Beaumont Health, the state’s largest health care system, informed employees that anyone who refuses a transfer to work with COVID-19 patients will be considered to have resigned and ineligible for future employment. The policy provides exceptions for those with underlying conditions, and comes amid increasing angst in Metro Detroit hospital systems that are reaching capacity in the face of the nation’s third largest outbreak of the coronavirus. Adding to the stress is the news of deaths and hospitalizations of colleagues and concerns over shortages of protective equipment. “There has not been a time, in my lifetime, of so much angst and tension in the healthcare community,” said Dr. Richard Balon, program director for the psychiatry residency at Detroit Medical Center and a professor of psychiatry and anesthesiology at Wayne State University's School of Medicine. “We are facing an additional crisis – mental health issues in healthcare workers due to this enormous pressure, tension, the push to make difficult decisions, feelings of lack of support, lack of protection, long hours, not being with their families, and worry about endangering their families by bringing the infection home.”

More instant tests are in the hands of Detroit doctors fighting against the coronavirus pandemic. Wayne State University Physician Group has purchased four new devices that quickly deliver COVID-19 test results. The devices can process a total of 500 tests each day and provide results within an hour. They will be placed in Detroit hospitals so patients who test positive can be isolated immediately. “Once patients have symptoms or they have contracted the virus, the most important thing is access to testing, and the faster we can get the results from testing the better job we will be able to do,” said Dr. Charles Shanley, CEO of Wayne State University Physician Group.

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.

Having a coronavirus outbreak in Detroit is like “putting oil to the fire,” says infectious disease specialist Dr. Teena Chopra, who is a professor of internal medicine at Wayne State University’s School of Medicine. The city is set to become on the U.S. hot spots of the pandemic largely due to the city’s higher risk and “socially disadvantaged” population, according to Dr. Chopra, who spoke with As it Happens host Carol Off.

It was three weeks ago today that Michiganders woke to the start of the state’s coronavirus crisis. Between Wednesday, March 25, and Tuesday, March 31, the number of completed coronavirus tests for Michigan residents increased from 9,109 to 25,711. Of those 25,711 completed coronavirus tests on Michigan residents, 6,150-- or 24% -- were positive, according to the Michigan Department of Health and Human and Services. It’s unclear how many tests are pending. Some Michigan residents have been pushing for public data on the number of people who have recovered for coronavirus. But it’s too soon to have those numbers, considering the timetable of the epidemic and the timetable of illness and recovery for individual patients, said Dr. Paul Kilgore, a public-health doctor and epidemiologist at Wayne State University. He said that coronavirus symptoms typically last from 10 to 14 days and many are still recuperating “for a couple of weeks afterwards,” he said. “If you’re in the intensive care unit, your recovery is going to be even longer.” Considering the first cases in Michigan were confirmed only three weeks ago, “it’s not all” surprising there is no public data on recoveries from coronavirus, Kilgore said.

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."

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.

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. 

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.

Top research doctors at four Southeast Michigan health systems and Wayne State University have formed a partnership to participate in large-scale COVID-19 drug trials they hope will lead to a vaccine, antiviral medicines and other drugs to combat the deadly coronavirus. Physician participants who formed the study group are part of Henry Ford Health System, Ascension Michigan, Beaumont Health, Detroit Medical Center and Wayne State. "We hope our work here will last well into the future, should COVID-19 continue to be a threat," said Dr. Phillip Levy, professor and associate chair for research in Wayne’s State’s department of emergency medicine. "By combining forces, we can marshal greater research capabilities to effectively test vaccines and treatments to combat this virus."

Arash Javanbakht, M.D., director of the Stress, Trauma, and Anxiety Research Clinic (STARC) at Wayne State University, wrote a piece for Psychology Today about surviving in the age of COVID-19. Javanbakht wrote: “There are aspects of all of our lives that are affected by the new pandemic, regardless of our political, religious, age, or national background. This virus is a reminder that we humans are all vulnerable to what nature throws at us, and in it together. Overnight, our ability to dine out, be at a coffee shop, or exercise declined. This is important especially for those who had routines including these activities, or those with less social support, whose social interactions were limited to such activities, or their social life did involve such activities like spending time with friends at the gym. Remote working, reduced work hours and income, and inability to predict future of work, especially for those with limited financial resources, or jobs mainly affected by the crisis are highly stressful. We all are also stressed by the news, especially given the inherent emotionally triggering nature of the U.S. news media, and too much focus on disaster pornography, as well as contradicting news, predictions, and recommendations coming from different outlets and authorities. The constantly changing and evolving nature of such news is also stressing on all those who follow them.”

