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!

Racism Declared a Public Health Crisis in Michigan

On Wednesday, Governor Whitmer declared racism a public health crisis in Michigan. The Michigan Department of Health and Human Services has been directed to prioritize health equity, all state employees will undergo implicit bias training, and the Governor is creating a Black Leadership Advisory Council to tackle issues related to racism. The move comes as COVID-19 continues to disproportionately impact people of color, throwing the oft-ignored health impacts of racism into stark relief.

Under the Executive Directive, the Department of Health and Human Services is tasked with following "to combat racism as a public health crisis and the resulting health inequities"

  • Collect and analyze data to understand "racial disparities in societal, economic, environmental, and behavioral factors intersect to affect access to resources that promote good health, including good jobs, access to healthy and affordable food and housing, equitable transportation options and excellent public education" and "how violence in the community and racism are related, and the impact of violence on the overall health of people and the community at large"

  • "develop a plan that outlines in detail how the State of Michigan will eliminate the root causes of the inequities that cause disparities in health outcomes for our residents"

  • "Develop direct service programs and services to address the negative impact that racial inequities have had on specific populations as well as programs that empower communities to tackle these systemic barriers."

  • "Engage historically marginalized communities to identify problems and solutions and support community-driven responses."

  • Require all state employees to complete implicit bias training by the end of the year, and to receive training every two years thereafter

  • Require all new state employes to complete implicit bias training within 60 days of being hired

The Black Leadership Advisory Council will be housed within the Michigan Department of Labor and Economic Opportunity, and will be responsible for identifying laws that result in inequities; promoting new legislation to ensure equity and reduce structural inequities; promoting economic growth, wealth equity, and arts in Black communities; and serving a resource for community groups to benefit the interests of Black communities. The group "will consist of 16 voting members representing Black leadership in economics, public policy, health and wellness, technology, the environment, agriculture, arts and culture, and more."

More Information

Wearing Masks Could Prevent Serious COVID-19 Illness

While mask wearing has been encouraged to limit the spread of the virus by preventing or limiting droplets released from those with COVID-19, there is growing evidence that mask wearing could prevent serious COVID-19 illness. Some disease experts believe that a person who becomes infected but was wearing a mask when exposed to the virus could end up being asymptomatic or develop only a mild case of COVID-19, with less risk of serious complications or death. This is due to less virus being inhaled because of the mask, so there is less immediate exposure. A smaller viral load will mean less virus in the body, potentially leading to a less severe case of the illness. Rationale about amounts of exposure and severity of an illness dates back to the 1930’s. With a smaller amount of the virus in the body, the body’s immune system has a better chance of successfully defending against it. More research needs to be done on this, but mask wearing could be more beneficial for the wearer than previously thought. Masks should always be worn when out in public and when around people who do not live in your house to slow the spread of COVID-19.

More information:

Clotting Factors and COVID-19

Recent studies have shown that people with higher levels of certain clotting factors in their bodies might be more at risk for severe complications from COVID-19. One of the ways in which COVID-19 impacts the body is by damaging the inner lining of blood vessels, which is where the virus attaches to cell receptors. The body’s natural response to such damage is to release a clotting protein called von Willebrand factor (VWF). VWF helps the body respond to the damage by promoting the attachment of platelets, cell fragments naturally found in our blood, to the damaged part of the blood vessel forming a sort of “patch.” This natural process can lead to potential complications if these clusters of platelets break off and get stuck somewhere else in the body, forming dangerous clots that cut off blood flow to organs. If clots get stuck in the lungs, for example, that can cause difficulty breathing and affect the lungs’ ability to supply oxygen to the rest of the body. This is a major complication of COVID-19. Clusters of platelets can break off as a result of the natural flow of blood, but especially in circumstances when blood pressure is high and/or the body is under stress. It is being proposed that one reason why individual patients respond so differently to COVID-19 is because there is variation in the amount of VWF people have in their bodies. People whose bodies have more VWF are more likely to experience these dangerous clots. One response might be for care providers to try to reduce VWF levels in those suffering from COVID-19. Previous studies have shown variation in VWF linked to hereditary differences as well as differences in blood types. More research needs to be done to better understand the role of VWF and other clotting factors in COVID-19, but this is one pattern that has recently emerged as a source of potential study.

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COVID-19 Reinfection vs. Prolonged Disease

There is not yet definitive evidence that there is a widespread risk of reinfection of COVID-19 in those who have recovered from it or who have developed antibodies, although the possibility has not been ruled out. It is more likely that what was reported as reinfection is rather the prolonged disease in patients and a recurrence of symptoms weeks to months later.

