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Biden Continues to Update Federal Approach to Racism and Healthcare

In the last week, President Biden has signed a number Executive Orders, memorandums, and proclamations addressing racism and healthcare (summaries quoted from CNN):

Racism

    • Executive Order Reforming Our Incarceration System To Eliminate the Use of Privately Operated Criminal Detention Facilities (1/26): "Directs the attorney general not to renew federal contracts with private prisons."

    • Memorandum on Redressing Our Nation's and the Federal Government's History of Discriminatory Housing Practices and Policies (1/26): "Directs the Department of Housing and Urban Development to review the Trump administration's regulatory actions for their effects on fair housing and to then 'take steps necessary' to comply with the Fair Housing Act."

    • Memorandum on Tribal Consultation and Strengthening Nation-to-Nation Relationships (1/26): "Recommits federal agencies to ‘engage in regular, robust and meaningful consultation with Tribal governments.’"

    • Memorandum Condemning and Combating Racism, Xenophobia, and Intolerance Against Asian Americans and Pacific Islanders in the United States (1/26): "Acknowledges the rise in discrimination against Asian Americans and Pacific Islanders in the past year, directing HHS to consider issuing guidance on best practices to improve 'cultural competency, language access and sensitivity toward AAPIs' in the federal government's Covid-19 response. The memorandum also directs the Department of Justice to partner with Asian American and Pacific Islander communities to prevent hate crimes and harassment."

COVID-19 and Healthcare

    • Proclamation on the Suspension of Entry as Immigrants and Non-Immigrants of Certain Additional Persons Who Pose a Risk of Transmitting Coronavirus Disease (1/25): "Reinstates Covid-19 travel restrictions for individuals traveling to the United States from Brazil, the Schengen area, the United Kingdom, Ireland and South Africa."

    • Executive Order Strengthening Medicaid and the Affordable Care Act (1/28): "Reopens enrollment on HealthCare.gov from February 15 through May 15, and directs federal agencies to reexamine policies that may reduce or undermine access to the Affordable Care Act."

    • Memorandum on Protecting Women's Health at Home and Abroad (1/28): "Rescinds the 'Mexico City Policy,' a ban on US government funding for foreign nonprofits that perform or promote abortions. The memorandum also directs the US Health and Human Services Department to immediately move to consider rescinding the Trump administration rule blocking health care providers in the federally funded Title X family planning program from referring patients for abortions, according to the Biden administration."

    • Executive Order - President's Council of Advisors on Science and Technology (1/27): "Reestablishes the President's Council of Advisors on Science and Technology. Moving forward, the council will advise Biden on policy that affects science, technology and innovation."

    • Memorandum on Restoring Trust in Government Through Scientific Integrity and Evidence-Based Policymaking (1/27): "Charges the director of the Office of Science and Technology Policy with responsibility for ensuring scientific integrity across federal agencies. Agencies that oversee, direct or fund research are tasked with designating senior agency employees as chief science officers to ensure agency research programs are scientifically and technologically well founded."

Additionally, President Biden signed an Executive Order Enabling All Qualified Americans To Serve Their Country in Uniform on 1/25 that "Reverses the Trump administration's ban on transgender Americans joining the military."

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Should People Wear 2 Masks?

New variants of COVID-19 have been recently reported. Although we still do not have enough information to determine the infectivity or properties of these new variants, many experts, including Dr. Anthony Fauci, suggest double-masking, which could be more effective in preventing infection with COVID-19 and its variants.

What are some considerations when choosing which masks to wear?

  • Good fit and breathability capacity. Look for a mask that has air filtration capacity, such as a surgical mask, and that fits snuggly against your face. If you opt for a cloth mask, it should have multiple layers made of a tight-weave fabric.

  • Mask with the highest filtering capacity goes first. Experts recommend wearing the mask with the highest filtering capacity first (i.e., closest to your face). For example, the KN95 mask will go first, followed by a cloth mask. This will not only increase the filtering of possible COVID-19 viral particles, but will also improve the fit, as looser masks, like many surgical masks, would then be on the outside.

