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.  

Dr. Mark Schweitzer, dean of the School of Medicine and vice president of health affairs at Wayne State University, co-wrote an op-ed about the need to address personal health issues that may have been neglected during the pandemic. “As we’ve watched our state battle to reduce the toll of COVID-19 on Michigan residents, we’ve understood — and supported — the sense of caution that has kept people home rather than visiting their doctors or going to the hospital if they think they need medical help. But as health care specialists trained as medical doctors, we also know the risks of getting medical attention too late. Strokes, heart attacks, diabetes and cancer don’t take a break just because we’re in the middle of a pandemic. The danger of hospitals being overwhelmed by the need to treat COVID-19 patients required us to limit access this spring so patients could receive the treatment they needed and caregivers could get the personal protection equipment critical to protecting their health. But the situation today is much different. The doctors affiliated with our three universities that make up Michigan’s University Research Corridor — Michigan State University, the University of Michigan and Wayne State University — along with our clinics and Michigan Medicine, UM’s medical center, are taking the steps to help their patients through telemedicine, where appropriate.”

Tabitha Moses, MD/PhD candidate at Wayne State University, wrote a Conversation piece about the growing trend of using military metaphors in references to the coronavirus. “Sometimes war involves battling other countries; other times, it’s the metaphorical kind, like our current “war” against the coronavirus. We see this war reflected in the language that gets used by politicians, policymakers, journalists and healthcare workers. As the “invisible enemy” rolled in, entire economies halted as populations “sheltered in place.” We were told to “hunker down” for the long battle ahead and to “support our troops,” the health care workers, fighting on the “front lines.” These military-inspired metaphors serve a purpose. Unlike the dense linguistic landscape of science and medicine, their messages are clear: Danger. Buckle Down. Cooperate. In fact, studies have shown that sometimes military metaphors can help unite people against a common enemy. They can convey a sense of urgency so that people drop what they’re doing and start paying attention. However, as someone who has studied the way language influences behavior, I know that this kind of rhetoric can have long-term effects that are less positive, particularly within health and medicine. In fact, research has shown that these metaphors can cause people to make decisions that go against sound medical advice.”

Lauren Hamel, Ph.D., assistant professor and member of the Population Studies and Disparities Research Program at Karmanos Cancer Institute and the Wayne State University School of Medicine, was awarded a Research Scholar Grant by the American Cancer Society. She will use the grant to test the effectiveness of a patient-focused intervention to improve patient-provider treatment cost discussions and other patient outcomes related to the financial consequences of cancer treatment. Hamel and her team responded to the growing problem of financial toxicity, or the severe material and psychological burden of the cost of cancer treatment. Financial toxicity affects an estimated 30% to 50% of patients with cancer, especially patients who are racial/ethnic minorities, have lower incomes or are under 65. However, well-timed and effective patient-oncologist treatment cost discussions could help.

Julie Wargo Aikins, associate professor of psychiatry and behavioral neurosciences, Merrill Palmer Skillman Institute, wrote this piece earlier for The Conversation. “Children's social worlds have been upended by the suspension of school and extracurricular activities due to the pandemic. Many older children and adolescents have been able to maintain their friendships over social media. But, for younger children, this approach is less likely to be available to them and less likely to meet their social needs. In some places, a silver lining of Covid-19 may well be the resurgence of childhood friendships in American neighborhoods.”

Arash Javanbakht, associate professor of psychiatry, wrote an article for The Conversation about celebrating the Fourth of July with respect to individuals with PTSD. “For some combat veterans, the Fourth of July is not a time to celebrate the independence of the country they love. Instead, the holiday is a terrifying ordeal. That’s because the noise of fireworks – loud, sudden, and reminiscent of war – rocks their nervous system. Daily fireworks in many U.S. cities in recent weeks have no doubt been interfering with the sleep and peace of mind of thousands of veterans. This reaction is not unique to veterans with post-traumatic stress disorder, or PTSD. Also affected are millions of others, including civilians, refugees, and first responders. As a psychiatrist who specializes in trauma and PTSD, I urge you not to overdo an act which causes so much suffering for so many of your fellow Americans.”

