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June 21, 2020: Roundup & Myth Busting 

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Table of Contents

Intro and Disclaimer
Michigan’s COVID-19 Success May Be Undone By Lax Citizen Response
Governor Whitmer extends protections to Michigan migrant and seasonal farm workers
Use of Hydroxychloroquine and Chloroquine in the treatment of COVID-19 are no longer supported by the FDA
Coronavirus economy affecting trans and nonbinary community, especially BIPOC
Response to Less-Lethal Weaponry and Rubber Bullets
False-Negatives in Testing
Pet Update
Questions to consider when looking over Public Health Data on Demographics and Health Outcomes
QM Public Health Crisis Round-Up Team (in no particular order):

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’s COVID-19 Success May Be Undone By Lax Citizen Response

Governor Whitmer is being praised for having saved tens of thousands of lives in the state from COVID-19 and some recent news reports touted Michigan as the only state with a 50% decrease in new cases. That success is at risk of being undone, however, as many Michiganders are returning to pre-COVID behavior patterns. The lifting of the stay-at-home order and the reopening of businesses was done with the understanding that it would only be safe to do if people wore masks, maintained physical distance from others, and followed other health and safety protocols (washing hands frequently, sanitizing surfaces, etc). Unfortunately, people have increasingly ignored those rules, and cases are on the rise once again. It is critical that people take COVID-19 seriously and follow precautions like wearing a mask when in public, or we may have a second spike in cases and find ourselves under a second stay-at-home order (and become a case study in how not to handle a pandemic).

Free COVID-19 testing is available in Lansing and throughout Michigan:
https://www.michigan.gov/coronavirus/0,9753,7-406-99891_99912-530161--,00.html

More information:

  • https://www.detroitnews.com/story/news/local/detroit-city/2020/06/12/study-whitmer-stay-home-orders-saved-perhaps-tens-thousands-lives/5342143002/

  • https://time.com/5852913/covid-second-wave/

  • https://www.clickondetroit.com/news/michigan/2020/06/19/coronavirus-in-michigan-heres-what-to-know-june-19-2020/ 

  • https://www.mlive.com/public-interest/2020/06/michigan-reports-211-new-coronavirus-cases-five-new-deaths.html 

Governor Whitmer extends protections to Michigan migrant and seasonal farm workers 

Governor Whitmer ordered increased protections for migrant farm workers earlier this month (June 1), as reports of COVID-19 outbreaks have been reported in food processing facilities and migrant farm worker camps nationwide. Michigan produces about $1.4 billion in fruits and vegetables annually, and the estimated 45,000 migrant farm workers, many of whom are of LatinX heritage, make a tremendous contribution to harvest this food each year. It is estimated that 25% of migrant farm workers have family income below the poverty line, putting these individuals at a higher risk of being priced out of affordable and accessible routine healthcare maintenance, which may predisposeexpose them to acquiring underlying conditions that carry a higher risk of acquiring COVID-19. Moreover, migrant farm workers’ essential worker status means less isolation, compared with other workers who can work from their home. Local to the Lansing area, Cristo Rey Community Center is an organization that is recognized as a supportive resource for migrant and seasonal farmworkers by the Michigan government. More information on their services, and opportunities for donation, can be found at https://www.cristoreycommunity.org.

More information: 

    • https://www.politico.com/news/2020/06/09/farm-workers-coronavirus-309897

    • http://nfwm.org/farm-workers/farm-worker-issues/low-wages/

    • https://healthpolicy.usc.edu/evidence-base/individuals-with-low-incomes-less-education-report-higher-perceived-financial-health-threats-from-covid-19/

    • https://www.michigan.gov/documents/FIA-MigServ_HealthProv_11652_7.pdf

    • Executive Order 2020-0111: Protecting the Food Supply and Migrant and Seasonal Agricultural Workers from the effects of COVID-19:
      https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-530679--,00.html 

    • https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html

Use of Hydroxychloroquine and Chloroquine in the treatment of COVID-19 are no longer supported by the FDA 

Newest updates: 

On June 15, 2020, The Food and Drug Administration (FDA) withdrew the Emergency Use Authorization (EUA) for hydroxychloroquinehydrochloroquine and chloroquine in the treatment of COVID-19 due to safety concerns. Despite Donald Trump’s statements, the FDA analysis of available data on the use of hydroxychloroquinehydrochlorquine and chloroquine for COVID-19 demonstrated that the risks of their use on a patient's health outweighs their potential benefits. This update from the FDA does not revoke their use in treating other medical conditions like Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE).