  • KN95. The CDC recommends that N95 masks be reserved for first respondents and health care workers. KN95s could be an alternative for non-clinical settings.

  • Breathability. Wearing too many masks is possible - your masks shouldn’t prevent you from being able to breathe or take in enough air.

It’s important to note that the Center for Disease Control and Prevention has not changed their guidelines, and still recommend wearing one mask that has two or more layers. Whether double-masking or not, proper use of masks remains one of the most important aspects in combating COVID-19. Remember, the mask or masks should cover both the nose and mouth, reaching past the chin at all times.

So should you be wearing two masks? According to the latest reports, it doesn’t hurt, and may help.

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First Cases of More Infectious COVID-19 Virus Variant In Michigan

The variant of the virus that causes COVID-19 first found in the UK (as reported in our December 20 update) has now reached Michigan. The first case in the state was found in Washtenaw County last weekend. The strain appears to be at least 50% more transmissible (i.e., it spreads more easily), though there is not yet any evidence that it is more deadly or causes more severe infections. Please continue to wear a mask and maintain physical distance whenever you are around people from outside your household, wash your hands, and follow other health precautions.

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Ingham County Now Vaccinating Seniors 65 and Up

On Wednesday, the Ingham County Health Department announced that they would begin vaccinating seniors aged 65 to 69. While those individuals are part of Phase 1B of the vaccine rollout (which ICHD is currently in), the department had been including only seniors 70 and up previously, in order to focus on those most vulnerable. The current groups of people living or working in Ingham County are currently eligible to receive a vaccine:

  • Law enforcement

  • Firefighters

  • Shelter workers

  • Corrections workers

  • Pre-kindergarten through high school teachers, support staff who usually have direct contact with children

  • Child care workers who usually have direct contact with children

  • People age 65 and up

To sign up for a vaccine in Ingham County, complete this form or call 517-887-4623 for assistance.

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Michigan Deputy Fired After Arresting Black Man Who Had Not Committed A Crime

A Calhoun County sheriff's deputy has been fired for arresting a Black man, La'Ron Marshall, in Springfield (just west of Battle Creek) who was collecting signatures to start a neighborhood tenant's association. On January 2nd, two deputies were sent out after receiving a call from a neighbor concerned about a suspicious person that they believed might be soliciting. Video of the incident shows deputies immediately telling Marshall to put his hands behind his head. He asked why he was being arrested, and after being told it was for soliciting, he explained that he was collecting signatures for a neighborhood association. A deputy then demanded his ID, and arrested him after he refused. It is not illegal to refuse to provide ID to law enforcement in Michigan unless they have reasonable suspicion that a crime has been committed. Video also shows that the deputies refused to provide their badge numbers to a witness. Both deputies were maskless during the incident.

All charges have been dropped against Marshall and on January 22nd, the Sheriff announced that one of the deputies was terminated, but their name was not released. No action has been reported to have been taken against other deputy. A statement from the Sheriff said that "We hold ourselves to high standards of professionalism to the communities we protect. When we are right, we are right. When we are wrong, we admit we are wrong. On January 2, we were wrong." "Transparency and honesty to our community is the foundation to all of our success. The conduct and actions of this case, in which Mr. Marshall was collecting signatures, does not represent our commitment to our community. The actions that Mr. Marshall took that day of circulating a petition are protected by our constitution. While some ordinances in communities, even within Calhoun County, prohibit vendors from selling items without a permit, no law — local, state or federal — prohibited Mr. Marshall from exercising his constitutional rights on January 2." The department is reportedly reviewing their procedures and training in light of the incident.

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Pfizer Expects to Deliver Vaccine Doses Ahead of Schedule

In a recent announcement, the CEO of Pfizer announced that the company will be able to supply the U.S. with 200 million COVID-19 doses by the end of May, almost 2 months sooner than initial estimates. This news comes largely due to a change in the vaccine’s label. The change allows healthcare workers to extract an extra dose from each vial of the Pfizer vaccine, giving up to 6 doses per vial. So far, a total of around 50 million Pfizer and Moderna vaccine doses have been delivered in the U.S., with about 30 million doses administered, per the CDC.

