With the recent uptick in cases of COVID-19 in Michigan and throughout much of the country, Detroit Today’s coverage about this moment of the pandemic is a top priority. There’s reason to be at least cautiously hopeful about the recent news of potential vaccines for the virus, but there’s still a real need for continued research for alternative treatments. One such effort involves the use of convalescent blood plasma through trials being led locally by Wayne State University and Johns Hopkins researchers. Dr. James Paxton is the leader of the Detroit branch of the trial. He’s also the Director of Clinical Research for Detroit Receiving Hospital Department of Emergency Medicine, and Assistant Professor of Emergency Medicine at Wayne State University School of Medicine. He explains that convalescent blood plasma therapy is really just using antibodies found in the blood of people who have previously had COVID-19. ”Antibodies are essential to fighting any infection… and your body retains the antibodies so that it can remember how it defeated [the virus] before in case it needs to defeat it again in the future.” Paxton says that his work at the Detroit trial site involves matching processed plasma with those who need to receive it. “We think it will work,” he says of the plasma transfusion pointing to the history of this kind of medical intervention.

Hilary A. Murasak, assistant professor in the Department of Psychiatry and Behavioral Neurosciences at Wayne State University’s School of Medicine, wrote an article for The Conversation on the rise of CBD usage during the pandemic. “Many people have turned to cannabis and its derivatives as they search for pandemic relief, and one of the most widely available ones is CBD. It is also legal and readily available. You can buy oils, tinctures, capsules, gummies, cosmetics and even toilet paper said to contain the molecule. Martha Stewart has a line of CBD products, and some companies are marketing CBD products for holiday gifts. And, you can even buy CBD products for your pet. An investment bank has estimated that this market will be worth $16 billion by 2025, even though many of the products that allegedly contain CBD may not contain any CBD all. And, if they do, the amount often is far less than the amount stated on the product bottle or box.”

Michiganders trying to get tested for COVID before seeing loved ones at Thanksgiving might find that a collective rush on testing labs will make that impossible. And if you are lucky enough to get tested, well, expect… to … wait for your results. Though Michigan doesn’t track turnaround times, it appears that roughly two weeks before the holiday it’s already taking three to five days for test results, said Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services. The state’s testing capacity is being overwhelmed as the virus spreads “out of control,” Dr. Joneigh Khaldun, the state’s chief medical executive and deputy director of MDHHS, noted at a media briefing Thursday. Testing demand has soared as the number of coronavirus cases in the state has spiked and the percentage of tests coming back positive has risen to roughly 14 percent. Testing also has increased in recent weeks at Wayne State University, as cases surged around the state — “and that’s a good thing,” said Laurie Lauzon Clabo, dean of the college of nursing. The school, which does 750 to 800 tests weekly now, is largely a commuter university, so it doesn’t face the same pressure as other universities to step up testing before Thanksgiving break since many of those students already live at home or are with their families, she said. But it will be important for the 1,350 or so students living on campus or who, for example, perform lab work, to be tested after the holiday. “There are tough days ahead,” she said.

Pharmaceutical giant Pfizer announced this week that their vaccine trial is more than 90% effective at preventing COVID-19, based on early data. That’s far above the standard set by the Food and Drug Administration, which set the bar at 50% effectiveness for emergency use. This is the first vaccine for the novel coronavirus to exceed the mark, raising hopes that a return to relative normality could be on the horizon. Experts, while optimistic about the development, urge caution as COVID-19 cases surge across the county, and widespread distribution of any vaccine is still months away. Dr. Teena Chopra, professor of internal medicine in the Division of Infectious Diseases at Wayne State University School of Medicine says the new development in the quest for a vaccine is very encouraging. “It’s a testament to how quickly research is moving,” says Chopra of Pfizer’s vaccine trial. Manufacturing a potential vaccine will be another hurdle, something Chopra says Pfizer is already tackling. “Pfizer applied for an emergency use authorization… and claims they have started manufacturing millions of doses.” After manufacturing comes the widespread distribution of a vaccine, another challenge for pharmaceutical companies. This particular vaccine needs to be refrigerated and stored at a very cold temperature, complicating the task. According to Chopra, distribution will rely on collaboration. “We don’t just need one kind of vaccine… that’s not enough to be distributed globally. We need tons, we will look at all the vaccines… there should be heavy emphasis on the data.”

