A two-day virtual 2021 Child & Adolescent Behavioral Health Summit, held April 13-14, invited professionals and insiders to address critical topics related to mental health, wellness, substance use disorder and suicide prevention. The event was designed for clinicians, social service providers, educators, parents, and anyone who works with youth. “What is the worst stress you’ve experienced in your life?” This question can help mental health professionals get to the core of a patient’s distress. But, according to Dr. Arash Javanbakht, director of the Stress, Trauma and Anxiety Research Clinic (STARC) at Wayne State University, it often goes unasked. Javanbakht led a session on the role of trauma and Post-Traumatic Stress Disorder (PTSD) during the summit. He explained that about 8 percent of Americans suffer from PTSD, described as an overgeneralization of fear, when memories are not where they belong in a person’s timeline. With PTSD, the brain reacts as if things are happening now, not as a memory. The brain is trained to be in a constant survival mode, making normal life nearly impossible to enjoy. Javanbakht said that diagnosing PTSD is not always a part of a children’s mental health professional’s training. “The two things you have to ask about are usually not volunteered: sex life and trauma,” he advises mental health professionals. “Trust is hard, especially when it comes to painful memories.” Javanbakht discussed different treatments for PTSD, including a variety of therapy options as well as medications. He said it’s important to see PTSD as a disease that can be treated.

Nonvictims can be affected harshly by mass shootings. In today's Academic Minute, Wayne State University's Arash Javanbakht determines that even those not hit can become afflicted. Dr. Javanbakht is an associate professor in the department of psychiatry and behavioral neurosciences at Wayne State's School of Medicine. 

Pharmaceutical companies are already hard at work to make the next generation of vaccines for COVID-19 easier to administer, less invasive in some cases, and more effective against a wider range of illnesses. Pfizer and Moderna are already conducting trials to evaluate booster vaccines to protect against new variants, the results of which are expected later this year. “They have to be as good or better than the current vaccines that we have," said Dr. Paul Kilgore, an associate professor and the director of research in the Department of Pharmacy Practice within the Eugene Applebaum College of Pharmacy and Health Sciences at Wayne State University. Kilgore, who is also a senior investigator with Henry Ford Health System's Global Health Initiative, told Action News hitting that gold standard takes time. “The first approach is to develop an mRNA vaccine very similar in design to the original vaccine that Pfizer and Moderna have, but what they will have is a new sequence in the mRNA that corresponds to the new spike protein in the variant," he said. 

Michigan's 15 public universities are bracing for a potential change that would severely alter how state aid is divided up among them, with most schools expected to see increases at the expense of two of the state's top research institutions. The Michigan House of Representatives this month passed controversial legislation that would tie the annual appropriation for the state's public universities to the number of full-time Michigan students enrolled. The House plan does not include an increase in funding for higher education — unlike the 2% increase passed by the Senate and recommended by Gov. Gretchen Whitmer. Instead, it would keep the appropriation around $1.3 billion but shuffle how much each college gets while phasing the changes in over three years. Under the House plan, UM's Ann Arbor campus stands to lose the most: $39.5 million, or 12% of its state funding, in the first year and nearly $125 million over the first three years. Wayne State would lose $8.2 million, or 4% of its state aid, in the first year and nearly $29 million in three years. Both universities, respectively, educate a larger percentage of non-resident students. Michigan would become the only state in the nation to use resident enrollment as the sole basis for state funding, said Britany Affolter-Caine, executive director of the University Research Corridor, an alliance of UM, WSU and MSU that promotes research as a driver of the state's economy. Wayne State University President M. Roy Wilson said a cut of $28.6 million over three years would dramatically impact tuition and services at the urban research institution where 2,135 of the 24,155 enrolled students are not from Michigan. The proposed funding change is a similar mechanism that is used to fund K-12 education in Michigan, which pays a set amount per student to schools each year, but it costs more to educate graduate and professional students, Wilson said. Some universities can put 300 undergraduate students into one lecture hall whereas a medical school class may not have that many. "There is a difference of scale here," Wilson said. "There needs to be a more sophisticated mechanism that better recognizes the unique missions of the 15 public universities in Michigan." Wilson added there is an underappreciation of research universities' contributions to the state's economy and residents' health and wellbeing. "Michigan has not historically appreciated the value of research," Wilson said. "There is a huge (investment) return on research. ... Research has a multiplier effect. The kind of technologies that come out of research universities: the life-saving discoveries and the improved quality of life is also really important. It's not just the financial benefit."

