May 31, 2020: Roundup & Myth Busting 

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!

Stand Up for Black Lives #BlackLivesMatter

The murdering of Black people by police is a public health crisis, like COVID-19 is a public health crisis. The pandemic did not create this problem  or the system of hate and oppression that fuels it, but it is exacerbating it. Stand in solidarity with Black people in Lansing, across the state of Michigan, and throughout the United States, but try to do so in ways that do not increase risk from COVID-19 (e.g., if you go to a protest, try to spread out and keep physical distance, and always wear a mask). During this pandemic, it is even more critical that white and non-Black people of color do the work to end violence against Black communities, and that they center and amplify Black voices, follow Black leaders, and participate in Black-led protests, events, and activities. To our Black Queering Medicine family: We stand with you. 

Links to help you start/continue Anti-Racist work: 

• Showing Up for Racial Justice: https://www.showingupforracialjustice.org/ 

• Follow Black Lives Matter Lansing: https://www.facebook.com/blmlansing/ 

Racial Justice Reading list, curated by the Student National Medical Association (SNMA): 

• White Rage - Carol Anderson

• White Fragility - Robin DeAngelo

• Why are all the Black Kids Sitting Together in the Cafeteria - Beverly Daniel Tatum

• Understanding Race, Ethnicity, Power - Elaine Pinderhughes

• The New Jim Crow - Michelle Alexander

• Medical Apartheid - Harriet A. Washington

• Reproducing Race - Khira Bridges

• The Immortal Life of Henrietta Lacks - Rebecca Skloot

• When and Where I Enter - Paula J. Giddings

• Between the World and Me - Ta-Nehisi Coates

• Tears we cannot Stop - Micheal Eric Dyson

• Crucial Conversation - Kerry Patterson 

There Is Risk of Being Out in Public

“...there's no such thing as a zero-risk outing right now. As states begin allowing businesses and public areas to reopen, decisions about what's safe will be up to individuals.” - NPR Morning Edition

Queering Medicine could not agree more. Being outside during this pandemic comes with risk. How you mitigate and decrease risks depends on the activity you are engaged in. We believe we each have a personal responsibility for keeping one another safe. Many folks are aching to be outside—that is a very real feeling. We cannot forget that the virus that causes COVID-19 has not been defeated, we still do not have a viable treatment, and we still do not have a vaccine. 

A National Public Radio (NPR) article is circulating that outlines various activities and their risks. These activities include hangouts in your backyard, grabbing takeout from a favorite restaurant, going on nature walks, and going out to a lake/beach to name a few. As Stay-at-Home orders begin to ease, keep your personal safety and the safety of others in mind. Always wash your hands, keep hand sanitizer nearby (if you have it), and wear a mask. 

This article is a good place to start thinking about activities you may be planning on doing. Keep in mind the article does not break down the nuance of risk, and  some things listed as “lower risk” are still very much a high risk activity for some people:

• https://www.npr.org/sections/health-shots/2020/05/23/861325631/from-camping-to-dining-out-heres-how-experts-rate-the-risks-of-14-summer-activit 

Update on Hydroxychloroquine

A large, influential study recently published came to the conclusion that medication regimens involving hydroxychloroquine for treatment of COVID-19 provided no benefit and were associated with decreased in-hospital survival (i.e., higher risk of death) as well as increased risk of heart issues. As a result, the World Health Organization (WHO) has paused all clinical trials involving hydroxychloroquine in COVID-19 treatment.

There has been some pushback about the validity of the study, however a majority of current research published currently shows that, at the very least, hydroxychloroquine shows no benefits in treatment of COVID-19.

Sources:

• CNN Article on Recent Hydroxychloroquine Study:
  https://www.cnn.com/2020/05/22/health/hydroxychloroquine-coronavirus-lancet-study/index.html

• Scientists Question Validity of Major Hydroxychloroquine Study:
  https://www.nytimes.com/2020/05/29/health/coronavirus-hydroxychloroquine.html

• WHO Pause Hydroxychloroquine Use in COVID-19 Clinical Trials:
  https://www.nytimes.com/reuters/2020/05/25/world/asia/25reuters-health-coronavirus-who-hydroxychloroquine.html

• Publication:
  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

Transmission of the virus via air conditioning

Research suggests it is possible, but unlikely, that air conditioners can transmit the virus that causes COVID-19. The risk is greatest in restaurants and spaces with minimal air flow and a higher density of people over a long period of time. For example, a recent study suggests that nine diners sitting at neighboring tables in an air conditioned restaurant in China became infected with the virus. It is believed an asymptomatic person sat near an air conditioning unit which facilitated droplet transmission to those sitting near them, up to 14 feet away. With that said, there is no documented evidence of the virus being transmitted through air conditioning units in high rises or similar spaces where air is shared between apartments. The study suggests sharing the same physical space as the infected person, like in a business or restaurant, was a key factor. Experts in the United States have responded to concerns raised by the study to say that air conditioning systems in the United States are different from the air conditioning system used in the restaurant in the study. Standard air conditioning systems in commercial and public facilities in the United States, including restaurants, replace the air inside with air from outside to a variable degree over a given period of time based on the specific system. These air conditioning systems also usually have a component of filtration, further reducing the risk of viral transmission. The air conditioning unit described in the study did not filter the air or replace inside air with fresh outside air. Similarly, ceiling fans do not replace or filter air in a space and may carry a different degree of risk than the standard air conditioning units described above. In order to ensure the safety of customers, some experts recommend property owners review the current functioning of their air conditioning systems and adjust as needed to provide adequate fresh air into the system.

