Sweeping Federal COVID-19 Vaccine Mandates Announced

On Thursday, President Biden announced major changes to the way the U.S. is fighting the COVID-19 pandemic, including vaccine mandates that are expected to cover up to 100 million workers. Despite objections from prominent anti-vaccine Republican Governors, vaccine mandates are not unconstitutional, and have been used throughout U.S. history to fight epidemics, including smallpox. That said, whether OSHA can require that private employers mandate vaccination without Congressional approval could potentially be overturned by the courts, though that is unlikely.

Federal vaccine mandates:

  • An Executive Order was issued that requires COVID-19 vaccination for all federal employees (with limited exceptions required by law, such as for those who are medically unable to be vaccinated).

  • The U.S. Occupational Safety & Health Administration will be mandating that all businesses with at least 100 employees require their employees to be vaccinated or to be tested weekly for COVID-19. Employers will be required to provide paid time off for employees to get vaccinated.

  • The U.S. Centers for Medicare & Medicaid Services will be mandating that healthcare workers in hospitals, clinics, and other facilities that accept Medicaid and Medicare must be vaccinated (a mandate is already in effect for nursing homes).

  • Head Start and other federal education program employees must be vaccinated.

Federal mask mandates:

    • Masks will continue to be required for interstate travel, and the TSA will be doubling fines for people who do not wear masks during air and train travel.

    • Masks will continue to be required in federal buildings.

The President also asked (but did not mandate) that Governors require vaccination for school employees and that stadiums, arenas, and other large venues require proof of vaccination or negative COVID-19 test results. He stated that the federal government will provide money for testing in schools, and that a booster shot campaign is being developed.

Several major retailers, including Walmart, Amazon, and Kroger, will be selling COVID-19 home tests at cost, and more pharmacies will offer free testing.

More information:

Large-Scale Study Shows Masking Is Effective In Reducing Transmission

​​A large-scale study in Bangladesh found that wearing surgical masks significantly reduces COVID-19 transmission in communities. The study, which enrolled more than 300,000 people, is the first large-scale, randomized controlled trial to analyze the effectiveness of masking. This is important because randomized controlled trials are considered one of the most effective means of studying a treatment or intervention in medicine.

The study included 600 villages separated into two groups. In the experimental group, community members were provided with free surgical masks, education about masking, and reminders about masking if they were not wearing a mask in public. This group of villages also had what the study calls “role-modeling,” which was the presence of community leaders wearing masks in public. The other group of villages, the control group, were not provided with any of the previously mentioned interventions. This group served as a baseline for comparison.

By the end of the study, researchers found that the experimental group had three times the level of masking compared to the control group. The experimental group was also found to practice social distancing a little bit more than the control group, which the researchers interpreted as evidence that masking does not lead to a false sense of security -- a concern widely circulated at the beginning of the pandemic. In regards to COVID-19 transmission, the study found that participants in the experimental group were 11% less likely to get symptomatic COVID-19. This number jumps up to 35% less likely for people older than 60. The study specifically promoted the use of surgical masks in communities, and data from usage of cloth masks showed only a 5% reduction in risk.

The study proves that wearing masks is an easy and effective way to reduce COVID-19 transmission in communities, even if not everyone in the community is wearing a mask. Ultimately, with all the interventions, the experimental group still had less than 50% of the community wearing masks in public. Nonetheless, risk for the community was still significantly reduced, showing that every additional person who wears a mask can make a difference.

For a link to the full study, click here.

More information:

FBI Reports Rise in Hate Crimes

The FBI released a report of hate crimes in 2020 reported by 15,136 law enforcement agencies. The agencies submitted incident reports that stated 7,759 criminal incidents and 10,532 related offenses were motivated by bias toward race, ethnicity, ancestry, gender, sexual orientation, disability, or religion. This is an increase from 2019, even though less law enforcement agencies submitted reports, and it's the highest number of hate crimes since 2008. Incidents related to racial bias accounted for the highest incidents. Out of 10,800 people who reported they were a victim of a hate crime, 61.9% said they were targeted because of race and 56% of those reported were because of anti-Black bias. Hate crimes due to racially motivated bias saw the biggest increase from 2019 to 2020 than any other category. While crimes against Black individuals rose the most, there was also an increase in attacks against Asian Americans. This aligns with data reported by Stop AAPI Hate regarding an increase in attacks against Asian Americans in 2020, but the FBI data reports significantly less incidents than Stop AAPI Hate. The next highest category for bias motivated crimes is sexual orientation at 20.5%. Of the 6,431 offenders who were able to be identified in some way, 55.2% were white. Of the 5,915 known offenders where age was reported, 89.1% were 18 years of age or older. Increasing hate crimes, even amid a pandemic, is a cause for concern. These numbers do not include incidents that were never reported or that law enforcement agencies did not submit to the FBI.