Despite CDC recommendations, one Michigan University is mandating masks to be worn inside. Wayne State University says the school has no practical way of differentiating vaccinated and unvaccinated people. WSU also says it will not require masks to be worn outside of campus buildings. “We need to operate in a manner that protects the safety of every member of our campus community. Therefore, masks will still be required indoors on Wayne State’s campus. Mask wearing outdoors, regardless of vaccination status, will no longer be required. We do ask that people continue to exercise caution and avoid large outdoor gatherings if the vaccination status of all participants is uncertain,” said Wayne State University President M. Roy Wilson. 

There has been a spike in fentanyl-related overdoses in two counties on the west side of the state, according to the Michigan Poison Center at Wayne State University. Cass and Van Buren counties are experiencing more overdoses related to the drug that is 100 times more potent than morphine and 50 times more potent than heroin. So far, Southwest Michigan has had five overdoses this year, which is more than last year. Dr. Varun Vohra, a clinical toxicologist with the poison center, said Southeast Michigan, especially the Detroit area, has seen a lot of fentanyl in cocaine and heroin. "People are being exposed to potentially especially lethal concentrations of drugs, specifically fentanyl, which can be coproduced or co-formulated with other opioids or other drugs unbeknownst to the users," Vohra said. "If they get this highly potent spike of fentanyl in there it causes them to stop breathing and die." Vohra said that while all people cannot be stopped from using drugs, people who are using them should make sure they have a drug reversal medication, such as Narcan, nearby. "We know people will use these products and illicit recreational drugs, and they need to know the risks associated with that and have an antidote on hand or with them," Vohra said. "It would be a huge boom to mitigate these overdoses."

Wayne State University researchers have found that hospitalized COVID-19 patients who took statins regularly before they got sick were less likely to die from the disease or have severe infections. Statins, such as Lipitor, are most commonly prescribed to treat high cholesterol. But they have other roles, too. “They have anti-inflammatory properties and control the immune system at various levels,” said Dr. Prateek Lohia, an assistant professor of internal medicine at Wayne State. Lohia says clinicians had very little knowledge about COVID-19 when patients started filling hospitals in 2020, or how to treat it. He began reading scientific literature to see if any medications might help treat the novel coronavirus. He says studies had already been done on how statins might help people with other viral infections. “We found some observational studies that noted a significant decrease in mortality from influenza and community-acquired pneumonia,” Lohia says. The Wayne State team began its own observational study to see how statins might help COVID-19 patients in Detroit. They observed more than 1,000 patients at Detroit Receiving and Harper University hospitals. Lohia says about 45% of those observed had been taking statins at home. Their mean age was 65, most were Black and many had comorbidities known to increase the risk of severe infection and death from COVID-19. The researchers noticed that those who had been taking statins at home before they were admitted had a lower mortality rate and were less likely to suffer severe infections than those who had not. Lohia says dosage also made a difference. “Moderate and high doses did have an effect compared to patients who are taking low doses,” he says. The early results of the study are promising, but Lohia warns that more research is needed. “Ours was just an observational study, which shows association but does not point toward causation,” he says. “What is needed is a randomized controlled trial to provide the next level of evidence.”