Despite the fact that the risk of transmission through air conditioning systems in the United States is believed to be low, experts state the risk is dependent on many factors in an air conditioned space. For one, diners spend more time lingering in restaurants. Extended conversations in close proximity carry higher risk of infection at baseline. Another factor is how far apart people are within buildings. Fresh air in open areas is able to dilute viral particles more effectively than ventilated indoor or covered spaces. Nonetheless, regardless of the presence of air conditioning, remaining at least six feet apart indoors or outdoors is a key protective factor for preventing the spread of the virus that causes COVID-19. Some restaurants across the country are exploring the option of placing tables outside and further apart than they would be inside in order to try to minimize the risk to diners.

Key takeaways:

• Assuming commercial and public buildings in the United States are meeting air conditioning system standards, the risk of transmission through air conditioning units is perceived to be low. 

• Variables that alter risk in air conditioned spaces include the density of people in the space and how long people are using the space. 

• Fresh air in open spaces dilutes the virus most effectively compared to indoor and enclosed spaces regardless of air conditioning, however in all settings social distancing is a key factor in preventing transmission of the virus that causes COVID-19.

Sources:

• https://www.wbur.org/hereandnow/2020/05/19/air-conditioning-coronavirus

• https://www.washingtonpost.com/news/voraciously/wp/2020/05/28/as-restaurants-reopen-heres-what-you-should-know-about-air-conditioning-air-flow-and-the-coronavirus/

• https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

Drug Overdoses Climb During COVID-19 Pandemic

According to a Roll Call Article, which cited an Overdose Detection Mapping Application Program (ODMAP) publication, drug overdoses have risen this year (January-April, 2020) as compared to the same timeframe as last year. This echoes many news reports and publications that have noted increases in drug overdoses in individual cities, counties, and/or states, as well as internationally. The current consensus is that drug overdoses have been increasing, understandable, given the toll that COVID-19 has taken on individuals’ mental health, and the exacerbation of stress, increased domestic violence, decreased access to stress management/coping mechanisms, lack of social contact, etc.. 

The opioid crisis is still ongoing, and areas that may have shown some improvement in the past have been regressing during the pandemic. COVID-19 has also caused some needle exchange programs to be cut back and substance use treatment access has greatly diminished. COVID-19 has exacerbated an already existing issue, but there are still potential resources. Contact your healthcare provider if you are in need of medical treatment, and consider asking for telehealth options, if needed. Reach out to local needle exchange and substance use treatment programs if you are in need. Below are some MDHHS Provided Resources for Ingham County:

Mid-State Health Network:
1-844-405-3095

The American Medical Association (AMA) issued a statement providing guidelines to state policymakers and healthcare providers to ease access to necessary and essential treatments for opioid use disorders (OUD) as well as guidelines for harm reduction. This has been per new guidelines published by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Drug Enforcement Agency (DEA), which both state that opioid treatment programs (OTPs), during this public health emergency, should be able to dispense medication, and practitioners should be able to prescribe medication via phone evaluation, which is usually not the case. 

If you need help, the SAMHSA national helpline number is below, as well as a link to find a substance use treatment center near you. There is also a link to the Michigan Department of Health and Human Services, which provides contact information for substance use services by county.

Helpful Links

• SAMHSA National Helpline Number: 1-800-662-4357
  Website: https://www.samhsa.gov/find-help/national-helpline

• SAMHSA Substance Use Treatment Center Locator:
  https://findtreatment.samhsa.gov/

• MDHHS Substance Use Treatment Search:
  https://www.michigan.gov/mdhhs/0,5885,7-339-71550_2941_4871_29887-151431--,00.html#Ingham

Sources:

• AMA Recommendations Opioid Related Overdoses and Other Concerns during COVID-19 Pandemic:
  https://www.ama-assn.org/system/files/2020-05/issue-brief-increases-in-opioid-related-overdose.pdf

• AMA COVID-19 Policy Recommendations for OUD, Pain, Harm Reduction:
  https://www.ama-assn.org/delivering-care/public-health/covid-19-policy-recommendations-oud-pain-harm-reduction

News Reports:

• https://www.rollcall.com/2020/05/27/drug-overdoses-climb-during-covid-19-pandemic/

• https://files.constantcontact.com/a923b952701/dbf0b5a5-f730-4a6f-a786-47097f1eea78.pdf

• https://www.propublica.org/article/overdose-deaths-have-skyrocketed-in-chicago-and-the-coronavirus-pandemic-may-be-making-it-worse

• https://www.reuters.com/article/us-health-coronavirus-canada-overdose/opioid-overdoses-on-the-rise-in-canada-during-covid-19-pandemic-idUSKBN235302

QM Mythbusters (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

• 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