November 29, 2020: Roundup & Myth Busting
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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!
East Lansing Declares Racism a Public Health Crisis
The East Lansing City Council voted unanimously on Tuesday to declare racism a public health crisis. While the resolution is important, it took a surprisingly long time to come from a community that is often seen as progressive (e.g., in 1972, East Lansing became the first city in the U.S. to ban discrimination based on sexual identity/orientation). East Lansing's action comes more than five months after resolutions declaring racism a public health crisis was passed by the Ingham County Board of Commissioners and the Lansing City Council, and more than three months after Governor Whitmer declared racism a public health crisis in the state of Michigan. In addition to the declaration, the resolution calls for the City to:
"Identify specific activities to further enhance diversity and to ensure antiracism principles across the City of East Lansing’s leadership, staffing and contracting"
"Promote equity through all policies approved by the East Lansing City Council and enhance educational efforts aimed at understanding, addressing and dismantling racism and how it affects the delivery of human and social services, economic development and public safety."
"Commit to preserve the DEI administrative role as a permanent position within the city government"
Support "all additional efforts in the City of East Lansing and the State of Michigan, and nationwide to address public health disparities due to Racism"
"East Lansing city council approves resolution declaring racism a public health crisis"
"Resolution Declaring Racism as a Public Health Crisis in East Lansing"
U.S. Hospitals Approaching Capacity as COVID-19 Cases Continue to Climb
In our April 26th Round-Up, we explored the importance behind “flattening the curve.” By continuing to social distance, wash our hands, and wear face coverings, we exercise our responsibility in helping prevent our healthcare systems from being overburdened, helping to prevent more deaths. Unfortunately, COVID-19 fatigue becomes a huge obstacle to our efforts to flatten the curve. Folks are returning to pre-COVID-19 behaviors and not taking necessary precautions, and the steep upward curve in cases reflects that. As of November 20th, the U.S. Department of Health and Human Services reported that “more than 1,000 hospitals across the United States are critically short on staff.” Among the worst-hit states is North Dakota, with 51% of hospitals facing capacity issues. Michigan’s hospital system is experiencing similar troubles. There are six Michigan hospitals at 100% capacity and eighteen other hospitals in the state at 90% capacity or more as of November 25. Hospital capacity is much more than the number of beds available. It includes the number of healthy, experienced, and well-equipped hospital staffers. As hospital staffers catch the virus or burn out, this limited resource depletes. One spokesperson for the Missouri state hospital association adequately summarized the fear for hospital capacity issues: “If this was a regional or local crisis like we saw early on in New York, nurses would be volunteering to go run to the emergency...that isn’t available anymore because this is everywhere.” When hospitals do not have the capacity to treat patients, those patients are turned away or are not given necessary medical help, and may die as a consequence. This includes both COVID-19 patients and those experiencing other issues (e.g., if a hospital is full, they may not be able to help someone having a heart attack).
Studies Suggest Many COVID-19 Patients Experience Neurological Symptoms
A recent study of Chicago-area patients suggests that people with COVID-19 who require hospitalization have a high occurrence of neurological symptoms and experience longer hospital stays. The study also suggested that younger patients seem to have a higher occurrence of neurological symptoms than older patients, although their symptoms may be less severe. For example, neurological symptoms like muscle aches, headaches, dizziness, and loss of smell and/or taste were considered “less severe” by researchers, and seemed to occur more often in younger patients. In contrast, more severe symptoms like encephalopathy occurred more frequently in older patients and patients with a more severe disease course. Encephalopathy is a state of brain disease that alters function and/or structure and is thought to be caused by the intense inflammatory reaction that occurs in severe cases of COVID-19. Patients who developed encephalopathy were more likely to die and were more likely to already have underlying health conditions and/or neurological disorders prior to becoming infected with COVID-19. Other neurological symptoms experienced by COVID-19 patients were stroke and disorders that made it difficult for patients to move various parts of their bodies, but these symptoms were found to be less common. It is unclear why younger patients are experiencing greater occurrences of neurological symptoms, but it is possible this can be explained in part by the large emphasis on respiratory failure in older patients, which may have caused doctors to overlook other, comparatively milder symptoms. Therefore, further study more focused on neurological symptoms in older patients is warranted to better understand the difference in symptoms, if any, between age groups.