African Americans again are dying at a disproportionate rate from COVID-19 in Michigan, as the gap widens between Black and white residents who have been vaccinated. In the past four weeks, African-American residents have comprised 19 percent — 295 of 1,560 deaths — of all COVID-19 deaths, despite making up 13.8 percent of the state population. The uptick comes as demand for the vaccines decreases. Statewide, some 27 percent of African Americans have at least one dose of the vaccine, compared to 40 percent for white residents, according to state data. And Detroit, where 78 percent of residents are African American, has one of the lowest vaccination rates in the state: About 33 percent among adults compared to 55 percent statewide. Experts say the return of the death disparities underscores that the vaccine saves lives. Detroit has gone to senior housing apartments and run clinics at churches and neighborhood centers in an attempt to get as many people as possible vaccinated. “If you make it easy for people they’re more likely to do what is needed to keep them healthy,” said Phillip Levy, an emergency room physician who heads the Population Health Outcomes and Information Exchange (Phoenix) program at Wayne State University. As a physician at Detroit Receiving Hospital, Levy said he saw the rising number of COVID-19 cases pour into the emergency room in recent months. “It’s very worrisome,” said Levy, who is also chief innovation officer for Wayne Health. And he’s aware of the low vaccination rate in Detroit. “That’s really scary. We’ve got to continue to press and press hard.” To help, Levy’s group has been taking its mobile health unit across the region, to neighborhoods in Detroit, Eastpointe and Pontiac and elsewhere to bring basic care as well as vaccines to areas where “social vulnerability” — higher poverty, more seniors, less health care access — is highest. He lauded efforts at local churches to bring the vaccines closer to where people live, to have it offered in settings where people may be more comfortable.

Dr. Paul Kilgore, an associate professor of pharmacy practice at Wayne State University and Dr. Marcos Zervos, assistant dean of global affairs, talked about the safety of the vaccines. Both played critical roles in the development of the Moderna and Johnson & Johnson vaccines. They also served as principal investigators on both the Moderna and Johnson & Johnson vaccines.

Another university community is lobbying for a vaccine mandate for those returning to campus in fall. More than 700 Wayne State University professors, staff and students have petitioned the administration to require a coronavirus vaccine for students, faculty and staff to avoid outbreaks and promote safety. Campus leaders presented Wayne State's petition, dated April 8, to President M. Roy Wilson and Provost Laurie Lauzon Clabo two weeks ago and added their support to the university's efforts so far, said Fabrice Smieliauskas, a Wayne State assistant economics professor. But they have not received a formal response. WSU spokesman Matt Lockwood said university officials are surveying students, staff, faculty anonymously to assess the magnitude of who has been vaccinated among its community, which includes 24,000 students who enrolled in winter semester. It also needs to analyze the impact of the incentive the president offered to buy lunch for students if they got vaccinated. “We will consider this data and other COVID-related metrics before we consider taking any additional actions," Lockwood said. Wilson recently said during a radio interview that, "we may be heading into a mandate" but added that the lunch incentive was showing positive results. "I’d like to try to do anything possible to not issue a mandate," said WSU's president.

Detroit's infant mortality rate — once highest in the nation, exceeding many Third World countries — achieved a historic drop in 2019, helping Michigan achieve its lowest infant mortality rate in more than 100 years, according to state health officials. Detroit Mayor Mike Duggan noted programs, such as Make Your Date, a collaboration between the city and Wayne State University, and prenatal programs run by Henry Ford Health Center and Ascension St. John Hospital as well as community organizations such as the Black Mothers Breast Feeding Association. Infant mortality is considered the death of an infant before reaching the age of 1. Causes of infant mortality included birth defects, preterm or premature birth, maternal pregnancy complications, Sudden Infant Death Syndrome and injuries like suffocation. The greatest cause of infant mortality is premature birth, said Dr. Sonia Hassan, a professor of obstetrics and gynecology and maternal-fetal medicine who co-founded Wayne State University's Make Your Date program with Duggan in 2014. "It's amazing and great news," said Hassan of Detroit's reduction in infant mortality. "The reduction was for 2018 to 2019, but for years before that, there was a real big focus in the city by many groups on infant mortality — and it really made a difference. "Our program had high volume enrollment and others did too during that time. We were able to partner with the city on the transportation piece. So we were able to get a lot of people to services that they needed." Make Your Date, Henry Ford Health System, Ascension Health, the March of Dimes and numerous other partners focused on moving the needle, she said. "All of those people collectively as a group really were focused on infant mortality," she said. 