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COVID-19 Outbreak in Michigan State Prison

Earlier this month, a state prison in Michigan located in Tittabawassee Township (between Saginaw and Midland), was reported to be in “outbreak status” of COVID-19 with 774 of the 1,387 inmates testing positive as of January 11, 2021. So far, 123 inmates have died of COVID-19 in Michigan. Prisons have continually been in the news as locations for extensive spread of COVID-19. According to the Marshall Project, 1 in 5 prisoners in the United States has had COVID-19, and Michigan is among the worst states in the nation, with 1 in 2 prisoners having been infected. For those in close quarters and poor prison living conditions, as well as limited access to healthcare, COVID-19 has been deadly. Many in public health and in health care have pushed for low-risk prisoners to be released due to the incredible risk COVID-19 poses for this vulnerable population, and while some cities have released prisoners who were there for minor offenses, many are still at risk of dying. Prisoners are people, and prison sentences are not death sentences.

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WHO Updates Recommendations on COVID-19 Vaccination for Pregnant People

This past Friday, the World Health Organization (WHO) amended their recommendations regarding COVID-19 vaccinations for those who are pregnant. Earlier in the week, the WHO had stated that they did not recommend the vaccination for those who are pregnant unless they are also in a high risk category such as healthcare workers. In addition to a lot of concern and criticism from the public health and scientific community, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) put out a statement against that language, stating that they “firmly assert that pregnant individuals should be given the opportunity to make their own decision as to whether to receive the COVID-19 vaccine and that barriers should not be put in place to prevent access and hinder the ability of pregnant people to protect themselves from a virus that could potentially be life-threatening.” Friday’s change led to the WHO amending that language, announcing that “Based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.” They also acknowledge that data is limited for those who are pregnant but they have removed language explicitly stating that they did not recommend the vaccine. Their current recommendation now aligns with the CDC.

Language around vaccine recommendations is crucial, and such inconsistencies have already and will continue to cause confusion and raise more questions. If you have any or would like clarification, please feel free to reach out to us!

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Preliminary Data Suggest Pfizer, Moderna Vaccines Effective Against New Variants

In a recent announcement, Moderna stated that their vaccine was effective against the U.K. and South Africa variants of the virus that causes COVID-19. Moderna, however, is still continuing to research this while pursuing research in a booster vaccine that will hopefully provide additional protection.

An early report also stated that the Pfizer vaccine was effective against the U.K. variant, although antibodies produced by the Pfizer vaccine were slightly less effective against the South Africa variant.

While there is still a lot of research needed in seeing how effective available vaccines will be against these new variants, proactive measures are also being undertaken to determine whether a booster or other methods will be able to cover these variants and potential future variants of the virus that causes COVID-19.

More information:

New Johnson & Johnson Vaccine Data

Johnson & Johnson also announced preliminary Phase III clinical trial data analysis results this past week. The preliminary results showed that their single-dose COVID-19 vaccine showed an efficacy rate of around 66%, with U.S. data showing 72% efficacy, 66% efficacy in Latin America, and 57% efficacy in South Africa. In addition, 95% of the infections in clinical trial participants in South Africa were attributed to the new variant of the virus causing COVID-19. The vaccine data also showed an 85% efficacy rate in preventing severe disease. The study data included more than 44,000 participants in 8 countries around the world.

The COVID-19 vaccine being developed by Johnson & Johnson is unique compared to Pfizer, Moderna, and Novavax vaccines in that it only requires a single dose, while the others require two doses. While efficacy so far is lower than the other vaccines, the logistical barriers are far less for a single dose. In addition, the company has announced that they will continue to study a 2-dose regimen for more protection.