Dr. Paul Kilgore, associate professor and director of research at Wayne State’s Eugene Applebaum College of Pharmacy and Health Sciences, talked about the medical and public safety implications of the novel coronavirus on Detroit Today with Stephen Henderson. What are requirements for getting a test? “You can list, write down signs and symptoms you’re experiencing, including when they started. Record if symptoms getting worse. Call doctor/nurse and they’ll tell you if you need a test,” said Kilgore. At what point should people consult their doctor if they think they have symptoms? “The “disease can progress fairly rapidly, [so] write down progression. [It] doesn’t hurt to call the clinic if you have signs/symptoms and let them know, better early than late.” How do we help elders in our neighborhood or in our family in a safe way? “Organizations are out there trying to help, but don’t always know where vulnerable populations are. Might help to let those organizations know where help is needed.”

Schools are closed, bars and restaurants shut down, and many temporarily laid off or working from home. Disruptions to daily life are growing more severe in Michigan, where 54 cases of coronavirus were confirmed late Monday. And if other parts of the country and globe should serve as an indication, a weeks-long lockdown curtailing travel outside the home could be next. As Michiganders face a new reality, the question many are asking is “how long will it last?” Gov. Gretchen Whitmer has closed schools through April 5 and activity centers — including gyms and libraries — through March 30, but a local infectious disease specialist says it could be months before life returns to normal in Michigan. Chopra’s assessment of what’s in store for Michigan dovetails with recent comments from President Trump, who said in a Monday news conference that the outbreak may not end in the U.S. until July or August at the earliest. He added that he may advocate for quarantine or curfew in local “hot spots.” The San Francisco Bay Area on Monday announced a near-lockdown to last through April 7. Once things are under control, Chopra warns there will likely be a second wave of the virus as people resume social activity. That could be less severe and limited to local clusters, however, as the country will presumably be better prepared. A vaccine will still take up to 18 months to produce, she said.

Sarcoidosis is an inflammatory disease of unknown causes that affects multiple organs in the body. It occurs in patients around the world and is highly prevalent in Detroit and Michigan. It is characterized by abnormal masses or nodules – granuloma formations – in various organs, including lungs and lymph glands, brains and heart. Sarcoidosis has been described for more than 150 years, but there are no specific and simple tests developed to diagnose this disease. A team of researchers led by Lobelia Samavati, M.D., associate professor in the Center for Molecular Medicine and Genetics and Department of Internal Medicine at Wayne State University’s School of Medicine, has been working for more than 10 years to discover specific serological biomarkers of sarcoidosis and tuberculosis. With the help of a recent $1.98-million grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Samavati’s research team aims to advance their work of developing biomarker technology for identification of biomarkers of sarcoidosis. “We believe that our technology will be able to harness the diversity of antibodies and can aid to identify protective antibodies in various diseases in humans, including viral respiratory infections such as the corona virus,” said Samavati. “We believe that this study is the beginning of new era to identify protective immunity in form of antibodies.” Sorin Draghici, the Robert J. Sokol, M.D. Endowed Chair in Systems Biology in Reproduction and professor of computer science in Wayne State’s College of Engineering, is collaborating with Samavati. He contributed to the design of the study and will supervise the data analysis.