Dr. Arash Javanbakht, associate professor of psychiatry, wrote an article for The Conversation. “Recent clinical trials, including one soon to be published in Nature Medicine, have suggested that MDMA combined with psychotherapy may help treat post-traumatic stress disorder, or PTSD. The news generated considerable optimism and excitement in the media, and some in the scientific community. As a psychiatrist and an expert in neurobiology and treatment of PTSD, I think these developments may be important – but not the major breakthrough that some people are suggesting. This approach is not a new magic bullet.

While any regular physical activity can benefit your health, the ideal fitness plan requires the right balance. The American Heart Association recommends adults get at least 150 minutes of moderate-intensity aerobic exercise a week or 75 minutes of vigorous activity, or a combination of both; plus muscle-strengthening activity, such as resistance training, at least two days per week. "Aerobic exercise should be the foundation of any exercise program," said Barry Franklin, director of preventive cardiology and cardiac rehabilitation at William Beaumont Hospital in Royal Oak, Michigan, and professor of physiology at the Wayne State University School of Medicine. Doctors may suggest a medically supervised treadmill test to evaluate how a person's heart rate, blood pressure and heart rhythm respond to progressive levels of exercise, as well as their level of heart-lung fitness expressed as metabolic equivalents, or METs. Franklin calls METs the "currency of exercise." They are used to quantify one's aerobic fitness in order to recommend the appropriate level of activity.

The recent surge in COVID-19 cases throughout Michigan has dampened hopes of a prompt return to normalcy. Schools and universities are once again having to navigate reopening plans for the fall as the state endures significant community spread. Some universities in Metro Detroit, including Oakland University, have announced that they will require students, faculty and staff to be vaccinated before returning to campus. M. Roy Wilson is the President of Wayne State University. He says that Michigan was once seen as a leader in managing the racial disparities present in the spread of COVID-19. Now, he says, that progress has dramatically diminished. “Michigan really was a model early on in terms of what can be done … in terms of deaths and racial disparity. … Obviously, the overall situation has really deteriorated … it hasn’t gone back to as bad as early days … but it’s disappointing,” says Wilson on the disparate outcomes of COVID-19. With the benefit of hindsight, Wilson says while he wouldn’t enact a complete state shutdown at this point, perhaps he wouldn’t have opened the state back up when the governor did. On the criticism Gov. Gretchen Whitmer is facing, Wilson says it’s easy to play Monday morning quarterback. “It’s easy to pick one or two things and say this is the cause … overall, I think the governor has done a good job,” says Wilson. As for Wayne State University, Wilson says he hopes incentives will encourage more students and staff to get vaccinated before the fall. He adds that to open safely, a large majority of the campus must be vaccinated. “We may be heading into a mandate … I don’t want to jump into that, but it’s a possibility for the fall … right now, I’d like to try to do anything possible to not issue a mandate. … I’d like to see about a 90% campus vaccination rate,” says Wilson on a potential vaccine mandate for the fall.

Tamara Hew-Butler, associate professor of exercise and sports science, wrote an article for The Conversation on the health risks associated with overhydration. “The warmer weather and longer days have inspired reminders to “stay hydrated” and drink eight glasses of water – or about two liters – a day. Not to burst anyone’s water bottle, but healthy people can actually die from drinking too much water. I am an exercise physiologist, and my research focuses on overhydration and how drinking too much water affects the body. Since water – and sodium – balance is essential to life, it is extremely rare for people to die from drinking too much – or too little – fluid. In most cases, your body’s finely tuned molecular processes are unconsciously taking care of you.”

