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!
Michigan Starting to Re-Close Due to COVID-19
On Wednesday, Governor Whitmer announced that indoor seating and service at bars in Michigan, with the exception of those in the UP and Northern LP, will be closed due to the increasing number of COVID-19 cases, many of which have been tied to bars (the outbreak from Harper's in East Lansing now includes over 150 people in 15 counties). The order applies to establishments with more than 70% of receipts coming from alcohol sales. Outdoor seating can remain open, and the Governor signed orders to allow bars to sell "cocktails-to-go."
Plans to continue reopening Michigan have been halted. The Governor had planned to move most of the state into Phase 5 (reopening more businesses and loosening more restrictions) this weekend, but the rise in cases has taken that off the table. If the rise in cases continues, retail establishments and restaurants may be ordered to close again.
It's important to understand that the restrictions are necessary to save lives and protect the health of all Michigan residents, and that Black people and other people of color, as well as trans folks and other marginalized groups (and the intersections between them) are at increased risk of getting sick and dying of COVID-19.
The rise in cases has been primarily attributed to people around the state socializing, going to restaurants and bars, going shopping, and going to work while not wearing masks or maintaining enough physical distance from others. The rise has not been connected to protests (places with large Black Lives Matter protests occurring every day are not seeing a significant rise in cases, while places that have reopened restaurants and retail establishments are). The message is clear: Do not stop wearing a mask. Do not get closer than six feet from people you don't live with. No, it’s not fun to wear a mask or maintain physical distance when hanging out with your friends or shopping, but it’s critical to protect the lives of everyone in your community.
“Michigan Executive Order 2020-143: Closing indoor service at bars”:
"Gov. Gretchen Whitmer closes Michigan indoor bar service, except for Up North" - Detroit Free Press:
"As coronavirus cases rise, Whitmer halts plans to further reopen Michigan" - Bridge Magazine:
"Coronavirus cases tied to East Lansing bar climbs to 158 in 15 Michigan counties" - Detroit Free Press:
States Shatter COVID-19 Records
Across the US, there were a total of over 56,000 new cases of COVID-19 reported on July 3, 2020 alone, the highest daily count for this pandemic. Daily cases have continued to rise as states have begun to reopen, and the number of cases is not just due to increased testing.
Clearly, the pandemic is not over, nor were we in a place to reopen. States such as Florida and Texas have halted or reversed their reopening plans as cases continue to surge, and implemented new restrictions or measures, such as mask-wearing mandates.
There has been a clear theme across various news sites and reports: The virus is not in control, and if measures are not taken or reinstated, it will be uncontrollable. According to interviews with top officials from the CDC, certain effective measures such as contact tracing and isolation are only effective and practical if there are enough resources, but “we have way too much virus across the country right now” to be able to effectively contact-trace, isolate contacts, and quarantine accordingly.
What we know can help curb the spread of this virus continues to be measures such as social distancing, washing your hands, and wearing a mask.
States Shatter Coronavirus Records As Officials Eye Holiday Weekend With Alarm: https://www.npr.org/sections/coronavirus-live-updates/2020/07/04/887286322/states-shatter-coronavirus-records-as-officials-eye-holiday-weekend-with-alarm
CDC says U.S. has ‘way too much virus’ to control pandemic as cases surge across country" https://www.cnbc.com/2020/06/29/cdc-says-us-has-way-too-much-virus-to-control-pandemic-as-cases-surge-across-country.html
'Window is closing' for US to get coronavirus under control, Trump's HHS secretary warns" https://www.cnn.com/2020/06/28/politics/hhs-alex-azar-coronavirus-rise-in-cases-cnntv/index.html
"Fauci: COVID-19 cases could swell to 100,000 a day if U.S. doesn't control virus" https://www.nbcnews.com/health/health-news/fauci-covid-19-cases-could-swell-100-000-day-if-n1232526
Recently, there have been reports around the country of people trying to enter businesses without a mask, claiming that they are exempt due to the Americans with Disabilities Act (ADA) and threatening legal action if not allowed in. In some cases, they have cards from groups like the “Freedom to Breathe Agency” (which is not a government organization) that carry the seal of the U.S. Department of Justice (DOJ). The DOJ quickly responded and released an official statement saying that those cards are fraudulent.
There are a variety of disabilities that may make it dangerous or impossible for a person to wear a mask (e.g., cerebral palsy, PTSD, COPD, cystic fibrosis, autism, quadriplegia, etc.), and the ADA requires that "reasonable accommodations" be made for those individuals. Reasonable modifications to a face mask policy could include allowing a different type of face covering (like a full face shield or a scarf), offering curb-side pickup, or offering phone- or internet-based services. Businesses offering these types of alternatives to customers are likely in compliance with the ADA.
