Michigan Still High-Risk for COVID-19

Michigan continues to be a hot-spot for COVID-19 in the U.S., currently ranking second in 7-day case rate, behind only New Jersey. Michigan also continues to rank second in number of cases of the B.1.1.7 variant (which is more infectious and deadly than the original strain), and more than 16,000 have died in the state from COVID-19. Dr. Fauci called on Michigan to "hold off for a bit" on reopening the state. While schools have been found to be the leading sites for COVID-19 outbreaks in Michigan in recent weeks, there is no single reason for the rise in cases. There are a variety of likely contributing factors, including the reopening of restaurants and other venues, people engaging in more risky behavior due to the increase in vaccinations, students returning to in-person instruction, and the more infectious virus variants.

It is clear that we need to remain vigilant. Wear a mask, maintain physical distance from people outside your household, wash your hands, and get vaccinated as soon as you are eligible.

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Nearly 1/3 of Michigan Adults Have Received At Least One COVID-19 Vaccine Dose

According to the latest data (updated on Friday), 18.1% of Michigan residents age 16 and up have been fully vaccinated against COVID-19 and 31.0% have received at least one dose. Ingham County is currently at about the same rates, with 18.2% fully vaccinated and 31.2% having received at least one dose.

In Ingham County, 66.1% of people age 65 and up have been fully vaccinated and 77.9% have received at least one dose. Statewide, 45.0% of people age 65 and up have been fully vaccinated and 65.2% have received at least one dose.

Statewide, 2,018,521 doses of the Pfizer vaccine have been administered, as have 1,826,453 of the Moderna vaccine, and 74,822 of the Johnson & Johnson vaccine.

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Georgia Enacts Sweeping Voter Suppression Laws; Black Queer Legislator Arrested

Georgia's Governor signed a comprehensive voter suppression bill into law on Thursday. The new restrictions are a reaction by the Republican-led legislature and Republican Governor to Democratic victories in the 2020 elections, with Joe Biden beating Trump in the state and two new Democratic Senators being elected (Jon Ossoff and Raphael Warnock). The new includes a ban on providing water to people waiting in line to vote (the number of polling locations has been significantly reduced in recent years, resulting in hours-long lines to vote in major elections in the state), makes mail-in voting more difficult, allows the state to take over local election boards, and restricts the use of ballot drop boxes. The Governor claimed that the laws are "another step toward ensuring our elections are secure, accessible, and fair," despite all evidence showing that the 2020 election was the most secure and accessible in history. The measures will disproportionately disenfranchise Black voters.

Georgia Police arrested Park Cannon, a Democratic state Representative protesting the changes, for knocking on the Governor's door to request the opportunity to witness the bill's signing. Cannon is an openly queer Black woman (one of the few openly LGBTQ+ lawmakers in the state).

The New Georgia Project (founded by Stacey Abrams), the Black Voters Matter Fund, and Rise, Inc. have already filed a lawsuit against the state over the new laws, which they say violate the 14th Amendment and the Voting Rights Act.

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Washington Sheriff Under Scrutiny After Calling 911 on Black Man Delivering Newspapers

Sedrick Altheimer, a 24-year-old Black man delivering newspapers door-to-door in Pierce, Washington, found himself being followed by an unknown car at 2:00am. The person following turned out to be Sheriff Ed Troyer, who felt Mr. Altheimer was suspicious. The Sheriff became confrontational when Mr. Altheimer sought further clarification as to his intent and motivations for following him. Seeing this questioning as threatening and accusatory, the newly elected Sheriff called 911. Dozens of police cars from multiple agencies responded, placing the young man in serious danger of police brutality. Officers on the scene and dispatch operators noted several discrepancies between their records and Troyers' accounts. At various times, the Sheriff told 911 dispatchers and officers on the scene that Mr. Altheimer had made lethal threats, appeared homeless, was stealing, was controlling his neighbors garage doors, had been trapped in a driveway by the Sheriff, was preventing the Sheriff from returning home, was trespassing, and never actually threatened him.

The same department is facing investigation following the murder of Manuel Ellis approximately one year ago due to deadly use of force by police officers. Sheriff Troyer was acting as the department's spokesperson at the time and provided a narrative to the public that was contradicted by eyewitness accounts and video. Some have called for the Sheriff to resign while others feel he should be charged for providing false information to the police. Both the investigation carried out by the Sheriff's department after this situation and Ellis’s death are under scrutiny. Independent investigations are planned or underway.