Tamara Hew-Butler, associate professor of exercise and sports science, and Phillip D. Levy, assistant vice president for translational science and clinical research innovation, wrote an article for The Conversation about reopening school and club sports amidst the pandemic. “Along with the revival of professional sports comes the yearning for a return to amateur sports – high school, college and club. Governing officials are now offering guidance as to when and how to resume play. However, lost in the current conversation is how schools and club sports with limited resources can safely reopen. As an exercise scientist who studies athlete health and an emergency medicine physician who leads Michigan’s COVID-19 mobile testing unit, we wish to empower athletes, coaches and parents by sharing information related to the risks of returning to play without COVID-19 testing. This includes blood tests to see if athletes have already had COVID-19 plus nasal swabs to test for the active SARS-CoV-2 virus. Regular COVID-19 testing on all athletes may seem like overkill, but the current tally of 150 collegiate athletes, mostly football players, who have tested positive for COVID-19 grows longer by the day.”

Dr. Jennifer Gomez, an assistant professor in the Department of Psychology and an expert in the impact of violence on black and other minority youth and young adults, had this to say about the Black Lives Matter protests. "The tragedies that we're witnessing are neither new nor isolated. And, of note, they haven't stopped, even though videos have made it possible for the world to be watching and condemning the government-sanctioned violence against black people in the U.S. The difference is this moral elevation, this action-oriented hope, that has resulted in so many of us coming together to fight for justice. And, at long last, for some of us to finally listen and bear witness to the anti-black hate and violence that so many of us for so many years have been sharing without being believed." Gomez explained that as a black feminist trauma psychologist, she sees moral elevation often. "What should be completely depressing engenders action-oriented hope," she said. "When truth of depravity is finally acknowledged, we discover avenues for enacting change on large and small scales. Witnessing those actions in ourselves and others gives us this moral elevation that makes life worthier of living."

A new study by Chinese researchers found that COVID-19 pediatric patients had higher incidents of initial symptoms like fever, vomiting, and diarrhea than adult patients and often recovered an average of 3 to 4 days after treatment. Research on COVID-19 pediatric cases is still limited, but this new study offers a fresh perspective on the early diagnosis and epidemic control of COVID-19 in children and could enhance early intervention and diagnosis. The new study highlights the fact that so much about the pathogen underlying the disease remains unknown and there’s so much more to learn, added Dr. Teena Chopra, a professor of infectious diseases at Wayne State University’s School of Medicine. “[What] is interesting is that the children [in the study] did not present with severe disease unlike adults,” she said. “And most of them had mild or moderate symptoms.” Chopra added that the study has lots of implications for authorities pondering decisions such as school reopenings in the fall. Although the sample size is a “small number, it gives us insight into the world of children and helps us understand the impact on a younger age group,” said Chopra who serves on Wayne State’s reopening task force as well as one of a Detroit area school. School officials “should take studies like this into account before opening schools and making decisions about whether it can affect children or not,” she said.

David Rosenberg, professor of psychiatry and neuroscience, wrote an article for The Conversation. “One of the hallmarks of obsessive-compulsive disorder is contamination fears and excessive hand-washing. Years ago, a patient with severe OCD came to my office wearing gloves and a mask and refused to sit on any of the “contaminated” chairs. Now, these same behaviors are accepted and even encouraged to keep everyone healthy. This new normal in the face of a deadly pandemic has permeated our culture and will continue to influence it. Many stores now prominently post rules mandating face masks and hand sanitizer use and limit the number of customers allowed inside at one time. Walkers and joggers politely cross the street to avoid proximity to each other. Only a few months ago, this type of behavior would have been considered excessive, irrational, even pathological, and certainly not healthy. So, where do doctors draw the line between vigilance to avoid being infected with the coronavirus and obsessive-compulsive disorder that can be harmful? This is an important question that I, a psychiatrist, and my co-author, a wellness and parenting coach, often hear.”

Julie Wargo Aikins, associate professor of psychiatry and behavioral neurosciences, Merrill Palmer Skillman Institute, wrote an article for The Conversation. “As the weather has warmed in my Midwestern town, my neighborhood is full of children on bicycles pretending to be riding through the Wild West. I can’t walk down the sidewalk without stepping on chalk drawings or hopscotch boards. There are children jumping rope and playing ball. In the eight years I’ve lived here, I’ve never witnessed this before. As a clinical psychologist who studies children’s friendships, I am fascinated by this development. Children’s social worlds have been upended by the suspension of school and extracurricular activities due to the pandemic. Many older children and adolescents have been able to maintain their friendships over social media. But, for younger children, this approach is less likely to be available to them and less likely to meet their social needs. In some places, a silver lining of COVID-19 may well be the resurgence of childhood friendships in American neighborhoods.”

