HRT Does Not Provide Protection Against COVID-19, Despite Anti-Vaxxer Claims

Despite recent claims on Fox News, there is no evidence that hormone replacement therapy (HRT) can prevent or treat COVID-19. The bizarre claims come from a group of anti-vaccine conspiracy theorists and discredited researchers that call themselves the "Frontline COVID-19 Critical Care Alliance." The group is best known for their promotion of ivermectin to fight COVID-19, despite there being no evidence for it being effective (and despite the significant health risks from taking it).

The HRT claims are part of what the group refers to as "second-line agents" to fight COVID-19 (they consider ivermectin to be a first-line treatment). Their "second-line" list includes "anti-androgen therapy," and specifically mentions Spironalactone (commonly called "Spiro" in the trans community) and Finasteride, both of which are commonly used for medically transitioning by transfeminine people. There is absolutely no evidence that either drug (or any other form of HRT) provides protection against COVID-19 or that they can treat COVID-19. The claims, like all other claims made by the "Frontline COVID-19 Critical Care Alliance," are not based in science, are not supported by evidence, and put lives at risk.

If you are taking Spiro or Finasteride, the only way to protect yourself against COVID-19 is to get vaccinated and boosted, to wear a mask when around other people, to avoid gatherings, and to wash your hands. HRT will not provide you with any protection. Additionally, COVID-19 vaccines do not interfere with or interact with any form of HRT, so you're safe to get vaccinated! (The vaccines are also safe for people on PrEP or HIV treatments, which has been a concern for some LGBTQ+ folx.)

Hopefully, the claims will not result in Fox News viewers trying to get Spiro or Finaseride thinking they'll be helpful against COVID-19. In addition to side effects (which are well known to many trans folx), a rush on the drugs could create shortages that would make it harder for trans folx and others with medical needs to get them.

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Recent Study Suggest Booster Needed for Omicron Immunity

A recent study published in the science journal “Cell” suggests that initial two-dose mRNA vaccination does not provide much neutralization of the Omicron variant of the virus that causes COVID-19, however those who received a booster shot of either mRNA vaccine showed significant neutralization of the Omicron variant. Blood was taken from 239 individuals who had been vaccinated and antibody titers and other tests were done to determine neutralization effect. While this is a small sample, this is more evidence supporting booster shots to protect oneself from COVID-19 infection, particularly from the Omicron variant with the recent surge in cases.

While this study suggests that an initial two-dose series of an mRNA vaccine might not be sufficient, it does offer some protection, and many vaccines need multiple doses for people’s immune systems to develop stronger, lasting immunity. In addition, real life data so far has continued to show that a majority of severe COVID-19 and hospitalizations are in those who are unvaccinated.

If you have not yet been vaccinated or boosted, please do so if and when you can! MSU is partnering with the Ingham County Health Department to host more vaccination clinics at MSU’s Breslin Center. Currently, there are three vaccination clinic days scheduled for January: Jan. 17, Jan. 26, and Jan. 31 from 10 a.m. to 6 p.m. To make an appointment, schedule one by clicking here. There is also information in the provided link to schedule with the Ingham County Health Department separately.

As always, in addition to getting vaccinated/boosted, continue to wear high quality masks for the most protection as well as practice proper hand hygiene and socially distance when possible. Please reach out if you have any other questions!

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At-Home COVID-19 Antigen Test Update

In conjunction with the recent surge in cases and the spreading of the Omicron variant, standard PCR testing sites have been struggling to keep up with demand. As a result, many people have been searching for at-home rapid antigen tests for COVID-19. It is known that rapid antigen tests are not as good as PCR tests, and some data suggest it may lags a few days behind a standard PCR test in detecting whether a person is infectious or not with COVID-19 due to the Omicron variant. A small, recent study, while not yet peer-reviewed or published, suggests that these rapid antigen tests are not able to detect Omicron early enough, and that people can test negative while still being infectious. This study suggested that on average, it took 3 days after a person’s first positive PCR test to also test positive on certain at-home antigen tests.

