTE, and the FEMA helpline.
Lambda Legal National Help Desk (legal advice), toll free: (866) 542-8336
National Center for Transgender Equality (help make sense of policies/advocate against discrimination: (202) 642-4542
Court orders for legal name, sex, and gender changes
Any identification that shows your chosen name and/or gender (for example, a driver’s license, passport, or school ID)
If you don’t have identification matching your gender, a letter from your therapist or doctor if you have one
Important documents (such as insurance, medical records, bank account numbers, Social Security card, etc.)
Cash and change
Chest Binding: All folks wearing chest binders should know about possible complications related to the COVID-19 virus. Be safe and be aware! We are resharing this from an earlier Facebook post.
“Binding is not expected to put you at higher risk of infection. However, if you become infected, binding could accelerate the symptoms and infection. While specific research has not been conducted to prove this to be the case, it is reasonable to assume based on our understanding of COVID-19 and the impacts of binding. Therefore, if you bind and you get symptoms of COVID-19, the safest thing to do is to avoid binding while you have symptoms.” — Dr. Karl Neff, Clinical Lead of the National Gender Service in Ireland.
Chest constriction can exacerbate respiratory illness like pneumonia and acute respiratory distress syndrome (ARDS)
If entirely stopping chest binding is not possible or a safe option for you, consider the following:
Wearing tight singlets or shirts under clothes
Take breaks from the binder when you can.
Once you take off the binder, take some deep breaths to expand the lungs. Stretch chest muscles by reaching up high to the sky, keep arms up and lean to one side then to the other. Stretch the neck muscles.
Check with your local Department of Health, the Centre for Disease Control, or the World Health Organisation for more information about COVID-19.
QM Mythbusters (in no particular order):
Mauricio Franco (he/him/his), M.S.- Global Medicine, Third year medical student.
Andrew-Huy Dang (he/him/his), Third year medical student, B.S. Microbiology.
Wyatt Shoemaker (he/him/his), Third year medical student.
Antonio Flores (he/him/his), Second 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, First year medical student.
Kryssia Campos (she/her/hers), First year medical student.
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