Wayne State University has been awarded nearly $700,000 in federal funding to study protecting children from lead exposure in their homes, officials said. The grant is part of $9.4 million the U.S. Department of Housing and Urban Development has given to 13 universities to research ways to reduce housing-related health hazards, such as pests, injury hazards and asthma triggers. HUD officials said WSU will be given $699,171 to partner with the Michigan Department of Health and Human Services, CLEARCorps Detroit and the Detroit Health Department to study the cost effectiveness of protecting children from lead exposure through improved temporary emergency relocations and new permanent voluntary relocations. The goal of the study is to establish whether the policies are effective in reducing blood lead levels in children and then to compare the costs of relocation to the costs of current approaches.

Shortly after I got our results I sent a text message to Phillip Levy, M.D., an ER doctor, associate chair for research at Wayne State University School of Medicine and a co-investigator in numerous COVID-19 clinical trials. He also heads up WSU's public testing outreach program. "It doesn't really necessarily mean much, it just means that her body is shifted to the next phase of the adaptive immune response, meaning that it's no longer about having enough protection available at the ready," Levy said in his best bedside manner. "That's the antibody response. It's about now having the memory to mount the response if you would need it." So, let me get this straight. Her negative test means she doesn't have any COVID-19 antibodies left? You know she was counting on having those for a long time, right? "Yes, what happens is that as soon as you're exposed to the virus, certain types of cells start making these antibodies as part of that immediate response. Those cells live to produce the antibodies for as long as the body thinks it might need to protect itself. And that peak, (we now know from research) is about 50 days or seven weeks."

The disrupted college lifestyle is weighing on Wayne State University students, its leaders have found. So, on Oct. 30, they want a pause in activities, including classes, for a mental health day. "We've been checking in on students and they're feeling pretty stressed," Interim Provost and Senior Vice President for Academic Affairs Laurie Clabo told the Free Press. "We know they're tired. We're seeing students who are feeling isolated. We're just worried about them." So the university will drastically slow down on that day. "We want them to take a day to just take a pause and recharge so they are ready to finish out," Clabo said. M. Roy Wilson, the university's president, said in a pair of emails sent Thursday morning to the campus community. "The purpose of this day is to allow you time to focus on your health and emotional well-being during these challenging times, connect with fellow students, learn more about the resources available to help you cope and thrive, or close the laptop and dedicate the day to self-care. Faculty are being encouraged to give students some leeway on assignments, and even cancel classes for the day, if feasible."  Wilson encouraged faculty and staff to give themselves a break as well. "Many faculty and staff have not been on campus since March, and continue to face additional stresses, from Zoom/Teams fatigue' and balancing work and child care, to the loss of working alongside our colleagues and the benefits that come with in-person engagement and collaboration. Many are working harder — and longer — and are not taking earned vacation time. While the changes in how we work were made with safety in mind, they bring new challenges, some of which can be unhealthy if not addressed." If Oct. 30 isn't feasible as a mental health day, leaders should consider allowing people to use another day, Wilson said.

Public health authorities have issued warnings about a new drug called purple heroin which is tied to overdoses in the Upper Peninsula and the death of one person in west Michigan. Purple heroin — which gets its name because it is often purple in color — contains the synthetic opioid fentanyl, acetaminophen (the ingredient found in Tylenol), flualprazolam (an illicit sedative similar to Xanax), buspirone (an anti-anxiety drug), niacinamide (a form of Vitamin B) and, most notably, a new drug named brorphine. "We want to try to get ahead of it to make sure … it's not making its way down the state," said Varun Vohra, a director of the Michigan Poison Center at Wayne State University which issued an alert Wednesday. Little is known about brorphine. “Not many people know about it. It was a surprise to us as well," said Vohra. Vohra asks that anyone who needs information on purple heroin or has come across it to call the Michigan Poison Control Center, 800-222-1222. The center is not tied to law enforcement.