Many experts believe that while rapid antigen tests are not as sensitive at detecting COVID-19 infections, they can serve a role in helping individuals be more informed about whether they have COVID-19 or not, especially when standard PCR testing is not easily accessible. In addition, the Biden administration has stated that private health insurers are required to cover at least 8 rapid antigen tests for individuals.

Beginning on Saturday, Jan. 15, 2022, every individual in the United States is supposed to be able to purchase up to 8 at-home rapid antigen tests a month with their insurance or submit receipts for reimbursement. In addition, starting Wednesday Jan. 19, 2022, every home in the United States should be able to order up to 4 free at-home COVID-19 tests at

A recent news report had also brought up the question about whether rapid antigen tests are viable especially with winter weather. Per some of the antigen tests, they should be stored at certain temperature ranges. For example, the report outlines the following tests:

  • BinaxNOW: Store between 35.6 and 86 degrees F

  • QuickVue At-Home OTC COVID-19 Test: Store at 59 degrees F to 86 degrees F which is 15 degrees C to 30 degrees C

  • iHealth® COVID-19 Antigen Rapid Test: Store between 36 degrees and 86 degrees Fahrenheit (2 degrees C to 30 degrees C)

Tests may still work if kept outside of these temperature ranges for longer periods of time, however these are the ranges the tests are evaluated at, and ideally, you are able to keep tests stored within these temperature ranges.

In addition, most at-home antigen tests approved and available in the United States have been tested for use as nasal swabs. Recently, anecdotal reports have shown that some people will test negative when using these tests as instructed, doing a nasal swab, however they have tested positive for COVID-19 when using these tests as throat swabs. This has brought concerns that antigen tests are missing cases unless a throat swab is done. Ultimately, these tests are only tested and approved for what they are intended for, mostly nasal swabs. If the antigen test you have shows instructions for a throat swab as well, then it should have been tested and approved for that use. This does not mean that these tests can’t be used as throat swabs, but this is not the studied use of these tests and ideally, we are able to operate with the confirmed instructions. These tests have been made and designed for nasal swabs, and ideally they are used as instructed at least until more tests and evidence supports otherwise.

One final important note, the FDA releases an announcement for people to stop using the LuSys Laboratories COVID-19 Antigen test, as they believe this test has a particularly high risk of giving a false result, in particular, that it will show negative results when in fact the individual may have COVID-19.

If you have any other questions, please feel free to reach out to us!

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COVID-19 Surge Continues

COVID-19 cases continue to surge in the U.S., with a new record for daily number of cases being set every week. Military medics are being sent to hospitals in six states to provide assistance, including Henry Ford Wyandotte Hospital in Michigan.

Locally, in Ingham County, 30-39 year-olds have the highest case rate, followed by those who are 20-29 years old. Significant racial disparities are present locally: So far in January, Black people in Ingham County are more than twice as likely to be infected (1,989.7 per 100,000) as White people (878.3 per 100,000).

Data from Sparrow Hospital in Lansing shows that 85% of the people hospitalized with COVID-19 there were unvaccinated. Currently, only 59.3% of people in the county are vaccinated, with only about half of those having received a booster (84,000 booster/additional doses have been administered, out of 163,903 who have received a full initial vaccine regimen). Overall, that means only 30.4% of the county is likely to have adequate protection against the Omicron variant.

Sparrow Hospital also announced that it was limiting visitors, in response to the surge in cases. Effective January 11th, only one visitor is allowed per patient each day.

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Supreme Court Overturns Biden's COVID-19 Mandate for Businesses

On Thursday, the Supreme Court blocked the OSHA federal mandate that businesses with more than 100 employees must require their employees to get vaccinated against COVID-19 or provide a weekly negative COVID-19 test as a condition of being in the workplace, and that unvaccinated workers must wear masks indoors. The ruling was 6-3, with all of the typically conservative justices (all of whom were selected by Republican Presidents) ruling against the mandate, and all of the typically liberal justices (all of whom were selected by Democratic Presidents) voting in favor of the mandate. At the same time, the Court upheld federal vaccination rules for healthcare workers by a 5-4 vote.

Many believe that the ruling was purely ideological, and doesn't rest on firm legal reasoning. Regardless, the ruling only applies to the Biden administration's federal mandate for employers with more than 100 employees. It has no impact on any state or local mandates, nor does it prevent employers from creating their own rules.