More information:

MDHHS Provides COVID-19 School Quarantine Guidance

Earlier this week, the Michigan Department of Health & Human Services issued school quarantine guidelines for asymptomatic students, as well as information about MI Safer Schools Testing Program, Community Testing Locations, and Home Tests. The information below is excerpted directly from the current version of the guidance document.

Quarantine and isolation are determined by the local health department and are used as important tools to prevent the spread of disease.

  • You isolate when you are already infected with COVID-19 and have tested positive, even if you do not have symptoms. Isolation is used to separate people who are infected with COVID-19 from those who are not infected.

  • You quarantine when you might have been exposed to COVID-19. This is because you might become infected with COVID-19 and could spread COVID-19 to others.

The local health department may modify quarantine policies based on different factors, including how close the contact is, the duration and intensity of the contact, if the students were wearing masks, and what is happening in the local community. Schools and local health departments should work together to decide what quarantine policies work best in their community. While designed for K-12 settings, this guidance may be appropriate in preschool settings.

Vaccination Is the Best Way to Protect Against COVID-19:

A higher rate of vaccination is the most effective way to prevent severe disease, reduce the risk of transmission and allows students and staff to engage in more activities more safely. MDHHS highly encourages all eligible individuals to get vaccinated.

COVID-19 School Quarantine Guidelines for Asymptomatic Students

School quarantine guidance for asymptomatic students who were exposed to a student infected with COVID-19 varies depending on a variety of circumstances, many of which are detailed below. In all scenarios, the student who has tested positive for COVID-19 should isolate and follow directions from their local health department.

School Quarantine Guidance

What to do when a student is exposed to COVID-19 but doesn't have symptoms.

Masking helps keep kids in the classroom.

    • If the COVID-exposed student was:

      • Vaccinated regardless of masking and distance.

        • Then they should: Test on day 3, 4, or 5, and monitor symptoms for 14 days. [Stay in-person]

      • Distanced 3-6 feet and masked AND the COVID-positive student was masked.

        • Then they should: Monitor symptoms for 14 days. [Stay in-person]

      • Less than 3 feet apart and masked AND the COVID-positive student was masked

        • Then they should:

          • Daily test for 7 days and monitor symptoms for 14 days. [Stay in-person]

          • Stay home for 7 days, return after day 7 with negative test or return after day 10. [Stay home]

      • Unmasked OR the covid positive student was unmasked

        • Then they should: Stay home for 7 days, return after day 7 with negative test or return after day 10. [Stay home]

Michigan Department of Health & Human Services — Michigan.gov/Coronavirus

  1. When a student exposed to a COVID-positive student can remain in school: A fully vaccinated student (regardless of whether they wore a mask) who came in close contact with a COVID-positive student.

    • The exposed student can remain in school if they wear a mask and monitor symptoms for 14 days after their exposure. Students who were not wearing a mask, or if they were within 3 feet when they were exposed, should test for COVID-19 once on day 3, 4, or 5 after their last exposure to the COVID-positive student. If the exposed student tests positive, then the student should isolate and follow directions from their local health department.

  2. A student who was masked and exposed to a COVID-positive student who was also masked in an indoor school setting, so long as the students remained at least 3 – 6 feet apart.

    • The exposed student can remain in school if they continue to wear a mask, but they should monitor symptoms for 14 days following the exposure.

  3. A student who was masked and exposed to a COVID-positive student who was also masked in an indoor school setting, but the students were less than 3 feet apart and the student tests daily.

    • The exposed student can remain in school if they wear a mask. They should monitor symptoms for 14 days and test daily before coming into the school building for the 7 days following the exposure. They should continue to monitor for symptoms for a total of 14 days following the exposure.

    • The exposed student should work with their school district and local health department to determine options available for daily testing. If the student cannot complete daily testing for 7 days following the exposure, the student should not remain in school and should follow the guidance below.

Even though the students in the three scenarios above can attend school, they are still a close contact with an exposure to COVID-19. The family should consider this before having the student visit family members and friends who may be at risk of severe outcomes for COVID-19 infection. The student’s social activities outside of school should be limited for at least 10 days.

When an unvaccinated student exposed to a COVID-positive student should not remain in school:

  1. If the exposed or infected student, or both were not wearing a mask.
    Unvaccinated students who are unmasked are more likely to become ill because they are more likely to have been exposed to larger amounts of virus.

    • The exposed student should not remain in school, and instead the student should quarantine at home for 10 days following the exposure.