The desperately ill patients who deluged the emergency room at Detroit Medical Center in March and April exhibited the telltale symptoms of the coronavirus: high fevers and infection-riddled lungs that left them gasping for air. With few treatment options, doctors turned to a familiar intervention: broad-spectrum antibiotics, the shot-in-the-dark medications often used against bacterial infections that cannot be immediately identified. They knew antibiotics are not effective against viruses, but they were desperate, and they feared the patients could be vulnerable to life-threatening secondary bacterial infections as well. “During the peak surge, our antibiotic use was off the charts,” said Dr. Teena Chopra, the hospital’s director of epidemiology and antibiotic stewardship, who estimated that more than 80 percent of arriving patients were given antimicrobial drugs. “At one point, we were afraid we would run out.” Chopra and other doctors across the country who liberally dispensed antibiotics in the early weeks of the pandemic said they soon realized their mistake. “Many physicians were inappropriately giving antibiotics because, honestly, they had limited choices,” she said. Chopra estimated that up to a third of coronavirus patients who died at the hospital were killed by opportunistic pathogens like C. difficile, a pernicious infection that causes uncontrolled diarrhea and is increasingly resistant to antibiotics. That figure, she said, was quite likely heightened by the poor underlying health of patients who also had diabetes or hypertension or were obese. “Even before Covid hit, our population in Detroit was very vulnerable to drug-resistant infections,” said Chopra, a professor of infectious diseases at Wayne State University.

Arash Javanbakht, associate professor of psychiatry, updated a Jan. 11, 2020 article he wrote for The Conversation about how the human brain can be  manipulated to tribalism during the politics of fear and racism. “Tribalism has become a signature of America within and without since the election of President Trump. The nation has parted ways with international allies, left the rest of the world in their effort to fight the climate change, and most recently the pandemic, by leaving the World Health Organization. Even the pandemic was not a serious issue of importance to our leaders. We did not care much about what was happening in the rest of the world, as opposed to the time of previous pandemics when we were on the ground in those countries helping block the progress so long as it was China’s or the European Union’s problem. This marks drastic change from previous U.S. altruistic attitude, including during the World War II.” Javanbakht continued: “The irony of evolution is that while those attached to tribal ideologies of racism and nationalism perceive themselves as superior to others, in reality they are acting on a more primitive, less evolved and more animal level.”

A doctor at Detroit’s Wayne State University School of Medicine has published new findings of a trend in older patients who are severely ill with COVID-19 and also test positive for Clostridioides difficile — a bacteria sometimes referred to C. diff or CDI. The CDI bacteria causes life-threatening diarrhea and is usually a side effect of taking antibiotics, according to the CDC. Wayne State’s observations offer the inaugural CDC journal report of CDI infections in COVID-19 patients. “This is the first report highlighting COVID-19 patients who presented with diarrhea and were found to have both C. diff and diarrhea as a co-infection,” says Dr. Teena Chopra, who is also a professor of infectious diseases at the WSU School of Medicine and corporate medical director of infection prevention hospital epidemiology and antibiotic stewardship at WSU and the Detroit Medical Center. “Most of these patients were very sick and had a higher mortality. COVID-19 can present as diarrhea, and a lot of these patients are getting unnecessary antibiotics. We always think of C. diff when we have patients who have diarrhea, and now we have to think of COVID-19 in these patients, too.”

Stephanie Hartwell, College of Liberal Arts and Sciences dean, Sheryl Kubiak, School of Social Work dean, and Ijeoma Nnodim-Opara, assistant professor of internal medicine and pediatrics, wrote an article for The Conversation about how COVID-19 has disproportionately hit lower-income areas and communities of color. “Nowhere is this discrepancy more evident than in prisons, jails and homeless shelters – made up disproportionately of poorer, black and Latino men and women. Here, COVID-19 cases have mushroomed due to dormitory-style living conditions and the inability of people, often with underlying health issues, to practice social distancing. As the virus rages on, comprehensive COVID-19 testing for these populations remains elusive. As experts on jails, health disparities and how to help former prisoners reintegrate into society, we believe that missteps in how we transition incarcerated individuals back to the community would only put this vulnerable populace at greater risk of getting and transmitting COVID-19.”