Public accommodations are not required under certain circumstances.
One exemption is when an accommodation would create a "direct threat to the health or safety of others." In the context of a pandemic that is spread by breathing, talking, and coughing, allowing someone to be indoors near other people without a face covering likely falls under that exemption, as COVID-19 presents a direct threat to the health and safety of other people present.
Another exemption is anything that would fundamentally alter the nature of a business. For example, a store that does not offer any delivery services is not required to make deliveries to accommodate individuals with disabilities.
Exemptions are also provided for accommodations that would create an undue burden. For example, a small, independently owned store may not be required to make accommodations that are costly enough to put them out of business.
The reasonableness of any accommodation is dependent on a variety of factors (for example, governments are subject to different rules than businesses, and a business has different obligations to employees and customers) and every situation is unique. When in doubt, check with an expert on ADA accommodations and the law. In general, however, the ADA cannot be treated as fully exempting people from wearing a mask during a pandemic. Note that that doesn't mean that everyone has to wear a mask - there are legitimate medical reasons that some people cannot do so - but instead, that individuals who cannot wear a mask may not be able to participate in all activities in the same ways that people who can wear a mask are able to do so right now.
"Face Mask Exemption ID Cards Are Going Viral and the Department of Justice Says They're Fake" - Time Magazine
“COVID-19 ALERT: Fraudulent Face Mask Flyers” - U.S. Department of Justice
"Disability Issues Brief: The ADA and Face Mask Policies" - Southeast ADA Center and Burton Blatt Institute (BBI) at Syracuse University
“Current ADA Regulations” - U.S. Department of Justice
Wearing a Medical Mask Doesn’t Cause Oxygen Deficiency or CO2 Intoxication
The prolonged use of medical masks* when properly worn, DOES NOT cause CO2 intoxication nor oxygen deficiency
The prolonged use of medical masks can be uncomfortable. However, it does not lead to CO2 intoxication nor oxygen deficiency. While wearing a medical mask, make sure it fits properly and that it is tight enough to allow you to breathe normally. Do not re-use a disposable mask and always change it as soon as it gets damp.
* Medical masks (also known as surgical masks) are flat or pleated; they are affixed to the head with straps or have ear loops.
Masks Should Not Be Worn When Exercising
Can people wear masks while exercising?
People should NOT wear masks when exercising as masks may reduce the ability to breathe comfortably.
Sweat can make the mask become wet more quickly which makes it difficult to breathe and promotes the growth of microorganisms. The important preventive measure during exercise is to maintain physical distance of at least one meter from others.
BLM: How to Defund the Police
Black Lives Matter has released a simple explanation of how we defund the police:
First. Demand that lawmakers support reparations for all families of those killed and survivors of police violence.
Second. Demand that every State, city and municipality spend LESS on law enforcement and incarceration. Period.
Finally. Demand investment into Black communities. It is not enough to defund the police, we need to put in place systems to uplift and protect Black communities.
That means divesting from police in schools and investing in teachers & counselors.
That means divesting from criminalizing mental health and investing in mental health & restorative services.
That means divesting from military weapons against citizens and investing in community-led harm reduction.
Social Media Links:
Academic Medicine and Black Lives Matter: Time for Deep Listening
Now more than ever, it is critical that we hold the institutions that train our future healthcare professionals accountable for the mission statements, vision statements, and promotion of diversity and equity that they make to their students. The answers on how to make these changes and address oppression are not always clear; however, this cannot continue to prevent leadership from making the effort to change the future of medicine and healthcare. The effort to impact public health and eliminate health disparity must include the education of medical professionals.
The article asks readers, and those in the medical field to critically think about the following truisms
Racism is present in academic medicine.
Academic medical centers exercise an outsized influence in the practice of medicine...there is a responsibility to provide not only the biology but also the sociology of medicine.
What works is simply not clear….precisely because of the paucity of data that academic medicine must be responsive.
Leadership matters. Culture change, especially of this magnitude, is a top-down process.
“Nothing will change in the practice of medicine if that change is not initiated, promulgated, and sustained by academic medicine and championed by the leaders of academic medicine. A new rumble needs to be heard in the alcoves of academic medicine,” according to Dr. Clyde Yancy, MD.
Where to Get a COVID-19 Test in Michigan
The Michigan.gov website has a new page that helps residents of Michigan find a testing location by entering their ZIP Code. Search results can be filtered to show tests with no cost, tests for people without symptoms, tests that don’t require a doctor’s order, and tests for underinsured people.
