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What to know while pregnant in the coronavirus era

Experts acknowledge there are still enough unknowns about the virus and its impact on pregnancy to keep expectant mothers – and their doctors – up at night. Many U.S. hospitals now require that all incoming patients have their temperatures taken and symptoms screened at the door. As tests for the virus become more available and in more common use at metropolitan hospitals, some doctors urge they should be standard practice everywhere. “This is a hot topic among hospitals now,” said Char-Dong Hsu, chair of the Wayne State University Obstetrics and Gynecology Department. Similarly to the population at large, as many as eight out of ten pregnant women who have covid-19 may be asymptomatic yet contagious, he noted, meaning they could pose an extra danger to other women and providers if they aren’t identified.
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Race disparities amid infectious diseases aren't new. It's time we took action | Opinion

Wayne State President M. Roy Wilson wrote an op-ed about race disparities amid infectious diseases and the need to take action. The Centers for Disease Control and Prevention (CDC) recently published data on hospitalizations for COVID-19 across 14 states from March 1-30 in its Morbidity and Mortality Weekly Report. It documented that African Americans accounted for 33% of the hospitalizations but only 18% of the total population in the 14 states. Many states have reported an even starker reality. African-Americans accounted for 40% of COVID-19 deaths in Michigan and 43% in Illinois despite making up only 14% of the population in both states. Such disparities in disease outcome by race are unacceptable, but not surprising. Health disparities by race/ethnicity have existed for a long time in our country.” Wilson continued: “I urge that we focus now on what can be done to narrow this racial disparity in outcomes for COVID-19, starting with a more effective communication effort targeted toward African-American communities.”
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Health officials expect a gradual loosening of social distancing measures

There are indications that Michigan’s coronavirus case count may be leveling off, prompting even Gov. Gretchen Whitmer to start thinking about how the state will begin to ease the stay-at-home order and other social distancing measures implemented to contain the outbreak. Since April 3, when the state reported nearly 2,000 new cases, new positive cases have started to decline. The executive order mandating stay-at-home expires April 30. One of Whitmer’s criteria for at least partially reopening the state involves testing and that could be problematic, according to health officials. Dr. Teena Chopra, a professor of infectious diseases at the Wayne State University School of Medicine, said testing in Michigan is very limited and not sufficient to understand the true burden of disease. “I would recommend the state to start universally testing all high-risk individuals including (the) elderly, obese, diabetics, immunocompromised etc., regardless of symptoms,” she said. “Once life reopens it won’t be like a switch on, it will be from darkness to dimness,” said Chopra. “We would need to have a structured restart. I would still advise to keep a distance from others and wear a mask while (shopping) for groceries.” Even as the social distancing measures are modified or lifted, Chopra said that the virus will still be placing demands on health officials, the government and the public. “Pease remember we are still in the mitigation phase of the pandemic and we need to plan for the other phases now. All of this planning and further planning to prevent future pandemics should be done now,” she said.

Coronavirus is causing a mental health crisis. Here’s how to fight it

As weeks of distancing turn into months, many people are experiencing a greater and greater sense of isolation. They’re also dealing with the uncertainty of when and how the pandemic will end, the fear of getting infected, the economic crisis that has cost millions of Americans their jobs, and the inconsistent messaging about the virus from authority figures. “All aspects of life are affected” by the pandemic, said Arash Javanbakht, a trauma specialist and assistant professor of psychiatry at Wayne State University. “It was like one day, everything changed.” And while the current crisis is stressful for everyone, people who already have conditions like anxiety or depression may be especially at risk, psychologists say. For people with anxiety disorders, for example, “any new stressor can make it worse,” Javanbakht said. It’s safe to say that billions of people around the world are in a stressful situation right now. For many, life changed nearly overnight, with little time to prepare, Javanbakht noted. Some are now trying to work from home while caring for children. Others have been laid off or furloughed and may be worried about how they will pay their bills. Meanwhile, people are getting a lot of contradictory information about the virus and the measures needed to combat it, Javanbakht said. While President Trump may say one thing, public health officials may say another. “It’s confusing and stressing,” Javanbakht said.
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As Michigan fights coronavirus, hospitals gush money and workers lose jobs