The Johnson & Johnson vaccine contains DNA which our body’s cells will convert to mRNA. The mRNA is then used by our bodies to create the spike protein that mimics the spike protein of the virus that causes COVID-19. The DNA made is delivered to our cells through a modified adenovirus, providing a “shell” and essentially a delivery system so that the synthetic DNA is delivered to our cells. In addition, the adenovirus “shell” provides stability and allows the vaccine to be stored at normal refrigeration temperatures for up to 3 months.

Ultimately, more vaccine options will greatly help the lack of vaccination supply currently occurring. The opportunity to provide more methods of protection from COVID-19 are all causes for celebration and important steps to ending the pandemic. In addition, however, it is crucial that while so much more data is needed, we must continue to protect ourselves and each other by washing our hands properly, wearing masks (even doubling up on them), socially distancing, and continuing to follow public health guidance.

More information:

New Novavax Vaccine Data

Novavax, one of the companies supported by Operation Warp Speed in developing a COVID-19 vaccine, reported this past Thursday that its vaccine was 89.3% effective in preliminary analysis of its U.K. Phase III clinical trial data. This portion of the study enrolled more than 15,000 participants between the ages of 18-84, with 27% of participants over the age of 65.

Preliminary analysis of trial data out of South Africa, however, shows the vaccine at around 49.4% efficacy against the new variant of the virus that causes COVID-19 first discovered there. The South Africa sample was much smaller, at only around 4,400 participants, and included both HIV-positive and HIV-negative participants. Novavax has been one of the first in COVID-19 vaccines in development to present data on the efficacy of their vaccine on one of the new variants of the virus and states that it will begin studies in a new vaccine tailored for the variants.

Novavax is conducting its COVID-19 vaccine research in the U.K., South Africa, Mexico, and the U.S. Its vaccine is different from the Pfizer and Moderna vaccines which are mRNA-based. Both the Pfizer and Moderna vaccines provide the “blueprint” for the spike protein, the protein found on the outside of the virus that causes COVID-19. This protein is a key component of the virus that allows it to attach and infect cells in our body. The “blueprint” then allows our own bodies to make just the spike protein, which our bodies then recognizes, mounts an immune reaction to, and learns to recognize for potential future exposure. In contrast, Novavax’s vaccine contains copies of the spike protein itself. These copies are made in insect cells, harvested, and assembled into nanoparticles which are then delivered in a vaccine. None of these vaccines contain any actual virus, only components of the virus made synthetically or by our own bodies.

More information:

CDC Unsure of Available Vaccine Doses

While this is good news, there are still many issues with logistics and distribution of COVID-19 vaccines. In particular, Dr. Rochelle Walensky, the newly selected director of the CDC, stated that the federal government is not sure how much vaccine they actually have. The CDC tracks how many doses have been delivered and administered, but it is unknown exactly how many doses are available in total. This is important information, especially since without knowing how much vaccine is available, it is almost impossible to plan and tell states and public health departments how much vaccine they will receive. Without that information, it is difficult to plan access and availability to the vaccine ahead of time.

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Falsely Linking Deaths to COVID-19 Vaccine

Hank Aaron, considered one of the greatest players in baseball history, passed away last Friday, January 22nd. Earlier this month, Aaron received the COVID-19 vaccine and tweeted about it. Public health officials have been asking prominent community figures such as Aaron to share their stories to help build trust and increase vaccination rates. Unfortunately, the timing of Aaron’s death resulted in skeptics blaming the vaccination and timing to say that COVID-19 vaccines are dangerous. There is no evidence that the vaccine played a role in Aaron’s death. So far, almost 30 million people have received at least one dose of either the Pfizer and Moderna vaccine in the US. Out of any group of 30 million people, thousands will die for unrelated reasons - the vaccine protects against COVID-19, not heard disease, cancer, car accidents, etc. Yet the timing of events will allow opportunistic vaccine skeptics to use that information as leverage and dissuade folks from getting the vaccine. The data currently suggest the vaccine is safe, especially compared to the chance of death from COVID-19. Folks may have concerns and questions, yet it is important not to jump to conclusions as we learn more about the events that happened.