Seth Norrholm, an associate professor of psychiatry at the Wayne State University School of Medicine and an expert on post-traumatic stress, said that Twitter had offered Mr. Trump a round-the-clock forum to express his contempt and anger, a direct channel from his id to the internet. Every time he used all-caps, Professor Norrholm said, it was as if “an abuser was shouting demeaning statements” at the American people. Although “out of sight, out of mind really works well for a lot of people in helping them to move forward,” he continued, Mr. Trump has refused to go away quietly. Indeed, he has set up a sort of presidential office in exile at Mar-a-Lago, his Florida resort, emerging intermittently to issue statements on quasi-presidential letterhead and to heap derision on Republicans he deems insufficiently loyal. “It’s as if you’re in a new relationship with the current administration, but every now and then the ex-partner pops up to remind you that ‘I’m still here’ — that he hasn’t disappeared entirely and is living in the basement,” Professor Norrholm said. “What’s going to happen over the next couple of years is that you will hear rumbles from the basement. We don’t know whether he’ll emerge or not, or whether it’s just some guy in the basement making some noise.”

A discussion about mass trauma and dealing with the restrictions of COVID such as working from home, social distancing and other elements that restrict normal social behavior. Dr. Arash Javanbakht, director of Stress, Trauma, and Anxiety Research Clinic (STARC), and professor of psychiatry and behavioral neurosciences at Wayne State University School of Medicine, is the featured guest.

Spotlight on the News examined Michigan's recent surge in COVID-19 cases through the eyes of two of the state's most experienced infectious disease medical experts. Guests included Professor Marcus Zervos, MD, Assistant Dean, Global Affairs, Wayne State Medical School & Division Head, Infectious Diseases, Henry Ford Health System; and Associate Professor Paul E. Kilgore, MPH, MD, FACP, Pharmacy, Family Medicine & Public Health, Wayne St. University & Senior Investigator, Global Health Initiative, Henry Ford Health System. What do they think is behind Michigan being the nation's latest coronavirus hot spot?

More of Michigan’s population is getting vaccinated as the rollout picks up steam in Detroit and across the state. Despite this, COVID-19 cases are once again climbing. “There is definitely a perception that we are through the worst of it, and we can let down our guard. I would seriously caution people against that,” says Dr. Paul Kilgore, associate professor and director of research at the Eugene Applebaum College of Pharmacy and Health Sciences. He says the U.K. strain is partly to blame for the spread of COVID-19 cases in Michigan. “This is definitely one reason we’re seeing a surge in cases now.”  This strain of COVID-19 can spread more rapidly and needs fewer virus particles to establish an infection in the body. For this reason, he encourages people to continue to wear a mask, even after vaccination. Mask wearing, Kilgore says, will protect the individual until the vaccination takes full effect and will also protect others who have yet to be vaccinated. Pandemic fatigue has left many eager to resume life as normal, but experts say fully reopening too soon could compromise the progress made against the virus. “There is definitely a perception that we are through the worst of it, and we can let down our guard. I would seriously caution people against that,” says Kilgore.

Just as women have borne the brunt of economic damage from the pandemic, a new report makes clear that Covid-19 has also disproportionately taken a toll on women’s health and access to care. According to a national survey, conducted late in 2020 by the Kaiser Family Foundation (KFF), more than one-third (38%) of women had skipped preventive services, such as checkups or routine tests, during the pandemic. Nearly one-quarter (23%) had forgone a recommended test or treatment. In comparison, only 26% and 15% of men had missed preventive or recommended care, respectively. “The fact that women are more likely than men to delay their healthcare services is not surprising, as women have been disproportionately burdened with child and household care, home schooling and, in many cases, an inability to maintain employment due to the many obligations placed upon them,” said Dr. Sonia S. Hassan, professor of obstetrics and gynecology and associate vice president in the Office of Women’s Health at Wayne State University.