Shooshan Danagoulian, assistant professor in the economics department at Wayne State University, said the coronavirus pandemic is having a very sharp, negative impact on hospitals because they depend so heavily on elective and non-emergency care for revenue — medical work that has ground to a halt during the COVID-19 crisis. With so many workers now unemployed and lacking the health insurance their jobs provided, patients who do show up at the hospital may be unable to pay their bills, she said. "In this pandemic, hospitals are going to have to find new ways of reducing their costs. Right now, physician groups and hospitals are cutting physicians' salaries and hours, and administrators are taking pay cuts," she said. "Providers overall are feeling like they're caught between a rock and hard place," she said. On one hand, they're "running toward the fire" that is COVID-19. On the other, they're "having to make these tough financial choices: how to keep their staff, how to pay their staff, and who to let go ...  hospitals have no good choices for surviving this." Danagoulian said she believes hospital volumes will slowly recover through the summer, but will not return to pre-pandemic levels until next year.
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When and how will it end? Considering the end-game for Michigan’s coronavirus crisis

They’re the questions on everybody’s mind about Michigan’s coronavirus crisis. When will it end? How will it end? When will things get back to normal? Extreme social distancing is the only way to bring coronavirus numbers down to the point where the economy can re-open; it’s the only tool available, absent a vaccine, said Dr. Paul Kilgore, Wayne State University physician and epidemiologist. “I look at sheltering in place almost as a vaccine,” he said. “It’s our vaccine intervention for now. “The more we do it, the more it will continue to be effective,” he said. “We really need to get to that flattening curve ASAP. It’s absolutely the No. 1 priority.”
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Wayne State University opens up dorm for Detroit health care workers during COVID-19 pandemic

Wayne State University is offering a campus dorm to Detroit health care workers during the coronavirus (COVID-19) pandemic. Workers with the Henry Ford Health System and Detroit Medical Center have the opportunity to stay at Atchison Hall so they don’t need to return home as they battle COVID-19 on the frontlines. The building has private accommodations for more than 200 people. People staying in the hall will receive a hospitality snack bag and linens. They also have access to Wi-Fi, community kitchens and in-building laundry.
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Ford, Wayne State roll out mobile testing for COVID-19 in Metro Detroit

Ford Motor Co. and Wayne State University physicians are rolling out mobile testing units this week. A partnership between the carmaker, WSU, and the Wayne State University Physician Group will yield hundreds of new daily COVID-19 test kits for symptomatic first responders, health care workers and corrections officers. A first of its kind in the state, the testing will be done with the help of Lincoln Navigators fully equipped with staff and medical kits provided by the university. “This support for those on the front lines of the pandemic is critical, and we felt we needed to respond urgently by testing first responders and health care workers with drive-through testing,” said Wayne State President M. Roy Wilson. “Now we can expand our efforts with ‘drive-to’ testing for those first responders across the region who lack access to testing. We are extremely grateful to Ford for helping us expand this initiative and bring mobile testing to these high-risk individuals, and to the United Way for its support of both our drive-through and drive-to initiatives.”
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‘We need help’: Coronavirus ‘devastating’ black cities in outstate Michigan

One month since Michigan’s first case of coronavirus, the pandemic is taking a far heavier toll on African-American communities statewide, from metro Detroit to Ypsilanti and Flint to Lansing. Nationwide, African Americans in cities such as Chicago, New Orleans and Milwaukee have been infected at greater rates, while the Associated Press reported this week that African Americans comprised 42 percent of the nation’s deaths where demographic data were made public, some 3,300 of 13,000. “I'm not surprised and in fact I would say that it's expected,” said Dr. M. Roy Wilson, an ophthalmologist and president of Wayne State University. I'm somewhat surprised that people are surprised.” Wilson, who worked on strategic planning on minority health and health disparities at the National Institutes for Health, said poverty and lower levels of education have left more minorities exposed to the virus through jobs that can’t be done from home. African Americans also are more likely to have a harder time with the virus because of underlying health conditions, Wilson said. Wilson said those underlying conditions create a quicker sequence, or cadence, from “morbidity to mortality.”
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ACCESS providing drive-through COVID-19 testing for first responders, medical personnel

ACCESS Community Health and Research Center, in Dearborn, is among the sites offering drive-through COVID-19 testing for symptomatic medical personnel and first responders, who face exposure risks daily while on-the-job. In partnership with the Wayne State University Physician Group and Wayne State University Health Sciences, ACCESS is providing drive-through testing at two different locations. Dr. Phillip Levy, who is heading the drive-through testing initiative, is the assistant vice president for translational science and clinical research innovation at Wayne State University, and chief innovation officer for the Wayne State University Physician Group. His specialty is emergency medicine, and he is a professor of emergency medicine at Wayne State University. Levy said the people being swabbed are both grateful for the opportunity to be tested and afraid of what the test results might be. “They are afraid for their own health, and grateful that there are organizations such as Wayne State and the Wayne State Physician Group, as well as ACCESS, who are actually there to help them get some answers as to whether or not they are infected,” he said. Levy said they are only testing symptomatic people, in compliance with the NDHSS guidance.
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Black communities hit harder by coronavirus in Michigan, not just Detroit