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Racism in Housing

This week, it was released that in 2020 (the latest year for which data is available), Black mortgage applicants were denied mortgages at a rate 84% higher than white mortgage applicants. This difference has increased 10% since 2019, despite the active housing market. While Black home ownership has slowly increased over the past few years, it is still down from its peak in 2004. These disparities have deepened during the COVID-19 pandemic. Black individuals were more likely to report housing and economic challenges during the pandemic, including job loss, income loss, and difficulty keeping up with mortgage payments. Additionally, access to financial services has impacted home ownership rates. It is common to find a lack of traditional financial institutions, such as banks or credit unions, in primarily Black and Latinx communities. Without easy access to savings accounts to save for a house or access to build credit, it is challenging to begin the mortgage process, and this is to no fault of those in the community. Continued disinvestment in primarily Black neighborhoods and communities negatively impacts those living there. Even Black individuals who do own homes see disparities in the value of their homes compared to the average U.S. home. In October 2021, it was reported that homes owned by Black people were worth 16.7% less and that it would take more than 22 years for Black homeowners to catch up to the median. This is due to homes being appraised at lower values, but tax assessments being higher than they should be. Home ownership is a main factor in building wealth, and we continue to see people locked out of that. The wealth gap is so drastically different for Black and white individuals and continues to be because of systemic racism across our society - from being denied mortgages, making less money, to not having access to build credit. All of these play a role in the persistent disparities we see in the United States.

This month also saw two tragic housing fires in the Bronx and Philadelphia. A fire in a Bronx, NY apartment building killed 17 people and a fire in a Philadelphia row house killed 12 individuals. These deaths could have likely been prevented with safety precautions being up-to-date and operational. In the Bronx apartment building, a faulty space heater sparked the fire that quickly spread. Tenants had previously complained about lack of heat in the apartments, but nothing was done. The building had safety doors that failed to close and did not have any fire escapes or sprinklers. In Philadelphia, a Christmas tree sparked the fire, and while there were smoke detectors installed, none were operational in the three-story house. Black individuals are more likely to be killed in house fires. They represent 25% of those killed, while only making up 13% of the country’s population. So while fires are deemed accidental, if they were truly accidental then there would be a random distribution across different populations. But that is not the case. Zoning laws, racist policies, and systemic lockout have promoted housing segregation that we continue to see today. The high cost of housing forces individuals to live in neglected units that put lives at risk in preventable situations. It can be challenging to get problems fixed when landlords don’t listen and governments are slow to respond. Everyone deserves safe and affordable housing regardless of their race and identity, but unfortunately, that is not happening in the United States. Marginalized and minoritized people are left with worse options, while those in power continue on with no consequences. Housing is a human right and one this country continues to fail in.

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CDC Director Dismissing Impact of Covid-19 on Disabled Individuals

Last week, CDC Director Rochelle Walensky was interviewed on Good Morning America regarding the Omicron variant. In this interview, Director Walensky was discussing a study showing that vaccines help to protect from severe disease and death. Data from the study showed that a majority of the deaths occurred in people with four or more comorbidities, meaning those with chronic illness or disabilities. Director Walensky went on to say that “these are people who were unwell to begin with. And yes, really encouraging news in the context of Omicron.” This has sparked outrage within the disability community at the clear bias and lack of intentionality from Director Walensky - whose job is to protect and promote all residents’ health. The Disability Rights Education & Defense Fund posted an open letter to Director Walensky about the impact of her words and ways to center disabled individuals in pandemic response. This letter has been signed on to by 134 other organizations, including Disability Rights Michigan. Disabled individuals' lives are valuable and deserve protection. They are not expendable. Protecting the most vulnerable residents in the country ultimately protects everyone and provides us all a safer country to live in. While Directory Walensky tweeted saying she went into public health to protect those at highest risk, nothing else has been done from the director or agency. Without centering the most impacted and truly listening & valuing to their voices, we will continue to harm people. The CDC has a responsibility to end all forms of oppression in order to achieve equity and justice in the United States.