It can feel confusing to read and watch as elected officials and medical/scientific leaders release statements that contradict one another. We encourage our Queering Medicne community to continue to ask the following questions as you receive news from various sources: 

    1. Where is the data coming from? 

    2. Is this from a reputable source? 

    3. Are there direct links to the sources? 

More data will continue to become available on the virus and COVID-19 as researchers collect and analyze more data; asking these questions can help guide your understanding. 

Sources:

  • Article from The Hill:
    https://thehill.com/policy/healthcare/502748-fda-withdraws-emergency-use-authorization-for-hydroxychloroquine 

  • U.S. Nationl Library of Medicine Medicine:
    https://clinicaltrials.gov/ct2/results?cond=COVID-19

  • Frequently Asked Questions on the FDA revocation of EUA:
    https://www.fda.gov/media/138946/download

Coronavirus economy affecting trans and nonbinary community, especially BIPOC

As the economic impact of the pandemic continues to develop, it is becoming increasingly clear that marginalized communities, including BIPOC, trans, and nonbinary folx—especially those at the intersection of multiple marginalized identities—are disproportionally affected. Prior to the pandemic, BIPOC (Black, Indigenous, and People of Color) trans and nonbinary folx were already especially vulnerable to discrimination, job insecurity, and limited or no access to health care. According to the National Center for Transgender Equality’s 2015 U.S. Transgender Survey, transgender people of color are four times more likely to be unemployed and three times more likely to experience poverty.  

However, the full magnitude of the challenges faced by the trans and nonbinary community during this time are unknown because most states and the federal government have not been recording sexual orientation or gender identity in pandemic statistics. Thus, local and national LGBTQIA+ organizations have been identifying and speaking out against disparities. According to a New York Times interview with Elena Rose Vera, Trans Lifeline’s executive director, the peer support and crisis hotline has received four to five times more calls about unemployment and workplace discrimination during the pandemic. Additionally, requests for support with domestic violence and health care concerns have increased 300 percent, with difficulty accessing treatments and medications being significant factors. 

Of those in the trans and nonbinary community who are still employed during the pandemic, many are in jobs that cannot accommodate social distancing. This increases their risk for infection and is compounded by challenges accessing and paying for healthcare if they get sick.

Helpful Links:

  • https://www.nytimes.com/2020/06/16/us/coronovirus-covid-transgender-lgbtq-jobs.html

  • https://www.washingtonblade.com/2020/04/01/states-wont-collect-lgbtq-data-on-covid-19-and-advocates-arent-happy/

  • https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

Response to Less-Lethal Weaponry and Rubber Bullets

With regards to information posted last week, there doesn’t seem to be a consensus on how rubber bullets should be properly used (i.e., bounced off the ground or fired directly at extremities) other than being used as “less lethal” weaponry, distributing impact over a larger area on impact.

In response to rubber bullets being used against protestors and how they should be used, Queering Medicine would like to emphasize that we do not believe rubber bullets and other less-lethal projectile weaponry or gases should ever be used, especially in crowded situations such as in protests. Under such situations, rubber bullets are not safe to be used at all, even when they are fired only at extremities or if they are skip-fired. 

Sources:

  • https://www.nationalgeographic.com/science/2020/06/what-nonlethal-weapons-can-do-to-the-body-george-floyd/

  • https://www.themarshallproject.org/2015/09/23/alternatives-to-bullets

  • https://www.inverse.com/mind-body/rubber-bullets-cannot-be-used-safely

False-Negatives in Testing

Covid-19 should not be ruled out based on a negative result of a reverse transcriptase-polymerase chain reaction (RT-PCR) test. A recent pooled analysis from seven published articles found that the false-negative rate for Covid-19 RT-PCR testing is highly variable. The researchers found that the probability of obtaining a false-negative result is highest during the first five days after exposure (up to 67% on the first day after exposure) and lowest on day eight after exposure (21%) Furthermore, the false-negative rate began to increase again after day nine after exposure. 