Michigan Governor Gretchen Whitmer has introduced a 6-step plan to re-start businesses that have been shut down during the coronavirus pandemic. It aims to balance the desire to revive the economy against the need to prevent a resurgence of COVID-19. A new study says states can do both if they prioritize industries where workers can keep their distance from each other or work remotely. Wayne State University researchers Shooshan Danagoulian, Zhe Zhu and Philip D. Levy wrote the report. Danagoulian, an assistant professor of economics, says professional services such as accounting are best-suited to resume safe operation. “Accountants work in separate offices, which precludes the spread of the virus, but they can also do their work from home fairly effectively,” Danagoulian says. By contrast, factory workers can’t do their jobs from home. But manufacturers can take steps to help workers maintain their distance. “We suggest giving priority to industries where — if people can’t work from home — they can operate effectively while minimizing the spread of the virus,” Danagoulian says. “It would provide a bigger boost to the economy should production resume in those industries.”

Dr. Teena Chopra, professor of infectious diseases at Wayne State University and in charge of infection control at Detroit Medical Center, and Dr. Anita Chopra, board-certified in internal medicine and sees patients at the University of Washington Neighborhood Shoreline Clinic in Seattle, wrote an op-ed for Bridge. “As front-line medical workers, our battle with COVID-19 is personal. We are physicians and sisters, waging war against an enemy that caught us defenseless. As we helped our communities plan for battle in two U.S. hotspots, we’ve drawn strength from reminiscences of our childhoods. We are inspiring each other to relentlessly protect the well-being of our patients and communities. One in Seattle, which saw the first COVID-19 case in the United States in a situation that escalated quickly, and the other in Detroit, which has faced a tsunami of cases and become one of the nation’s epicenters.”

Researchers at Wayne State University have completed an analysis that studied specific industry characteristics to guide industry openings in a way that lowers contagion risks and maximizes economic benefits until broader COVID-19 testing becomes available and immunity testing becomes efficient and reliable enough. “With protective gear and testing still in limited supply, there is a need to find the safest way to open and operate businesses to avoid a resurgence of the virus,” says Dr. Phillip Levy, professor of emergency medicine and assistant vice president for translational science and clinical research innovation at WSU, and chief innovation officer for the WSU Physician Group. “It is critical that we look at alternatives to lower contagion risks and maximize economic benefits. Using specific industry characteristics to guide industries in their reopening efforts will be key to lowering the further spread of the virus.” Shooshan Danagoulian, assistant professor of economics, led the research. Levy and Zhe Zhu, assistant professor of economics, also worked on it. The scope for physical distancing and remote work will vary by industry and region. The team focused on Michigan and metro Detroit.

Just when you think you understand COVID, it changes. It's a very deceptive virus; to keep up with it, it is a challenge,” says Dr. Teena Chopra, corporate medical director for Hospital Epidemiology and Infection Control at Detroit Medical Center and a Wayne State University professor. “And particularly, it is manifesting differently by age, by race, by sex. Very early on, we were able to understand that, particularly in the city of Detroit.” One set of her COVID patients, especially the younger ones, are developing pulmonary embolisms – blood clots that get stuck in the lungs and can be deadly. “They are manifesting as sudden onset shortness of breath,” Dr. Chopra says. “And some of them are showing higher mortalities than others.”  Meanwhile, patients coming from nursing homes (a big part of DMC’s patient population) may not even appear to have COVID during a first examination, says Dr. Chopra. They may not have a fever or chills. “These older patients do not have the same symptoms,” she says. “They don't mount up the same immune response.” Yet many of them are testing positive for the virus. “We are beginning to test every patient coming from a nursing home, whether they have symptoms or not, because we want to assume they have it.”

Detroit residents waited for hours on Tuesday to get free COVID-19 tests at a new facility that for the first time offered testing to people who did not already have symptoms of the disease and a doctor's authorization for the test. Tuesday's tests were the start of a free program for Detroit residents, said Dr. Phillip Levy, professor of emergency medicine at Wayne State University. Even those without symptoms can get tested with a nasal swab for the virus as well as have their blood drawn to test for antibodies. "Detroit is one of the hardest hit areas in the country. It's got some of the highest case loads, some of the highest death rates, so it's really important that we get testing out into the community," Levy said in a telephone interview. "If you're thinking about restarting the economy, it's important to know you are not acutely infectious and you have evidence of immunity," he added. Michigan has been one of the worst hit states, but officials have said the infection rate is dropping. As of Monday, Michigan had reported more than 38,000 COVID-19 cases and 3,407 deaths. Detroit made up the largest portion of those with almost 8,700 cases and 950 deaths. The Wayne State program expects to test as many as 400 people on Tuesday and hopes to do the same every day for the next six to eight weeks, working closely with Michigan as it ramps up its own testing efforts, Levy said. In the Detroit program, the tests are administered by Garcia Laboratories using Abbott Laboratories instruments, Levy said.