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Aversive Racism Maintains Structural Racism in Academic Medicine

An article in the New England Journal of Medicine identifies aversive racism's role in creating a hostile environment among medical students, trainees, and faculty in academic medicine. The authors define aversive racism as “exhibiting racist tendencies while denying that one’s thoughts, behaviors, or motives are racist.” Individuals who feel their values are egalitarian will justify racism by invoking some factor other than race. The aversive racism of those in power reinforces structural racism in hierarchical systems. Like structural racism, aversive racism leads to fewer individuals from racial minorities receiving awards, job offers, and promotions. Some examples of aversive racism are “We want diversity, but we also want qualified people,” and “She was a promising candidate, but she just wasn’t the right fit for our department.” Aversive racism emerges from societal myths like “success is primarily based on a person’s abilities”, and cognitive processes like implicit bias and in-group favoritism.

The authors go on to describe aspects of aversive racism that make it difficult to address. First, individuals who hold the most power have the strongest preference for hierarchical systems and are also more likely to endorse societal myths that legitimize their racism. Individuals unaware of how intergroup dynamics affect their thoughts are especially at risk for accepting myths and expressing aversive racism. Those in power may maintain an egalitarian self-image by denying the inevitable influence of their biased cognitive processes, reinforcing their reliance on aversive racism. Several recommendation for addressing aversive racism are suggested in the report, all of which require intentional, consistent and long term practice:

    • Unlearning implicit bias by adding steps to your thought process that prevent reliance on automatic judgments

    • Countering negative stereotypes by replacing myths with knowledge of the barriers faced by underrepresented racial minorities.

    • Eliminating the influence of racial bias by examining the characteristics of white supremacy

    • Acknowledging and learning about intergroup power dynamics

More Information and Resources to Address Aversive Racism:

COVID-19 Vaccine Paperwork Issues for Trans and Nonbinary Folx

Getting vaccinated against COVID-19 can create some issues for trans and nonbinary folx. Not because of any medical issues, but because of paperwork. Like other medical and legal systems, the databases that vaccine records are stored in rely on legal names and legal gender information. As a result, trans and nonbinary folx have to use their deadname when filling out vaccine-related forms, and if the form requires sex to be filled in, they'll have to put their legal gender. The use of legal name is unfortunately necessary because the information is being matched to a state database and may be used for health insurance. Complicating matters are proof-of-vaccination cards and records. While the cards don't include gender information, they do include names, so anyone who goes by a name other than their legal name would be showing their deadname to people any time they have to provide proof that they are vaccinated. Even if the person writing the card is willing to write down the name a person goes by on the card instead of their legal name, that would create problems any time a driver's license or other legal ID needs to be provided along with proof of vaccination (since the names wouldn't match). For fraud reasons, giving people two vaccine cards with different names on them isn't a realistic option. As a result, there is no good solution.

For those who change their legal name after their initial vaccine dose, there is no clearly documented process in most states to get the name on the card updated, but it is possible. In many states, a new card can be printed online (in Michigan, that can be done through the Michigan Immunization Portal). If your name has been updated in the system, you should be able to print an updated card. If your name isn't updated, contact your local or state health department (for example, Ingham County Health Department for many in the Lansing area). Additionally, you can try asking for a replacement card with your new name when you get a booster or additional vaccine dose.

Queering Medicine's recently published LGBTQ+ COVID-19 vaccine guide has more details about filling out COVID-19 vaccine forms for trans and nonbinary folx.

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This Week's QM Round-Up Contributors (in alphabetical order):

    • Vanessa Burnett (she/they) M.P.H; Health Equity Consultant, Michigan Public Health Institute

    • Daniel Pfau (they/them/theirs), Neuroscience PhD, Postdoctoral Researcher, Obstetrics & Gynecology/Biomedical Engineering, University of Michigan

    • Wilfredo Flores (he/him/his), fifth-year PhD candidate in Writing and Rhetoric, M.A. Technical Communication

    • Grey L. Pierce (they/them); M.A., Cognitive Psychology; Chair, Power of We Consortium

    • Francis Yang (he/him/his), M.S.-Global Medicine, Third-year medical student