Lansing Police Chief Discusses Officers’ Brutality
Chief Daryl Green of the Lansing Police Department responded to recent police brutality during an arrest and the killing of Anthony Houlon by officers in the Lansing City Jail in an interview with WILX earlier this week.
Asked about the violent arrest caught on video earlier this month, he said, "definitely the incident at Baker Street was an incident that looked bad on camera, and we immediately took those steps to make sure that our public knew that we were concerned about their feelings," which does not acknowledge that police used undue force, that their actions were wrong, that the community is correct to be outraged, or that the police need to change their behavior.
Asked why he put the four officers who are responsible for Houlon's death back on duty, his answer does little to instill trust: "I’ve seen, you know, different camera angles and so, I have a little more information to make those decisions. You know, unfortunately I can’t, you know, the status of the case right now. I can’t release everything that I was able to review and fully discuss all of the variables and considerations I used to make a determination to bring those persons back to work." "You know, during a pandemic you know, to help our staff, make sure we can facilitate our mission to move forward. But, you know, there’s a host of different considerations and certainly...you know, I think it’s a little bit different when you’re talking about control setting in a detention center versus putting someone back out on the street."
"Lansing Police Chief addresses controversial arrest and community trust"
Many COVID-19 Patients Experience Mental Health Challenges
In a recent study examining the health records of 69 million people in the U.S., including 62,000 COVID-19 cases, 20 percent of patients diagnosed with COVID-19 were found to have experienced mental health challenges within 90 days. Anxiety, depression, and insomnia were most commonly experienced, with one in five COVID-19 patients reporting these as a first-time occurrence. According to the study, this suggests that COVID-19 patients are two times more likely to experience the first occurrence of mental health challenges in a three-month period as people who have not had COVID-19. A combination of the immense emotional stressors people are experiencing as a result of living through the pandemic and from experiencing COVID-19, as well as the physical effects COVID-19 can have on the brain is thought to be the cause for this trend. It is essential for communities and care providers to have resources available to support patients through these stressors, as it is a vital aspect of their health and recovery.
Large-Scale Suggests Long-Term COVID-19 Immunity May Be Possible
A recent study looking at the body’s immunity to COVID-19 more than six months after infection suggests that patients recovering from the virus may have long-term immunity. How long precisely the immunity will last is still unclear, but the study’s data shows that after six months, the body’s level of memory B cells, which produce antibodies upon re-exposure to the virus, had increased in number. This stability of memory B cells over time is promising for immunity potentially lasting many years. The persistence of memory B cells is also what causes the long-term immunity associated with other upper respiratory illnesses like the flu. Memory B cells are also an important factor in the way vaccines work. For example, memory B cells to smallpox post-vaccination are estimated to last 60+ years, although it is important to note that there is always some variation within individuals. The study also looked at the rates of decline of other immune proteins and cells, such as circulating antibodies, which remained relatively stable, and two kinds of memory T cells, which showed a decline. Antibodies, memory B cells, and memory T cells are all involved in different aspects of the immune response. Overall, further research is still needed to better understand immunity to COVID-19, particularly as other data has suggested that immunity to COVID-19 may last less than three months. However, this study is notable for being the largest so far to look at immunity six months post-infection, making some experts hopeful.
Vaccine Hesitancy Among Black and Brown Individuals
A study released Monday showed that only 48% of Black people in the U.S. and 66% of Latinx people in the U.S. would receive a COVID-19 vaccine, even if it was free of charge. In order to stop the pandemic, most people in the U.S. would need to receive the vaccine. The data from the study shows that there is significant vaccine hesitancy among populations hit hardest by COVID-19. While those opposed to vaccinations have spread disinformation in the past years, vaccine hesitancy among BIPOC individuals is rooted in systemic racism. The United States has used BIPOC bodies for medical experiments throughout history. From the Tuskegee experiment, which kept life saving syphilis medication from Black individuals, to gynecological studies and sterilization of Black and Brown women, the deeply rooted mistrust is based on decades of racial experimentation and discrimintation. Black leaders have begun to address the mistrust and urge individuals to listen to public health experts. While these populations are seeing the highest rates of COVID-19, there is significant work and healing needing to be done to address the historical impacts.