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NAACP Statement on Biden’s Anti-Racism Orders

NAACP President and CEO Derrick Johnson released the following statement regarding President Biden's Executive Orders and Memorandums directed at racism on Tuesday:

"The NAACP is very encouraged by the executive actions taken by President Biden today. It is refreshing to finally hear a President acknowledge white supremacy in their inaugural speech, and follow that with concrete actions less than a week later. President Biden's whole-of-government approach for racial equity, embedded within the Domestic Policy Council lead by Susan Rice, is a very good first step. However, Executive Orders are only as strong as the current President and can be reversed by future administrations. So we must continue to urge Congress to pass laws that ensure racial equity for all people in this country and codify it to prevent future Presidents from reversing these critical measures. We look forward to working with the Biden-Harris administration as we continue to address the systemic racism that has plagued our communities for centuries."

Source

Study Finds Troubling Patterns in Police Shootings of Black People

An NPR investigation found that since 2015, police have fatally shot at least 135 unarmed Black people in the U.S., and at least 75% of those officers were White.

Other findings regarding the officers who were involved in those deadly shootings:

  • "At least six officers had troubled pasts before being hired onto police departments, including drug use and domestic violence. One officer had been fired from another law enforcement agency, and at least two others were forced out."

  • "Several officers were convicted of crimes while on the force, such as battery, and resisting and obstructing, but kept their jobs. In one instance, officials in a tiny Louisiana parish repeatedly fired and rehired a deputy who got into trouble with the law: three times over 30 years, records show."

  • "More than two dozen officers have racked up citizen complaints or use-of-force incidents. A Fort Lauderdale, Fla., police officer had 82 reviews over use-of-force incidents but was never found in violation; a Vineland, N.J., officer had more than three dozen use-of-force incidents over a five-year period."

  • "Several officers have violated their department policies and been cited for ethics violations, including a Hollywood, Fla., officer accused of trying to steer business to his company, and an Arizona state trooper accused of misuse of state property."

Other findings:

    • "The killings have led to at least 30 judgments and settlements totaling more than $142 million, records show. Dozens of lawsuits and claims are pending."

    • "More than a quarter of the killings occurred during traffic stops, and 24 of the dead — 18% — suffered from mental illness. "

    • "Nearly 60% of the shootings occurred in the South, with more than a quarter in Texas, Georgia and Louisiana."

Source:

MSU Issues Enhanced Physical Distance Directive for Students

On Saturday, MSU issued an enhanced physical distance directive that will remain in effect through February 13th. The move was made due to the "rapid increase in COVID-19 positivity rates since students returned to the East Lansing area for the spring semester" and because some students were failing to adhere to existing guidelines. Per the directive, students on campus or within the East Lansing area "should not gather with others — on campus or off." Dining halls will be open only for takeout and mobile orders and exercise facilities (IM West and IM East) will be closed.

Per MSU Live On, students living on campus are not permitted to leave their residence except for:

  • Picking up meals from a dining location.

  • Attending an in-person class.

  • Conducting research or going to work.

  • Providing a sample for the COVID-19 Early Detection Program.

  • Receiving medical care.

  • Participating in distanced outdoor physical exercise for two people or fewer.

  • Accessing secure internet.

"Additionally, you may not have any visitors in your residence hall room, gather in groups in lounges or dine together — this includes suitemates, 'pod mates' or 'bubble mates.' You also must continue to follow the MSU Community Compact, which includes completing a daily health screening form and participating in the COVID-19 Early Detection Program."

“Failure to comply with this directive may result in your removal from on-campus housing without refund and/or suspension or expulsion from the university."

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

  • Kryssia Campos (she/her/hers), Second-year medical student.

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

  • Mauricio Franco (he/him/his), M.S.-Global Medicine, Fourth-year medical student

  • Daniel Pfau (they/them/theirs), Neuroscience PhD, Biological Sciences MS, Homeschool Teacher.

  • 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

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