Given this variability and the high rate of a false-negative test, a negative result should be taken with caution, and the full clinical history of the patient should be considered. 

Source:

  • https://www.acc.org/latest-in-cardiology/journal-scans/2020/05/18/13/42/variation-in-false-negative-rate-of-reverse

Pet Update

Dog Infected with COVID-19

At the beginning of June, a German Shepherd dog tested positive for COVID-19. This was the first and only case of a dog testing positive in the US. Symptoms were mild and so far, evidence suggests that dogs do not experience COVID-19 severely. Internationally, there have been reports of other dogs testing positive for COVID-19, as well as other pets such as cats.

As of now, there is still no evidence that pets can transmit COVID-19 to people, however in laboratory tests, pets were found to be able to transmit COVID-19 to other pets, and there is some evidence that people can transmit COVID-19 to their pets. Below are some takeaway points and guidance by the CDC:

If your pet tests positive for COVID-19:

  • Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or any other products not approved for animal use.

  • Only a few pets have been confirmed to be infected with the virus that causes COVID-19. Some pets did not show any signs of illness, but those pets that did get sick all had mild disease that could be taken care of at home. None have died from the infection.

  • If you think your pet has COVID-19, call a veterinarian first to discuss what you should do.

  • Pets with confirmed infection with the virus that causes COVID-19 should be restricted to isolation in the home until a veterinarian or public health official has determined that they can be around other pets and people.

In addition, general guidelines remain the same and can be seen here:
https://www.queeringmedicine.com/public-health-updates/weekly-round-upmythbusting/may-10-roundup#h.dp42npkyzea6

Dogs Sniffing COVID-19

There have also been reports of scientists studying to see whether specially trained dogs can tell whether someone is infected with COVID-19 based on smell! Studies are ongoing, and it is possible that if dogs can sniff out COVID-19, that they can aid in providing vital “testing” services. An article from Cornell stated that dogs could possibly detect that a person had the virus 4-5 days before they showed any signs or symptoms!

Sources:

  • COVID-19 and Pets
    https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/pets.html

  • If You Have a COVID-19 Positive Pet, CDC Guidelines
    https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/positive-pet.html

  • Dog Tests Positive
    https://www.buzzfeednews.com/article/danvergano/coronavirus-dog-us-first

  • Testing to See if Dogs Can Sniff COVID-19:
    https://allianceforscience.cornell.edu/blog/2020/05/dogs-sniff-covid19/?fbclid=IwAR0rWsk1iBkYqDv6TeHdvdLAUIvnbgrH1hAtHUyp9UduXWTiADuqKzEvFSU

Questions to consider when looking over Public Health Data on Demographics and Health Outcomes 

Demographics are often helpful in understanding public health issues like health disparities. Without context, sharing disaggregated data on groups of people can lead folks to make assumptions and believe stereotypes about certain communities. COVID-19 data at the ZIP Code level is becoming more available. As we digest and navigate this information we need to think upstream and understand the root cause of these health outcomes.  It is critical to understand the systems of oppression that contribute to comorbidities like diabetes, hypertension, and cardiovascular disease leading to worse COVID-19 outcomes, and the factors that result in people who work “essential” jobs or who have less health protections at work being more likely to be minorities and more likely to live near each other. 

Things to ask when reviewing public health data: 

    • Why is this area code having worse outcomes? 

    • What is the historical context (history of systemic oppression) in these communities?

    • What access do these groups of people have to the continuity of care?

      1. Continuity of care refers to the quality of care a person has over time. It is often used when discussing barriers to accessing quality care and being followd by the same medical team.  

    • What access do these groups of people have to stable housing, job stability, and food security?

    • Have public health/government officials invested in these communities? 

    • What is needed to support better health outcomes?

Sources: 

  • https://time.com/5608268/zip-code-health/

  • https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm

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

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