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Ingham County Bans Race-Based Hair Discrimination for Public Employees

On Tuesday, the Ingham County Board of Commissioners passed the CROWN (Creating a Respectful and Open World for Natural Hair) Act, which bans race-based hair discrimination for public employees in the county. Race-based hair discrimination is "the denial of employment and educational opportunities because of hair texture or protective hairstyles including braids, locs, twists or bantu knots." Race-based hair discrimination is an often-overlooked form of White supremacy that is used to discriminate against Black people (particularly Black women) by targeting their nature hair texture and common hairstyles as being unacceptable, and treating common White hair textures and hairstyles as the only acceptable options.

According to the Dove CROWN Research Study, Black women are 1.5 times more likely to be sent home from the workplace because of their hair and Black women are 80% more likely than White women to say that they have to change their hair from its natural state to fit in at the office.

Ingham County, home to the State Capitol and to Michigan State University, is the first county in Michigan to pass the CROWN Act. Eight states have passed the CROWN Act, including California, New York, and Virginia, as have a number of cities and counties throughout the country.

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Concerns About Racial Equity in Vaccine Distribution

There have been concerns about the distribution of the Johnson & Johnson (J&J) vaccine to primarily Black and Brown communities in the United States. The data from the J&J trials show that it is 72% effective at preventing COVID-19 infection and 100% effective at preventing death and hospitalization, while Moderna & Pfizer vaccine trial data showed them both being 95% effective at preventing COVId-19 infection. Comparing the data is more difficult than it may seem: The J&J vaccine testing included more cases of the new COVID-19 variants than the Moderna and Pfizer vaccine trials, which all three vaccines are less effective against. Although the data is not head-to-head comparable, the J&J vaccine has been described as a “second-class” shot, based on the lower published efficacy rate. When the J&J vaccine is distributed more widely to Black and Brown communities, this leaves people wondering if this is another example of racism in the medical field. While the J&J vaccine has a lot of positives, such as not needing special low temperature freezers and being only one dose, the depiction of it as not being the best shot is a challenge to overcome in vaccine distribution. While some officials are working to ensure that all vaccines will be distributed equally, more can be done to raise people’s understanding and trust. Public health officials need to acknowledge valid concerns and fears about the vaccine and barriers to receiving any vaccine (including transportation, lack of vaccination sites, difficulty using vaccine registration systems, and lack of information). Government officials need to be transparent about their processes for distributing each vaccine and garner trust with local communities to have the most impact. People want to be vaccinated, so attending to the barriers preventing them from receiving those vaccines or causing them to doubt the efficacy of the vaccines available in their community is crucial to achieving herd immunity. Between lack of pharmacies and healthcare locations providing the vaccines, technology barriers to reserving appointments, and confusing vaccine information, there are challenges in this country to equitably distribute vaccines. Being honest, transparent and intentional with how and why vaccines are being rolled out and listening to community concerns will help to overcome some of the challenges and hopefully improve trust.

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Medical Racism Is More Than Just the Tuskegee Study

The Tuskegee study, a U.S. government-funded study that ran from 1932-1972 which recruited Black men with syphilis but withheld treatment for the disease when it became available, has often been said to be the main cause of mistrust of the medical field by Black individuals. The project is still being used today as a reason to explain vaccine hesitancy in the Black, but studies have shown that while Black individuals are twice as likely to be hesitant to participate in medical studies, they are no more likely to refuse to participate. Continuing to cite the Tuskegee study as the cause of mistrust impedes the ability to see how current racism and access issues are the main reasons for mistrust. Additionally, hesitancy and mistrust is more likely to stem from a person’s lived experience and day-to-day interactions. Unequal treatment, bias, and microaggressions are likely to be encountered in the medical field by Black individuals. Vaccine hesitancy stems from the same places and often, people still want to receive the vaccine. Without acknowledging the structural racism that exists today, we miss the barriers such as a lack of pharmacies in areas with a higher Black population, poverty, and unemployment that prevent people from getting the vaccine. The mistrust makes sense when looking at the whole picture. The medical field needs to take responsibility for the harm they have done and continue to do and show up for Black individuals.

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Lansing School District Delays In-Person Classes Due to Rise in COVID-19 Cases

Earlier this week, the Lansing School District announced that in-person classes for students in grades 4-6 have been pushed back to April 12th from an original date of March 29th. The in-person classes are part of a hybrid plan to provide in-person instruction in combination with online learning. The change comes in response to rising COVID-19 rates.