The COVID-19 pandemic has swept through the United States, highlighting racial inequities in healthcare. The numbers of infections and deaths related to COVID-19 are far higher among people of color, especially Black Americans, than among white Americans. Despite these higher risks, Black Americans are less likely to sign up for experimental medical treatments or potential vaccines. To help bridge this gap and champion the interests of Black people and other marginalized groups during the pandemic, the National Medical Association set up an expert task force to vet regulators’ decisions about COVID-19 drugs and vaccines. “We are more interested in efficacy,” said Dr. Bret Hughes, a professor of ophthalmology at Wayne State University and longtime member of the National Medical Association. He added that the process for vetting vaccines and other kinds of medications is very regimented and specific, and has two goals: safety first and then effectiveness. But “there are political groups that are willing to bypass those procedures and say there is a vaccine in order to quell fears. In fact, you can take a vaccine and develop other conditions because there’s more in the vaccine no one is aware of until you get it.” Dr. Rick Baker, a professor of ophthalmology and vice dean for medical education at Wayne State University and a longtime National Medical Association member, said the association will be doing three things in vetting vaccines: making sure whatever is developed is scientifically sound and effective; assessing whether there’s adequate representation of people of color in the trials; and ensuring that the distribution of the vaccine is equitable. In these uncertain times, he added, someone needs to be the trusted messenger, adding that physicians are uniquely qualified to be that messenger. “The message needs to be transmitted from physicians to patients,” he said. “The physician-to-patient relationship is very important.”

Michigan’s battle with the novel coronavirus has taken a sharp turn, with the volume of cases sharply increasing almost daily along with hospitalizations, emergency room visits and deaths. For the past week, there have been over 1,100 newly confirmed cases a day. More than 1,000 people with COVID-19 are now in Michigan hospitals, following a recent low of 500 on Sept. 25. And deaths, which had been low, are creeping up in a likely “second wave” that will bring more cases. The recent rise in COVID-19 infections has not brought with it the volume of deaths suffered last spring. Cases are more widely distributed across the state and therapies and treatments have improved in Michigan, as they have elsewhere. Experts attribute the improved outcomes to a host of factors. Fewer patients spread across more hospitals have allowed for better care. Treatments have changed and some therapies have emerged, like using remdesivir,  which aided in President Trump’s recovery. And after the coronavirus ravaging nursing home residents in Michigan and elsewhere, changes were made to better protect those populations and many more are taking their own precautions, such as wearing masks and avoiding crowds. “All these precautions are definitely helping,” said Dr. Teena Chopra,  a professor of infectious diseases at Wayne State University who is in charge of infection control at Detroit Medical Center. Chopra said she has noticed that patients she sees at the Detroit Medical Center are younger, by about a decade, than those who were arriving in March and April. That’s made them more resilient to COVID-19. But it doesn’t mean it’s no longer to be feared. “The virus is not going to magically disappear,” Chopra said.

As the majority of public universities begin fall semester classes this week amid the COVID-19 pandemic, Wayne State University has developed a plan with specific benchmarks about when to take action to contain any potential spread of the virus. The university would take its most drastic step and depopulate the campus if testing shows positive cases within the university community to exceed 15%, or three or more clusters appear in seven days or if fewer than 15% of hospital beds and fewer than 15% of intensive care unit beds are available. The "tipping point metrics," posted online Monday, include thresholds that will trigger and guide Wayne State officials in their decision-making in the event of numerous COVID-19 cases. While many universities have a plan of when to take action, the Detroit university is among a small number of universities nationwide that are publishing specific numerical thresholds to trigger actions if coronavirus infections escalate. Wayne State made the move after watching other universities that have returned to campus and grappled with numerous coronavirus cases. It also wanted to be transparent and clear about what will happen if necessary, President M. Roy Wilson said. "I don't think the time to make a decision is ... when everything is getting worse," said Wilson, who is an epidemiologist. "You have to have some things already worked out so you are not wasting time. We know the science, and we know when things reach a certain level, it’s bad." 

For women who are pregnant, the pandemic can be particularly fraught with anxiety as they worry about the effects of COVID-19 on themselves and their babies, all while coping with potential job loss, child care issues and economic uncertainty. An evolving body of research — including a recent study by investigators at the Wayne State University Medical School and the National Institutes of Health Perinatology Research Branch in Detroit — has shown it's unlikely for the virus to pass from a pregnant woman to her fetus. A data analysis of U.S. cases, published by the federal Centers for Disease Control and Prevention in July, concluded that pregnant women are at no greater risk of dying from the virus than non-pregnant women, though they are more likely to end up in intensive care and require a ventilator. With 24 million cases of COVID-19 worldwide, including about 6 million in the United States and more than 100,000 in Michigan, there has been no consistent evidence of pregnant mothers passing the infection to their newborns, what's called vertical transmission. While other viral infections such as Zika, cytomegalovirus and rubella can be passed from mother to fetus, researchers led by Dr. Roberto Romero, chief of the Perinatology Research Branch at the National Institute of Child Health and Human Development at Wayne State, investigated why the same isn't true of SARS-CoV-2, the virus that causes COVID-19. "The rate of vertical transmission is extremely low," Romero said. "The best estimates that we have are less than 2%, or less than 1%. There have been some reports of neonates testing positive after birth, but there is always the question: Was that virus acquired in utero, or was it acquired from a mother who is sick?" 