According to the CDC, at this time it is believed that a person would be most susceptible to reinfection after three months from the initial infection when their antibody levels drop down. Antibodies are proteins that help the body identify viruses in the blood. The body makes these proteins in response to initial infection and retains them to help identify the next exposure to the virus more efficiently, contributing to immunity. However, months after initial infection it is not uncommon that antibody levels would drop. During that time, the body invests in other immune responses, like creating immune cells called memory T cells that can directly respond to viral invaders. In fact, it is being proposed that those people in the population who have a stronger T cell response, and who might by chance have T cells that recognize the virus that causes COVID-19 on initial exposure due to similarity to other viruses the person has been exposed to, may have milder symptoms and possibly a degree of pre-existing immunity.

Currently, variation in testing both for the virus and for antibodies can result in false positives, false negatives and varying sensitivity to antibody levels — details which make understanding disease progression more challenging. In response to developing knowledge about the role of memory T cells in COVID-19 patients, researchers are suggesting it may be important to begin testing for memory T cells, not just antibodies, to identify potential immunity post infection.

There is also the question of whether or not severity of disease has an impact on the risk for recurrence of symptoms and/or re-infection. Some researchers are suggesting that having a more severe disease initially makes someone more likely to have recurrent symptoms down the line, signifying a prolonged infection, but not necessarily reinfection. However, there has not been enough research yet to be confident about these findings. The only way to truly identify re-infection is to study the genetic makeup of the virus to identify two different infections, but this has not yet been done for patients with COVID-19.

It is also important to note that not all viruses result in lifetime immunity and even in those that often do, like the virus that causes chickenpox, a small number of people may experience a second infection. This can happen if the virus hides in the body and then reemerges. Conversely, viruses like the one that causes the common cold, can get people sick each year. An important area of study in the coming months will be to better identify ways to test for reinfection, and, if it is found that people are reinfected by the virus that causes COVID-19, to identify if the risk for reinfection is common or rare.

More Information:

COVID-19 Bounces Back Where It Had Been Knocked Out

There have been several headlines highlighting the rise of coronavirus cases in countries that were viewed as “pandemic success stories” early on in the COVID-19 pandemic. These include countries such as Japan, Germany, and Australia, as well as some areas like Hong Kong, which in recent news, reported that they were on the verge of a “large-scale outbreak” if social distancing measures were not adhered to.

Japan has seen the number of COVID-19 positive cases double since July alone. Cases have been rising in Germany, a country that has had a relatively high number of cases but a low case fatality rate. As cases rise, Germany has implemented mandatory COVID-19 testing at their airports. Earlier this week, Australia recorded their deadliest COVID-19 day, with 13 deaths.

Some countries like South Korea that have maintained their overall success have seen community outbreaks, leading to the reimplementation of stricter COVID-19 prevention measures.

This virus has proven to be incredibly resilient, and as restrictions have eased in countries which have been successful in curbing COVID-19, there has been a rise in coronavirus cases. If there is anything we can learn from other countries, it is that the pandemic is still here and doesn’t look like it will go away anytime soon, but strict public health measures and adhering to those measures (wearing a mask, maintaining physical distance from anyone not in your household, and washing hands frequently) works in reducing the transmission of COVID-19. As the pandemic continues, we must continue to be diligent about wearing masks and social distancing.

Sources:

Masks Required in Downtown East Lansing

In response to fears of MSU students returning to the area and spreading COVID-19, East Lansing has declared a state of emergency, and masks are now required to be worn in all outdoor public spaces in downtown East Lansing. Michigan State University has already implemented a mandatory mask policy for campus, including all outdoor spaces (with exceptions for those who cannot wear a mask due to a disability or medical condition).

More information:

Social Justice Resource List

The resources below are separated into three lists of information. The first list is intended to help those who are harmed by racism and other forms of oppression. This includes links to mental health organizations, social media accounts, and articles with information about mental health or healing. The second group is resources that provide information about how racism and other forms of oppression have continued to be perpetuated in the United States. This list speaks to structural and systemic oppression. Lastly, the third list is intended for those looking to dive deeper into anti-racism work.

Mental Health/Healing Resources

Historical and Current Context Resources

Anti-Racism Resources

QM Public Health Crisis Round-Up Team (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.

  • Alessandra Daskalakis (she/her/hers): First 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), 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