      • They may return after day 10 if they have not had any symptoms during those 10 days. They should continue to monitor for symptoms for a total of 14 days following the exposure.

      • They may after day 7 if they test negative that day and do not have symptoms. They should continue to monitor for symptoms for a total of 14 days following the exposure.

  2. A student who was masked and exposed to a COVID-positive student who was also masked in an indoor school setting, but the students were less than 3 feet apart and the student does not test daily.

Any individual that displays COVID-19 symptoms, regardless of vaccination status, should isolate and be tested for COVID-19. Individuals can return from isolation as directed by their local health department.

Home Tests

At-home rapid COVID-19 antigen tests such as Ellume and BinaxNow are now available and can be purchased over-the-counter in grocery stores and pharmacies. MDHHS has some at-home tests that will be available to schools through their ISDs. ISDs should contact the MDHHS-COVIDtestingsupport@michigan.gov team to order tests.

Additional Resources

For the latest information on Michigan’s response to COVID-19, please visit Michigan.gov/Coronavirus. You may also call the COVID-19 Hotline at 888-535-6136 or email COVID19@michigan.gov.

More information:

Federal Court Rules that Turning Back Asylum Seekers is Illegal

A federal court ruled that turning back asylum seekers at the U.S. border is illegal. U.S. Customs and Border Protection has been "metering" - using a daily cap on the number of people it allows to apply for asylum. The court found that the practice violates Fifth Amendment due process rights guaranteed by the Constitution, and that sending lawful asylum seekers back to Mexico "resulted in asylum seekers’ deaths, assaults, and disappearances after they were returned to Mexico."

More information:

MSU Refuses Basic COVID-19 Safety Precautions, Putting Faculty and Students at Direct Risk

Michigan State University is continuing to put students, faculty, and staff at direct risk of COVID-19. On Thursday, the State News reported that a number of faculty who have had students in their in-person classes test positive and subsequently requested permission to move their class online temporarily, and had those requests denied. To be clear: The reports indicate that MSU administrators are refusing to allow faculty and students to take the basic precautions after positive COVID-19 cases in their classes. Moving individual classes online after a positive COVID-19 test of someone in the class is the most effective solution, and is one that most faculty and students are now well-prepared for. MSU executives stated that decisions about moving classes online after COVID-19 exposures were being left up to individual colleges and departments, which is an unnecessary delegation of responsibility that clearly lacks appropriate guidance and has failed students, faculty, and staff.

MSU’s callously disregard the health and well-being of students and employees throughout the pandemic, and this is simply the most recent instance to come to light. In late June, executives announced that vaccines would not be required in the fall, disregarding the University Council (the primary representative body that brings together students, faculty, and staff), which had voted in favor of vaccine mandates. Then, just days later, the university announced that it was removing nearly all COVID-19 precautions, including mask requirements. The university finally reversed course later in July, mandating both vaccines and masks for the fall semester

More information:

Beaumont Health Study Shows Hospitalization for Those with COVID-19 Rare in Fully Vaccinated Individuals

A recent study conducted here in Michigan out of Beaumont Health showed that COVID-19-related hospitalizations in those who were fully vaccinated against COVID-19 was very rare. The study looked at the de-identified medical records of almost 12,000 patients with SARS-CoV-2 (the virus that causes COVID-19) infections and their vaccination status (whether they were unvaccinated, partially vaccinated, or fully vaccinated). The date ranges of these patients who tested positive for the virus were from December 15, 2020 to April 30, 2021. Out of all the hospitalizations of these patients, 91.9% of them were unvaccinated, 7% were partially vaccinated, and 1.1% of them were fully vaccinated, showing that those who were fully vaccinated were much less likely to require emergency care or hospitalization. It is important to note, however, that these numbers were collected up to the end of April, 2021 prior to the Delta variant becoming dominant. That being said, early data regarding the Delta variant shows that vaccinations are still effective in preventing severe COVID-19. If you have any questions or concerns about COVID-19 vaccines, feel free to ask your primary care provider or reach out to us!

More information:

Michigan Adults Can Now Access Their Immunization Records Online

Michigan residents who are 18 and older can now access their own immunization records online through the Michigan Immunization Portal. The records include COVID-19 vaccinations, allowing people who lose their vaccination card to print out a record that may serve as a replacement. In order to access records, people will need to upload a copy of a valid government ID (Driver's License, State ID, or Passport) to verify their identity.

More information:

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

    • Vanessa Burnett (she/they) M.P.H; Health Equity Consultant, Michigan Public Health Institute

    • Alessandra Daskalakis (she/her/hers), third-year medical student

    • 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; Chair, Power of We Consortium

    • Francis Yang (he/him/his), M.S.-Global Medicine, Third-year medical student