As colleges grapple with the decision of when to resume athletic competition, the NCAA’s chief medical officer suggested mental health issues — especially among Black athletes — are getting insufficient attention. Mental health concerns were highest among respondents of color, those whose families are facing economic hardship and those living alone, according to an NCAA news release about the findings of the survey, which was conducted April 10-May 1. Greater financial pressures and more instability at home among Black athletes make separation from their teammates an even bigger issue, said M. Roy Wilson, president of Wayne State University and a panelist. “We have to deal with those aspects with the same rigor and concentration as we do social distancing, wearing masks, sanitation of facilities,’’ Wilson said. “All those things are good. But we’ve got to look at the well-being of our student athletes also, because they’re not going to be able to come back if they don’t."

Tabitha Moses, MD/PhD candidate at Wayne State University, wrote an article for The Conversation about the challenges that online instruction can pose for students if they are required to keep their cameras on during class. “As the 2020-21 school year gets underway – both at the K-12 and college level – many students find themselves attending online classes via Zoom or similar teleconferencing platforms. Although sticking with remote instruction may be the correct decision from the standpoint of public health, it is not without problems. As a researcher who studies behavior and the brain, I have found the evidence suggests that online instruction can pose a range of challenges for students if they are required to keep their cameras on during class. Here are five reasons why I believe students should be allowed to keep their cameras off instead: Increased anxiety and stress; ‘Zoom fatigue;’ Competing obligations; Right to privacy; and, Financial means and other kinds of access

With two pen strokes last week, Gov. Gretchen Whitmer declared racism in health a priority within the state’s government offices. But health leaders say it will be the follow-up — funding, policy change and enforcement — that determines whether the move is symbolic or transformative. “I'm glad they're getting people to the table … The thing is we've been discussing this and discussing this and discussing this,” Dr. Lynn Smitherman, a Detroit pediatrician, associate chair of medical education at Wayne State University, and a diversity and inclusion champion for the American Academy of Pediatrics. “You still have to do something. Discussion without action is just another academic exercise,” she said. At a panel discussion last week organized by Wayne State University and others, Dr. Michelle Williams said Black Americans also face institutional racism when they are sick — with access at times only to lower-quality care and even clinicians that turn them away or don’t listen to their concerns. Lyke Thompson, director of the Center for Urban Studies at Wayne State University, has studied lead poisoning extensively and said Black children in Detroit often live in older homes that have high levels of lead paint, which can impair learning and hinder lifetime earning potential. Thompson said he has called for strengthening laws that hold accountable the landlords who don’t address those issues, but a lack of political will has stopped short of making that happen. An official declaration that racism plays a role in policies — and a commitment to address it — may finally make a difference, he said. “This takes serious, clear, ongoing focus,” he said.

In parts of Wayne County, including Detroit and eight surrounding suburbs, older adults are dying at twice the rate of those who live elsewhere in Michigan, according to a report, “Dying Before their Time,” a 19-year analysis between the Detroit Area Agency on Aging and Wayne State University Medical School. The agency attributed much of the cause to be a "result of deep-rooted negative social and economic policies and significant inequities in resource distribution." Chronic illnesses, living conditions, accessibility to health care and lack of health insurance, food and transportation are specifically cited as reasons for the shortened lifespans, the study found. Study co-author Dr. Herbert Smitherman Jr. of Wayne State University School of Medicine and Detroit Medical Center said it was shocking to discover how many people aren’t making it to 60 years old. “I’m a physician but also a scientist, so when they approached me, my first recommendation was that an analysis needed to be done since there was never data collected by the state,” Smitherman said. “To see we lost not 1 or 2%, but 23% of the entire population, it seemed unrealistic. The Detroit region had 1.3 million people and lost more than 150,000 people, that’s just what the (nation) lost with coronavirus. “That’s when we realized something was happening to seniors that wasn’t happening with any other population, and it got my full attention. Next, we realized if they’re dying before age 60, what’s happening before?" Smitherman worries the trend will continue without a coordinated push to reverse it. "What we’ve seen over 19 years is that it’s the same," Smitherman said. "Unless we have some sustained effort where they allocate funding and collaboratively work to improve health and reverse centuries of racial poverty, this trend will persist over many decades to come. "If we do nothing, nothing’s going to change."