Sites that do not require insurance and do not charge individuals
Sites that do ask for insurance, but cover any copays not covered by insurance
Tests people without symptoms (asymptomatic)
Sites that test individuals even if they don’t have symptoms of COVID-19
No doctor’s order needed
Sites that do not require an individual to bring a doctor’s order to the site, test can be ordered on-site
Tests uninsured individuals
Sites that test individuals who do not have insurance
You can also call the Michigan coronavirus hotline at 1-888-535-6136
Current COVID-19 Testing Criteria
Taken directly from https://www.michigan.gov/coronavirus/
New criteria includes asymptomatic patients who are preparing for surgery if testing is deemed necessary by the treating health professional.
It also includes asymptomatic people who have known exposure to someone who has COVID-19 or symptoms, or who work in a profession that puts them at high risk of exposure due to close contact with the public, such as dental technicians, or to COVID-19 outbreaks in certain industries like at food processing facilities.
MDHHS COVID-19 test prioritization criteria is now as follows:
Hospitalized patients with symptoms.
Any health care worker, first responder, or congregate care facility worker with symptoms.
Residents in any congregate care facility, including prisons and shelters, with symptoms.
Persons with symptoms of potential COVID-19 infection, including:
Shortness of breath.
New loss of taste or smell.
Vomiting or diarrhea.
Asymptomatic patients in preparation for surgical procedures, as deemed necessary by the treating clinician.
Asymptomatic people with known exposure to a person with COVID-19 or exposure to a person with COVID-19 symptoms.
Asymptomatic people living or working in a congregate care facility or other high-risk setting (such as nursing home, jail, prison, homeless shelter, assisted living facility, etc.) that:
Had a confirmed case among residents or workers.
Is located in a region of medium risk or higher, or
Is receiving patients from an area of medium risk or higher.
Asymptomatic people who work in a profession that puts them at high risk of exposure, including:
Repeated close contact of prolonged duration with the public.
Working in a high-risk profession where clusters of infections have been identified (such as migrant workers, food processing facilities, etc.).
Working in-person during a period of strict social distancing or, in areas with some sectors re-opening, having worked in-person during the period of strict social distancing.
Persons identified by clinicians or public health officials who can be tested for public health monitoring research purposes.
People without symptoms who live in communities where there has been inequitable access to testing and a need to increase the rate of people tested per day—such as areas with higher proportion of racial/ethnic minorities, rural communities.
Persons without symptoms who are prioritized by local health departments or clinicians, for any reason.
Asymptomatic people living or working in a congregate care facility or other high-risk setting (such as a nursing home, jail, prison, homeless shelter, assisted living facility) in any region.
Asymptomatic people leaving their home for work.
Per the FDA’s Drug Shortage website, there is currently a shortage of dexamethasone. This follows the preliminary data and release of a study that the drug decreased deaths of those hospitalized by COVID-19 by one third. Although not all forms of this drug are in shortage, many formulations and dosages of the drug are.
This pattern follows other drug shortages that coincided with drugs that appeared in widely circulating news about COVID-19, whether there was much evidence to support its ability to help COVID-19 patients or not. Shortages can have severe impacts on people who depend on those drugs. For example, many people with rheumatologic or other illnesses depend on hydroxychloroquine on a daily basis, and a shortage of such a drug due to increased demand, especially when there is still no scientific evidence for it to help COVID-19 patients, can greatly impact other people’s lives. Fortunately, hydroxychloroquine, according to the FDA’s website, has had its shortage resolved.
This highlights how increased demand as well as lack of time for the supply chain to meet demand, in addition to interference in production from the virus, all contribute to drug shortages. Demand stimulated by preliminary research can lead to a lack of life-saving drugs to those most in need, and those who take those drugs for other reasons than it has proven to be useful for can be hurting themselves. Before considering taking these drugs, please ask your doctor to see whether it is appropriate for you.
Dexamethasone Study Statement, University of Oxford:
FDA Drug Shortage Site:
Queering Medicine Is Still Collecting Masks
We recognize that not everyone we see without a mask is against their use or is medically unable to wear one. It is critical that we take a moment when we see folks without masks and consider the fact that they may not be able to afford one or know where to get one for free.
Access to masks, like access to healthcare services, is a critical barrier we must consider when working to address health equity and health justice during the pandemic. QM will continue to collect unused facemasks to be donated to Queering Medicine community members who need them, and will continue to share donated items with partnering organizations. If you are interested in donating facemasks or other COVID-19 necessities like hand sanitizer or face shields, contact email@example.com for more information.
A big thank you from all of us at Queering Medicine!
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