Residents of Michigan communities with large African-American populations are disproportionately sickened and killed by the coronavirus, according to a Bridge Magazine analysis of public health data. Detroit, which is 79 percent African American, has 7 percent of Michigan’s population but 26 percent of the state’s infections and 25 percent of its deaths. The outbreak so far is centered in southeast Michigan, as Wayne, Oakland and Macomb have 80 percent of the state’s 9,334 cases as of Wednesday. Bridge’s analysis of public records shows: In suburban Wayne County, communities with the largest black populations — Highland Park, Redford Township, Ecorse, River Rouge and Romulus — have roughly double the rate of infection as the county. In Oakland County, infection rates are highest in majority-black Southfield and suburbs with higher-than-average black populations: Lathrup Village, West Bloomfield and Farmington Hills. In Macomb County, nearly 35 percent of all infections were among African Americans, who comprise less than 15 percent of the county’s population. County maps show the most cases are in southern Macomb including Warren, Eastpointe and Roseville, all of which have a higher percentage of African-American residents. Matthew Seeger, a communications professor at Wayne State University who has worked with the U.S. Centers for Disease Control and Prevention, said public health officials must tailor messages to different audiences by using different media. He said Whitmer, Duggan and Evans have done an “exceptional job” so far.
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2 of Detroit’s homeless positive for COVID-19 as city adds 300-plus beds, testing

Two people in the city’s homeless shelter system have tested positive for COVID-19 and are being separated with 27 others at a new facility opened amid the fight against the novel coronavirus pandemic. Detroit has added about 325 shelter beds for homeless people, rooms for isolation and launched a formal testing program for symptomatic members of the homeless community in an attempt to quell the spread. Wayne State University, the Community Foundation for Southeast Michigan and the affiliated DMC Foundation have partnered for on-site COVID-19 testing at the location. Two staffers from Wayne State University are visiting the shelter on Mondays, Wednesdays, and Fridays to get swabs for testing, said Dr. Phillip Levy, professor of emergency medicine and chief innovation officer for the WSU Physician Group. Levy echoed experts in calling homeless people particularly at risk in the outbreak, saying members of the community don't have regular interactions with health care providers and have limited care other than emergency departments. "If we can avoid them getting exposed and potentially succumbing to worse outcomes because of their other risk factors, then it's really a no-brainer," he said. "... That's how you measure a society, how it takes care of its most vulnerable."
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COVID-19 and chloroquine: FDA authorizes use, but risks persist

The U.S. Food and Drug Administration has issued an emergency authorization to use chloroquine and hyrdoxychloroquine to treat patients with COVID-19. In a letter to the Department of Health and Human Services, the FDA’s Chief Scientist, Rear Admiral Denise Hinton, wrote that the potential benefits of treatment with these drugs outweigh the potential risks. She based that conclusion on “limited in vitro and anecdotal data” available from use of the drugs in other countries, and the fact that the novel coronavirus has created a national public health emergency. Chloroquine has been used for decades to treat malaria. A similar drug, hydroxychloroquine, is commonly prescribed for patients with lupus, rheumatoid arthritis and other conditions. Clinical trials are underway to determine if these are effective treatments for COVID-19. But until those tests are completed, physicians warn against calling it a cure yet. “There’s no good evidence at this point, no good randomized control trials to show that it will make a difference,” says Dr. Cynthia Aaron, medical director of the Michigan Poison Center at Wayne State University’s School of Medicine. Aaron says chloroquine and hyrdoxychloroquine did show some promise in treating people with severe acute respiratory syndrome (SARS), which is also caused by a strain of coronavirus. “But to say that there’s irrefutable evidence that it’s effective at this point, that just doesn’t exist,” Aaron says.
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Opinion: Incoming freshmen, don't panic. Colleges will support you