Rebecca Klisz-Hulbert, assistant professor, Department of Psychiatry and Behavioral Neurosciences, wrote an article for The Conversation. “Black youth in the U.S. experience more illness, poverty, and discrimination than their white counterparts. These issues put them at higher risk for depression and other mental health problems. Yet Black youth are less likely to seek treatment. About 9% of them reported an episode of major depression in the past year, but less than half of those – about 40% – received treatment. By comparison, about 46% of white youth who reported an episode were treated for depressive symptoms. Instead, some turn to suicide, now the second leading cause of death among Black children ages 10 to 19. That rate is rising faster for them than any other racial or ethnic group.”

The Centers for Disease Control and Prevention recommends that anyone who has spent more than 15 minutes within six feet of somebody who has COVID-19 should quarantine for 14 days. On the field, football players are continually within six feet of each other, especially at the line of scrimmage. Even if distancing six feet during football games and practices were possible, it might not be enough. Studies on superspreading events suggest that heavy breathing may spread droplets as far as 12 feet, or four yards, according to Gretchen Snoeyenbos Newman, an assistant professor of Infectious Disease at Wayne State University. “For football players on the field while they’re playing, the linemen are really your most at-risk people [to become infected]. Athletes are professional droplet producers.” Also, some conclude that professional athletes in peak physical fitness would be minimally affected by contracting the virus. Snoeyenbos Newman says that isn’t the case. There is increasing evidence that COVID-19 can damage the lungs, heart, and even the brain. Snoeyenbos Newman says that while the average person who contracts and recovers from COVID-19 may not notice if they lose 2 percent of their lung capacity, elite athletes will absolutely notice, and long-lasting lung or heart problems could be career-ending. “Getting really, really sick but not dying can also have very negative life-long consequences,” Snoeyenbos Newman says. “You don’t have to die in order for it to be really bad.”

Why are newborns born to mothers with COVID-19 rarely infected? Researchers at the Wayne State University School of Medicine and the Perinatology Research Branch of National Institute of Child Health and Human Development/National Institutes of Health in Detroit have found that placental cells minimally express the instructions, or mRNA, to generate the cell entry receptor and protease required by the virus that causes COVID-19 to invade human cells. The pandemic caused by SARS-CoV-2 has infected more than 10 million people worldwide, including pregnant women, yet to date there is no consistent evidence that pregnant mothers pass the virus to their newborns. “The findings of this study help to understand why mother-to-fetus transmission is so rare (less than 2% of cases),” said Roberto Romero, M.D., D.Med.Sci, chief of the PRB. “The most likely explanation is that the cellular instructions for the production of the main receptor for SARS-CoV-2 are not expressed in the human placenta. In contrast, the receptors for other viruses known to cause fetal infection such as Zika and cytomegalovirus were found in placental cells.” Roger Pique-Regi, Ph.D., assistant professor of the WSU Center for Molecular Medicine and Genetics, and of Obstetrics and Gynecology, first author of the study, explained that the single-cell genomics technology the researchers employed allows them to study the transcriptome of individual cells isolated in tiny oil droplets using microfluidics.  

President M. Roy Wilson wrote an opinion piece about the coronavirus disproportionately killing African Americans. “As of Tuesday, there were 3,407 coronavirus-related deaths in Michigan, with 1,622 in one county alone. That county, Wayne County, is home to Detroit, a city populated 80% by African Americans. By comparison, St. Louis city and county account for 175 of Missouri’s 274 deaths. African Americans are disproportionately represented among the victims. Fortunately, both the number of new cases and hospitalizations have reached their peaks in Detroit, and we are now on the downward side of the curve. Yet, few in Detroit have not been personally impacted by the tragic toll of death among friends and family. I believe that there are lessons to be learned from Detroit’s experience that can help mitigate the death toll in St. Louis’ African American community.”