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!
LGBTQ Households Disproportionately Impacted by COVID-19
COVID-19 Mortality Rates Higher in Native American Populations in the U.S.
A new analysis from a sample of 14 states, released by the Centers for Disease Control and Prevention, showed that Native American individuals have died at almost twice the rate of white individuals in the United States. The data account for a little over half of the country’s Indigenous population. While both Indigenous and white populations had mortality rates higher in men than women, Indigenous populations had higher mortality rates in all age groups than white populations, except for those 80 or older. In the age group 20-29 years old, the mortality rate was 10.5 times higher than for whites, in those 20-29 years old, the mortality rate was 11.6 times higher than whites, and in those aged 40-49 years old, the mortality rate was 8.2 times than whites.
Systemic racism has led to deeply embedded inequities that are clear in this analysis. Years of economic disenfranchisement have led to inequities in housing, transportation, access to health care, education, and food - all which impact COVID-19 mortality rates. Additionally, Native American individuals are more likely to hold a job that requires them to be in-person, increasing the risk of getting COVID-19. With vaccines out and allocation strategies being developed, health officials need to consider the drastic inequities and higher mortality rates that Native American populations are facing in the pandemic. Without adequate protection, the rates we are seeing now will only continue to rise.
Devices Used in COVID-19 Treatment Can Give Errors for Patients with Dark Skin
Pulse oximeters (often called a “pulse ox”) are very common tools used in a variety of healthcare settings to help determine oxygen levels in the blood. They typically clamp onto a single finger and give a percentage reading, 100% being fully oxygenated blood, 92% to 96% being a typical acceptable range, and lower numbers potentially indicating that something may not be right, often in the lungs, that is leading to a lack of oxygen in the blood. It does this by shining a harmless, small beam of red light and infrared light through your finger and determining how much light is absorbed. Oxygenated blood absorbs more infrared light, thus if more infrared light is absorbed and more red light passes through, it will indicate more oxygenated blood. While this has been a useful tool, it is not diagnostic and simply provides more data in conjunction with other methods to help healthcare providers determine if there is an issue.
Many things can affect how well or accurate a pulse ox can be, but a crucial and poorly investigated point has been about those with darker skin and how that can affect pulse ox readings. Pulse ox machines, like many other machines, formulas, and other tools used in medicine, have historically been developed primarily by and for White people and evaluated based on data collected from White patients. In the case of pulse oximeters, a recent study looked into those that identified as either White or Black to see how often a person had poorly oxygenated blood and how often the pulse oximeter missed this, with oxygen levels in blood recorded via more accurate testing methods. The study found that Black individuals were almost 3 times more likely to have low blood oxygen missed by a pulse oximeter. Considering how often this tool is used, this can be extremely impactful to communities of color, especially in a pandemic where lungs are often affected and blood oxygen levels are an important measure of lung function.
The COVID-19 pandemic continues to bring structural racism and inequities into focus, especially in medicine. This is yet another example of deeply embedded racial bias that ultimately impacts and far too often harms minority communities. In addition to all the systemic factors, more information is needed on the tools and measures that medicine uses to care for patients, and without this information, it will continue to be the same, with marginalized communities continuing to be harmed and dying at disproportionate rates.
Facemask Effectiveness Depends on Social Distancing and Limiting Face-to-Face Interactions
A recent study found that face mask effectiveness depends on the amount of distance between people, the direction people are facing, and water droplet size. To limit exposure to all possible viral particles, the researchers recommend masks always be used in conjunction with a minimum of six feet of physical distance and with limiting face-to-face interactions, even at a proper distance. The study also suggests that PM 2.5 wet masks were the most effective at reducing the number of droplets escaping or entering the barrier and should be used during close face-to-face interactions.
