Michigan Has Now Had Over 1 Million Confirmed COVID-19 Cases

As of Wednesday, Michigan passed another pandemic milestone: There have now been over 1 million confirmed COVID-19 cases in the state. By Friday, the total was 1,008,069 confirmed cases, plus another 124,582 probable cases, for a combined total of over 1.1 million. The state has had over 20,000 confirmed deaths, and including probable deaths, the death total in Michigan was 22,214 as of Friday.

Of those totals, 28,140 COVID-19 cases and 430 deaths have been in Ingham County.

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Booster Dose of Pfizer COVID-19 Update

On September 22, 2021, the FDA announced that they authorized the use of a booster dose of the Pfizer COVID-19 vaccine for the following populations, if it has been at least 6 months since they were fully vaccinated (i.e., when they received their second dose):

    • Individuals 65 years of age and older

    • Individuals 18 through 64 years of age at high risk of severe COVID-19

    • Individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19

This authorization only applies to the Pfizer-BioNTech vaccine as an amendment to the existing Emergency Use Authorization. Currently, only the first two doses are fully approved for COVID-19 vaccination.

In addition, for those who fall in the above categories, as well as those who are immunocompromised, a booster shot is now recommended by the CDC, in line with the FDA’s authorization. The recommendation comes from the CDC after the Advisory Committee on Immunization Practices (ACIP) recommended boosters for the first two categories of those listed above, but not for those with high risk of exposure from institutions or occupation. That means that initially, the ACIP initially did not recommend a booster shot for healthcare workers, teachers, etc. That changed on Friday, when the CDC Director overrode their decision and announced that the CDC would recommend booster shots for all of the groups authorized for a booster shot by the FDA. The CDC also recommends residents in long-term care facilities get a booster, and additional language on the CDC Pfizer booster dose recommendations is below:

    • people 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,

    • people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,

    • people aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and

    • people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

It is important to note that there is still important discussion ongoing with regards to booster shots, whether they may be necessary for other individuals, whether it is a premature move while the focus should still be on those who are unvaccinated, and whether the United States should be more focused on donating doses internationally rather than focusing on booster shots. If you have any questions about COVID-19 vaccines or the new booster recommendations, please feel free to reach out or speak with your primary healthcare provider.

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Local Health Officials Under Attack for COVID-19 Mandates

Throughout the COVID-19 pandemic, health and governmental officials have been scrutinized and threatened because of health mandates regarding the virus. The state of Michigan has largely put implementing restrictions in the hands of local officials in recent months, claiming that residents would be more likely to follow mandates if they were not broadly implemented across the state. While this sounds good in principle, this has brought threats and attempted assault to local health officials across the state. In late August, Kent County Health Director Adam London emailed the Board of Commissioners asking for help, stating the pushback he has received for implementing a mask mandate for preschool through sixth grade. A woman attempted to run him off the road twice and people spewed hateful and aggressive words, even calling for his arrest, at a Board of Commissioners meeting about the mask mandate. London stated in his email that he and his staff are receiving pushback for trying to do their jobs and it is burning out critical public health workers. Ingham County Health Director Linda Vail stated she has received messages threatening her job and even her life. In Genesee County, a woman was charged with threatening to kill two public health officials because of mask mandates. With increasing COVID-19 rates, restrictions and mandates are crucial to limiting the spread of the disease. This places increased burden on local health officials who are underfunded and exhausted from a year and half long pandemic. This could be a breaking point for public health officials as they become the next target of people with extreme viewpoints.

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California Study Finds One-Third of Participants Experience “Long COVID”

A new study out of Long Beach, CA found that one-third of participants in a survey of people who had tested positive for COVID-19 reported experiencing long-term symptoms. Additionally, participants who identified as female, were aged 40-54 years old, and/or had pre-existing conditions were more likely to experience at least one symptom two months after testing positive. The study also found that Black participants were more likely to experience some long-lasting symptoms, including shortness of breath, muscle pain, and/or joint pain than non-Black participants. The study has since been posted on the CDC website.

“Long COVID” describes symptoms lasting weeks to months after testing positive, and symptoms can vary from person to person. For the purposes of this study, long COVID was defined as experiencing symptoms for at least two months. In order to assess the prevalence of long COVID, the Long Beach Department of Health and Human Services randomly invited 3% of people from a pool of more than 28,000 positive tests to participate in an interview. Of the 791 invited, 366 participated. Although the sample size for this study is small and fewer people participated than were invited (which may have resulted in selection bias that could have affected results), its findings warrant further study to better understand how health disparities and biases are putting Black patients and vulnerable populations at risk for long-term effects of COVID-19. These long-term effects can significantly impact an individual’s physical and mental health in addition to having financial and social impacts.

According to the study, the four most common long COVID symptoms were fatigue, dyspnea (difficulty breathing), smell/taste disorders, and muscle/joint pain. Participants with pre-existing conditions were more likely to experience all four of the most common symptoms.

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U.S. to Donate 500 Million More COVID-19 Vaccine Doses to Other Countries, More Needed

Earlier this week, President Biden announced that the United States would be donating 500 million more Pfizer vaccine doses to other countries, bringing total donations from the United States to 1.1 billion doses. President Biden’s announcement came during a global vaccination summit during which time he pressed other wealthy nations to do their part to reach a goal of vaccinating 70% of the world’s population within the next year. The European Union has committed to donating 500 million doses as well.