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Updated CDC Recommendations for Physical Distancing in Schools

On March 19th, the CDC updated K-12 school recommendations on physical distancing.

    • In elementary schools where mask use is universal, students should be at least 3 feet apart (regardless of community transmission levels).

    • For middle and high schools where transmission is low, moderate, or substantial and mask use is universal, students should be at least 3 feet apart.

    • For middle and high schools where transmission is high, students should be at least 6 feet apart if cohortin is not possible. ("Cohorting is when groups of students are kept together with the same peers and staff throughout the school day to reduce the risk for spread throughout the school.")

The CDC also recommends at least 6 feet of distance in the following situations:

    • Between adults in school buildings

    • Between adults and students

    • In common areas (e.g., lobbies and auditoriums)

    • When masks cannot be worn (including when eating)

    • For "activities when increased exhalation occurs" (e.g., singing, shouting, band practice, sports, or exercise) and that those activities "be moved outdoors or to large, well-ventilated spaces whenever possible"

    • In community settings outside the classroom

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New Publication Finds Lower Vitamin D Levels in Black People Increase COVID-19 Risk

A study published earlier this month in the Journal of the American Medical Association (JAMA) looked into COVID-19 test positivity primarily comparing Black and White individuals, and how vitamin D could affect those results. The study suggested that the likelihood of testing positive for COVID-19 by Black individuals was greater in those who had vitamin D levels less than 40ng/ml. For context, there were 4 groups based on vitamin D levels: less than 20ng/ml (those considered deficient), 20 to 30ng/ml (considered insufficient), 30 to 40ng/ml, and 40 ng/ml or greater. In Black individuals in the study, every group under 40 ng/ml was found to be at greater risk for testing positive for COVID-19. In comparison, White individuals did not have increased risk of testing positive for COVID-19 when vitamin D levels were below 40ng/ml. Also mentioned in the publication was that those with lighter skin have increased vitamin D production when exposed to sunlight. That, in addition to socioeconomic factors, structural inequities, and oppression, have led to increased risk, but the study suggests that supplementing vitamin D levels so that they are not low may have some benefit in decreasing the risk of getting COVID-19. Further investigation is definitely needed and is ongoing to determine whether vitamin D supplementation will decrease chances of getting COVID-19, however currently there is no solid recommendation for this. It is, however, important to maintain overall health, and if you are deficient in vitamin D, it may be helpful to take a supplement.

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U.S. Health Body Expresses Concern Over AstraZeneca Trial Data

The Data Safety Monitoring Board (DSMB), an independent committee that oversees trial operations and data, “expressed concern that AstraZeneca may have included outdated information from that trial,” referring to the Phase III clinical trial of its COVID-19 vaccine in the United States. This comes just one day after AstraZeneca had announced preliminary data analysis results from their trials showing that their vaccine was 79% effective at preventing symptomatic COVID-19 disease and 100% effective at preventing severe disease, while also noting no increased risk of blood clots. Officials at the U.S. National Institute of Allergy and Infectious Disease (NIAID), a division of the NIH, released a statement urging AstraZeneca to work with the DSMB to rectify this issue, and while Dr. Fauci stated that while this statement was unusual, it was important for transparency purposes. As of March 25th, another updated data analysis report stated that the vaccine was 76% effective at preventing symptomatic disease, 86% effective at preventing disease in those 65 years of age and older, and maintaining the same 100% effectiveness at preventing severe disease while being safe. This discrepancy may be resolved, however with other unfortunate issues impacting the release and distribution of the AstraZeneca vaccine, issues such as this will likely cause trust in AstraZeneca’s vaccine to drop even further.

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Illinois City Provides Housing Support to Black Residents in Attempt to Address Systemic Racism

Evanston, Illinois will be providing $25,000 each to 16 Black residents/households for property repairs, down payments, and other housing costs. This project is meant to address the systemic racism within Evanston due to local laws, practices, and policies. Rather than putting funds directly into the hands of Black people, this measure requires that the money be used to address housing issues connected to racist housing policies between 1919 and 1969. This support is considered a good start to the complicated reparations process by some, while others, such as Evanston City Alderman Cicely Flemming, point out that true reparations should be defined and dictated by the Black community. This initial $400,000 is part of a larger project that will use the first $10 million dollars of the City’s cannabis tax to fund reparations for African American/Black Evanston residents. Future measures will likely include similar restrictions for use rather than providing money directly to Black residents.

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

    • 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

    • 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