The researchers directly examined the movement of artificial water droplets using a machine that mimics a sneeze and a cough. It can also simulate different social distances/dynamics, including far away and face-to-face, close and back-to-back, and close and face-to-face. The particles that get through the masks used in these situations can be detected by the machine. They found that both social distancing measures (i.e., at least six feet of physical distance between people) and a focus on limiting face-to-face interactions were needed to address droplets containing COVID-19. This was because of differences in droplet size. At a close distance, due to both the physical properties of the mask and exhaled droplet size during a sneeze or cough, the largest and smallest particles are easily trapped by the recommended face masks. However, droplets that were intermediate could enter masks and may contain enough virus particles to give someone a COVID-19 infection. Social distancing and limiting face-to-face interactions are the preventative measures most effective at limiting exposure to these intermediate particles while using facemasks.
Read Queering Medicine's recommendations for masking up right:
Michigan Water Shutoffs Banned through March
On December 22nd, Governor Whitmer signed bills that ban water shutoffs in Michigan through March 31st and require that public water suppliers restore water service to occupied homes. The move is expected to help around 800,000 people who are behind on their water bills, many of whom are in financial distress due to COVID-19. The bills largely reimplement changes made by the Governor earlier in the year that were invalidated by the State Supreme Court ruling in October.
"Whitmer signs bills banning water shutoffs, allowing virtual meetings by local governments"
Updated COVID-19 Restrictions in Michigan
On December 18th, MDHHS updated emergency COVID-19 orders to allow some businesses to reopen and allows schools to resume in-person classes. The new order is in effect through January 15th.
Michigan Department of Health & Human Services COVID-19 Dec. 18 Order: Gathering Guidelines:
Two-household gathering (high precautions)*
Small outdoor gatherings (25 people)
Preschool through 12th grad (local district choice)
Manufacturing, construction, other work that is impossible to do remotely, including technical education
Hair salons, barber shops, other personal services
Gyms, pools, roller and ice rinks (for individual exercise)
Restaurants and bars (outdoor dining, takeout, and delivery)
Parks and outdoor recreation
Funerals (25 people)
Theaters, movie theaters, stadiums, arenas
Bingo halls, casinos, arcades
Outdoor group fitness classes and non-contact sports
*See Social Gathering Guidance.
**Includes a limited number of NCAA sports.
Workplaces, when work can be done from home
Restaurants and bars (indoor dining)
Indoor sports & contact sports, except professional sports
Trampoline parks, water parks
Indoor group fitness classes
For more information about the order, visit Michigan.gov/Coronavirus.
Questions or concerns can be emailed to COVID19@michigan.gov.
MDHHS Gatherings and Face Mask Order:
Research Supports Association Between Vitamin D and COVID-19
A growing amount of research from highly respected and peer-reviewed journals demonstrates an association between vitamin D levels and COVID-19. Two studies found that a significant number of study participants with COVID-19 had inadequate levels of vitamin D. The studies suggest that "deficient vitamin D status was associated with increased COVID-19 risk." Additionally, another study highlighted more extended hospital stays among COVID-19 patients with vitamin D deficiency. Vitamin D may have some role in the prevention and treatment of COVID-19, but all of the studies mentioned earlier pointed out the need for further research in this area.
Commonly known for its role in keeping bones healthy and strong, vitamin D has also been used to protect against acute respiratory tract infections, especially among those who were very vitamin D deficient. Researchers are still unclear how poor vitamin D status and infections are linked, but they know that most of our immune cells express the vitamin D receptor. Vitamin D can be acquired by a diet of milk, orange juice, or yogurt with vitamin D added. Salmon and canned tuna fish also contain adequate amounts of vitamin D. However, most of our vitamin D comes from the sun. Our skin uses sunlight to make vitamin D. Supplements are another way people can get vitamin D.
While the studies provide evidence that a deficiency in vitamin D can make people more susceptible to COVID-19, they do not suggest that having more than the normal, healthy level of vitamin D provides extra protection or can treat the disease.