World health experts say that while the increase in donations is welcomed, more than 5 billion more doses are needed to support vaccination in developing countries, and so far only 15% of promised donations have been delivered. According to Reuters, for example, vaccination rates in Haiti and the Democratic Republic of Congo are less than 1%.

With vaccination rates so low across the globe, the United States has been criticized for promoting booster shots for fully vaccinated people in the U.S.. World health experts say that protecting vulnerable populations in countries with fewer resources should be a priority, and that in doing so there is also an opportunity to prevent new variants from developing in areas with high virus transmission.

In addition to vaccine access, support is needed for administering and distributing vaccines in other countries. This is especially true for the Pfizer vaccine, which requires storage at extremely low temperatures. The United States has promised to provide more than $750 million towards these efforts, according to Reuters.

While financial support helps vaccine distribution, leaders in international aid continue to advocate for wealthy nations to allow developing countries the rights and ability to make their own vaccines. President Biden has voiced support for waiving intellectual property rights for COVID-19 vaccines, but there has been no progress in developing such waivers. According to the Associated Press, there is debate between non-governmental organizations and United States officials as to whether increasing global production of vaccines will make the biggest difference in getting people vaccinated.

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U.S. Expels Haitian Asylum Seekers

Images of White men on horseback rounding up Black people fleeing for their lives may seem like something that would only be found in history books about slavery, but photographs of those very scenes were taken this week in Texas. Witnesses even reported that some of the men on horseback were using their horse reins like whips.

The men on horseback were Customs and Border Protection officers, and the Black people on the ground were Haitian asylum seekers. Haiti was devastated by a 2010 earthquake that killed approximately 250,000 people and destroyed the homes of over 1.5 million people. A cholera outbreak followed, killing another 10,000 people and making nearly a million more sick. Many fled to mainland Central America to find jobs and safety, particularly to Rio de Janeiro, Brazil, which needed workers to build facilities for the 2016 Summer Olympics. Over time, and particularly because of the COVID-19 pandemic, jobs have dried up in Brazil, Chile, and Venezuela, where Hatians had migrated to. Unfortunately, the situation in Haiti has gotten worse, making the prospect of a return to there unthinkable for most people. Less than two months ago, the President of Haiti was assassinated. Then last month, another major earthquake hit the country, killing thousands and destroying tens of thousands of homes. As a result, thousands of people have crossed the border into the U.S., seeking asylum.

More than 12,000 Haitian asylum-seekers ended up encamped in Del Rio, Texas, next to a bridge between the U.S. and Mexico and the U.S. government decided to take swift action. The U.S. government has now cleared out the camp and expelled them all, sending 17 flights full of asylum-seekers back to Haiti (approximately 2,000 people in total), 8,000 being forced back across the border to Mexico, and 5,000 are still being processed "to determine whether they will be expelled or placed in immigration removal proceedings." Customs and Border Protection officers were sent on horseback to stop more from crossing the river, resulting in the widely seen photographs. Whatever the best solution to this humanitarian crisis is, the approach the U.S. government has taken is clearly not it.

An analysis by the Associated Press found that people from Haiti are granted asylum in the U.S. at the lowest rate of any nation with a consistently high number of asylum seekers. Civil rights leaders have noted that Black immigrants can face greater barriers to entering the U.S. than people of other races, and are more likely to be removed from the U.S. on criminal grounds. More than 95% of Haitians are Black.

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Robert Green Honored for Efforts to Integrate East Lansing in the 1960s

Dr. Robert Green was honored by the City of East Lansing on Friday, and the former Pinecrest Elementary school was renamed to Robert L. Green Elementary. Green, who is Black, earned his Ph.D. from Michigan State University in 1962, and challenged redlining (racist real estate policies) in East Lansing that prevented him from buying a home in the city in 1964. MSU students protested in support of him, and with Carl Levin as his attorney (who went on to become a U.S. Senator), Green raised a legal challenge to the policies. The Federal Housing Administration decided in Green's favor, the first successful legal challenge to redlining in East Lansing. East Lansing eventually created a fair housing ordinance to try to prevent racism in real estate after Martin Luther King, Jr. was assassinated in 1968. Green was among the first people of color to own a home in East Lansing. In addition to the Elementary school being renamed, a historical marker is being placed by the site of the home he purchased.

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U.S. COVID-19 Death Toll Now Surpasses 1918-1919 Spanish Flu

The U.S. has now exceeded the estimated death toll in the country from the 1918-1919 Spanish flu pandemic. The 1918-1919 flu killed approximately 675,000 people, and the nation's death toll from COVID-19 is now over 680,000. While the 1918-1919 flu killed a much larger percentage of the population (the U.S. population is more than three times larger today than it was then), medical science has advanced tremendously in the last hundred years, and if more people had followed mask and physical distancing recommendations, more people got vaccinated as soon as they were able to do so, and if the federal, state, and local governments had taken better measures, the death toll from COVID-19 would be far lower, and would not have come close to the 1918-1919 flu by this point.

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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