Dawn Medley, associate vice president of enrollment management, wrote an opinion piece reassuring incoming freshmen during the COVID-19 crisis. “Today, my entire enrollment management division is working remotely as is 95% of our university. I spend my days at a laptop, with headphones, and managing in a time unlike any other. First we focused on making sure that our current students had their needs met. For some, they went home. For others, we are their home. Now we are taking events designed around the “in person experience” and turning them into “experiences for the person.” Our faculty are moving mountains to take all of their experience and plans for coursework and distill it into educational, engaging and electronic forms…Parents and students, higher education institutions will support you. No, we don’t have all the answers yet because the questions and landscape change daily, but we are adapting rapidly.
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'Southeast Michigan is burning': Michigan's coronavirus case count doubles every 3 days

Sick people fill intensive care units of already overtaxed southeastern Michigan hospitals at a pace of about 100 new coronavirus patients a day. So far, 111 Michiganders have died, and at least 4,650 had confirmed cases of COVID-19 as of Saturday afternoon, according to the state Department of Health and Human Services. What we do know is that the official coronavirus case count is currently doubling about every three days in Michigan. "Southeast Michigan is burning right now," said Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at DMC Harper University Hospital and a professor at Wayne State University. "Our hospital systems are being overrun at this point," Chopra said. "They are all struggling. ... We are under-resourced and we need to make sure that we get more help. You know, we are asking, all of us are asking, for help. And the governor knows that." It has been just 19 days since the state reported its first two confirmed cases of COVID-19 on the evening of March 10. Eight days later, a Southgate man in his 50s was the first to die of the disease, and that's when the case counts around the state began to rise rapidly because of "a combination of increased detection of cases through laboratory testing as well as community-wide transmission," said Dr. Paul Kilgore, an associate professor at Wayne State University's Eugene Applebaum College of Pharmacy and Health Sciences. Reducing the rate of COVID-19 infections hinges on how well people adhere to the governor's order, said Kilgore. "The way I've been looking at social distancing is that it's really kind of our vaccine. You're the vaccine. I'm the vaccine. And the extent to which we apply this intervention to the population is exactly the way that we would apply a vaccine. The more people that do social distancing, or the greater the percentage of the population that social distance, that will determine the effectiveness or efficacy of social distancing, just like you would evaluate a vaccine," Kilgore said. 
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For some recovering addicts, Michigan’s stay-home order sparks fear of relapse

Michigan’s stay-home order, meant to protect the health of state residents, could be a challenge to the health of recovering alcoholics and addicts who’ve found in-person support meetings canceled and services like methadone dispensaries modified. Now, they’ll have to navigate a world where many paths to recovery have become digital. Many meetings are moving online, and some in recovery are trying to stay in contact through phone calls and Internet meetings. Still, some state leaders in the recovery community acknowledge that the isolation that comes from being cooped up at home sparks fears of relapse. For many Michiganders, the promise of a $1,200 check and other unemployment benefits from the federal government will spell relief. But for those who are recovering from substance abuse addictions, a big check could trigger a relapse. There are some ways to avoid this potential trigger, according to Dr. David Ledgerwood, director of Wayne State University School of Medicine’s nicotine and tobacco research division. People in recovery should find a way to ensure that their stimulus check goes towards necessities, Ledgerwood suggested, such as setting up a bank account specifically for paying bills. They could also tell a trusted family member to distribute the money. Telemedicine therapy can be beneficial for folks who have limited transportation options or duties like childcare, said Dr. Arash Javanbakht, director of the stress, trauma and anxiety research clinic at Wayne State University. Doing therapy from the comfort of one’s home could also provide new insight for clinicians into a patient’s living situation as well, he added. Javanbakht, who had been seeing patients through video calls once a week before the outbreak, said he and his patients were skeptical of teletherapy at first, but left their sessions feeling excited by the prospect.
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Can I complain about coronavirus? Why it is OK to vent, sometimes

Arash Javanbakht, assistant professor of psychiatry, wrote an article for The Conversation about how the pandemic has changed our normal lives. “The COVID-19 pandemic is different from many crises in that it has affected all of us regardless of politics, economics, religion, age or nationality. This virus is a good reminder that humanity is vulnerable to what nature throws at us, and that we are all in this together. This pandemic has profoundly changed our way of living. Overnight, dining out, exercising at the gym or seeing friends in person became impossible for millions of Americans. Remote working, reduced work hours and income, and uncertainty are indeed stressful. Most of us are having to make important adjustments and quickly learn new skills, such as how to do virtual meetings or be motivated to work from home. Given we are creatures of habit, these adjustments can be hard. We are also stressed by continuous exposure to sad news, often contradictory predictions and recommendations coming from different sources. The constantly changing and evolving nature of this situation is very frustrating.”