A Boston doctor who received the Moderna vaccine this past Thursday was reported to have had a severe allergic reaction to the vaccine. The doctor, who has a severe allergy to shellfish, was allowed to self-administer his personal EpiPen and was then transported to the emergency department and is now doing well. This is the first report of a severe allergic reaction to the Moderna vaccine, and it was in an individual with a history of severe allergic reactions. Over 2 million doses of Pfizer/BioNTech and Moderna’s vaccines have been administered so far, and there have been 6 known reports of severe allergic reactions that have been potentially tied to the vaccine. Thus, severe allergic reactions remain extremely rare and should not be a significant deterrent from receiving a COVID-19 vaccine. While it is standard for those without an allergic reaction history to wait 15 minutes after being administered a vaccine, it is recommended that those with a history of more severe allergic reactions wait an additional 15 minutes.
The deployment of the vaccines in the U.S. has definitely had its share of logistical issues as well. Operation Warp Speed was originally estimated to have 7.3 million doses of the vaccine available in the second week of vaccine distribution, however only about 4.3 million are ready. This has resulted in states scrambling to rework their distribution and administration efforts for the vaccine. On 12/19, the chief operating officer of Operation Warp Speed, Army General Gustave Perna, stated that “it was a planning error, and I am responsible,” and continued to speak on this issue, not accounting for other measures required prior to the release of vaccines to states.
There was also the overall shortage and rush to order more doses when vaccine distribution began. Pfizer and BioNTech recently stated that they would supply the U.S. with an additional 100 million doses of their COVID-19 vaccine, with 70 million of those doses delivered by June. This would bring the total to 200 million doses. All doses are expected to be delivered by July 31, according to their press release. This means that, in total, 100 million people in the US should be able to be vaccinated fully (the vaccine requires two doses about a month apart to be effective), but this does not include the availability of the Moderna vaccine or others that may be approved in the coming months. In addition, more research is needed to determine how long immunity lasts for. As a result, it will be necessary to continue wearing masks, washing your hands properly, practice physical distancing, and follow public health guidelines well into next year as more people get vaccinated.
The WHO has provided a helpful page that explains the process by which a vaccine is developed as well as common ingredients and components that are often in vaccines: https://www.who.int/news-room/feature-stories/detail/how-are-vaccines-developed
With regards to the Pfizer/BioNTech vaccine, the ingredient list is below:
Nucleoside-modified messenger RNA (modRNA) encoding the viral spike glycoprotein (S) of SARS-CoV-2
(2- hexyldecanoate),2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide (ALC-0159)
Monobasic potassium phosphate
Basic sodium phosphate dihydrate
The active, modified mRNA ingredient acts as a blueprint which will allow your body to create one component of the virus that causes COVID-19. The component, the spike protein, is what your body will react to and learn to recognize and fight off, and is not capable of replicating (and thus, does not pose the risk that the actual virus does). As a result, none of the actual virus is put into you (neither a killed/inactivated virus, nor a weakened form of it). The lipids in the vaccine help provide structural integrity and allow for the mRNA to be delivered to cells in your body so that it can work, and they can also prevent clumping of the nanoparticles. These lipids are also a potential cause of allergic reactions. The salts in the vaccine help maintain its pH when administered so that it is not too acidic or alkaline (which would risk damaging cells). Finally, the sugar in the vaccine is included as sucrose, which is a stabilizer and protects the active ingredient when it is frozen. There are no other preservatives in this vaccine, but preservatives are typically used to protect and maintain a vaccine if there are multiple doses in one vial.
MSU Pushes Back Start of In-Person Classes
Michigan State University has announced that the start of in-person classes in the spring semester to January 19th in response to a request by the state government. The semester was originally planned to begin on January 11th, and it is not yet clear whether the delayed start will apply to fully online courses. MSU is offering ten times the number of in-person undergraduate courses in the spring as in the just-finished fall semester.
"Michigan State to push back spring semester start following state orders"
"MSU delaying classes until Jan. 19 in response to request from governor"
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