More information: https://www.washingtonpost.com/health/2020/11/23/covid-vaccine-hesitancy/
COVID-19 Vaccine Update
In recent COVID-19-vaccine-related news, the United Kingdom government has asked the Medicines and Healthcare Products Regulatory Agency (MHRA) to officially begin assessing the joint Oxford/AstraZeneca COVID-19 vaccine for approval. This is a significant first step in approving the vaccine for deployment to the general public in the UK. This comes right after news that the vaccine may have an overall 70% efficacy but that the vaccine’s effectiveness may be up to 90%. The 90% efficacy number came with some troubling news, however. Initial data suggested that those who received two full doses of the vaccine a month apart showed 62% efficacy. Upon further investigation, some participants incorrectly only received half as much vaccine for their initial dose and a month later, received a full dose. Those that only received the incorrect amount initially followed by a full dose showed a 90% efficacy in the vaccine. Combined, the vaccine showed 70% efficacy overall.
This dosing error has led to many questions being asked about the vaccine trial and the validity of the data. Scientists and other experts have pointed to multiple irregularities and omissions in the trial, as well as the trial having far fewer volunteers compared to the Pfizer and Moderna COVID-19 vaccine trials. AstraZeneca and Oxford have since defended the data, stating that “highest standards” were used and “additional analysis will be conducted” regarding their vaccine. Such issues that arise in clinical trials are not unheard of but bring into question how valid and trustworthy the vaccine may be. As a result, even if this vaccine is approved in the United Kingdom and other countries, it may not be approved here in the United States. Further testing and more trials may be needed before such a vaccine would be approved. Transparency is crucial in such processes. While it is important that such an error came to light, without further information, this will increase suspicion from those who are already wary of a COVID-19 vaccine and may make them less likely to be willing to receive one.
In addition to the Oxford/AstraZeneca vaccine news, questions continue to be raised about vaccine distribution, especially if people need to visit their doctors for multiple doses to be effective. There have been instances of side effects to some of the vaccines reported in the clinical trials. Relatively common side effects include flu-like symptoms, body aches, and/or fevers. While these are symptoms that show the body is appropriately reacting and the immune system is responding accordingly, this may turn away some people from getting a second dose. Also, the need for a second dose may be challenging for many folks due to transportation, time, money, and other reasons.
There have also been discussions about making COVID-19 vaccination mandatory when they are approved and available. The U.S. Occupational Safety and Health Administration has stated that employers can legally impose flu vaccine requirements for their workforce, and similarly can do the same thing for a COVID-19 vaccine. At the same time, individuals can request medical, religious, or other exemptions to vaccines. Whereas some industries, such as the healthcare sector, almost always require proof of vaccinations prior to work, the same can’t be said for others. Pushback is almost inevitable and will be another foreseeable challenge with regards to vaccinations.
Vaccine development seems to be progressing steadily, yet it may be a while before people are able to be vaccinated. Even when a vaccine becomes available and can be distributed, it will be important to continue social distancing, wearing masks, and practicing proper hand hygiene in addition to following any other public health measures if we are to protect ourselves and each other from COVID-19.
QM Public Health Crisis Round-Up Team (in no particular order):
Mauricio Franco (he/him/his), M.S.- Global Medicine, Fourth-year medical student.
Andrew-Huy Dang (he/him/his), B.S. Microbiology, Fourth-year medical student
Wyatt Shoemaker (he/him/his), Fourth-year medical student.
Antonio Flores (he/him/his), Third-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, Second-year medical student.
Kryssia Campos (she/her/hers), Second-year medical student.
Alessandra Daskalakis (she/her/hers): Second-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), fourth-year PhD candidate in Writing and Rhetoric, 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