A late February study in the Journal of the American Medical Association showed that children 10 and under accounted for just 1% of all COVID-19 cases, for example, while adults in the 30-79 age groups represented a whopping 87%. The World Health Organization (WHO) found something similar in China, with 78% of patients falling between the ages of 30 and 69. “Older people are more likely to be infected, especially older people with underlying lung disease,” says Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at Wayne State University. “For this population, mortality rates for COVID-19 are about 15%.” In this sense, COVID-19 behaves a lot like seasonal flu. From 70% to 85% of all flu deaths and 50% to 70% of flu-related hospitalizations occur among people in the 65-plus age group, according to the United States Centers for Disease Control and Prevention (CDC). The 2002-2003 SARS outbreak similarly proved lethal for more than 50% of people over 60 who contracted the disease. “People living in long care facilities have common meetings, they share common rooms,” says Chopra. Common meetings and common rooms can too often mean common pathogens. The health system itself may be playing a significant role in putting seniors at risk. People with multiple medical conditions typically visit multiple specialists, and every such visit means entering a health care environment that can be teeming with viruses and bacteria. For now, Chopra advises older patients to postpone doctor visits that aren’t absolutely essential, like “their annual eye visit. Dental cleaning can be avoided too.” Telemedicine—conducting doctor visits that don’t require hands-on treatment online—can be helpful too, as can e-prescribing, with drugs being delivered straight to patients, sparing them exposure to pharmacies.

Medical trainees want to help in less-resourced countries. But short-term programs can misread local needs, overburden hosts, and send students into situations they're not prepared to handle. Here’s how leaders are ensuring ethical, effective experiences. Programs that want to provide effective, ethical experiences should avoid veering toward "volun-tourism," experts say. Instead, they should build solid, respectful partnerships with local communities. Some call this “fair trade education,” borrowing from the “fair trade” concept that promotes equity between producers, who are often from lower-income places, and consumers in higher-income nations. To make sure it was achieving this and other goals, Wayne State University School of Medicine paused its student-run global health trips a few months ago. Until then, the school’s World Health Student Organization would raise funds, buy medicines, and travel to sites in less-resourced countries. “The students would create pop-up clinics” and organize trips with the help of U.S. nongovernmental organizations, explains Ijeoma Opara, MD, who codirects Wayne State’s new interdisciplinary Global Health Alliance (GHA). “It was students’ responsibility to arrange faculty to accompany them on travel as well as faculty in the host country to provide oversight.” Now, though, the school is working on extensive changes. “We want to focus on structured, competency-based learning experiences as well as on developing strong, long-term, bidirectional relationships with faculty leadership in host countries,” says Opara. “Hosts should be fully engaged in program design and defining intended outcomes. Only they really know their resources, their needs, and their capacity." At Wayne State, predeparture trainings include lessons in the history, language, and culture of destinations, combined with modules from the University of Minnesota’s Global Ambassadors for Patient Safety program. Students’ failure to understand local values can inadvertently cause problems for both patients and providers, notes Kristiana Kaufmann, M.D., who codirects the school’s GHA program with Opara.

The common cold is a top reason for missed work and school days. Most of us have two or three colds per year, each lasting at least a week. There's no real cure, but studies from the last several years show that some supplement containing zinc can help shorten the duration of cold symptoms by up to 40% — depending on the amount of the mineral in each dose and what it's combined with. Zinc has an interesting back story. It wasn't even acknowledged as an essential mineral for human health until the 1970s. But that changed thanks to the work of Dr. Ananda Prasad — a 91-year-old doctor who, decades ago, had a hunch that led to a better understanding of zinc's role in immunity. Back in the 1960s Prasad was studying a group of young men in Egypt who had not grown to normal heights and remained underdeveloped in other ways, too. Prasad wondered if the problem might be a lack of zinc. When Prasad gave them zinc supplements, the men grew significantly taller. "I couldn't believe it," he says. Prasad had never expected such significant growth. Some scientists challenged his findings, at the time, questioning the idea that zinc deficiency could even occur in humans. "It was controversial," Prasad says. But he pressed on with his research and  began to document the ways zinc influences immunity. Eventually, in the 1970's, the National Academy of Sciences (NAS) declared zinc an essential mineral, fundamental to many aspects of cell metabolism. NAS established a recommended daily allowance, which is the daily amount that's sufficient for good nutrition. Prasad says he felt vindicated by this action. "Absolutely," Prasad told us from his home in Michigan, where he's a researcher and professor at Wayne State University School of Medicine. What came next in his career may be just as surprising. Prasad had demonstrated that zinc had an effect on immunity — so he figured that it might help against a ubiquitous scourge — the common cold.

Arash Javanbakht, assistant professor of psychiatry, wrote a piece for the Conversation on the vulnerability of veterans, refugees and victims of war crimes to PTSD. “Mental health is often used in political discourse and arguments. Post-traumatic stress disorder was the subject Jan. 8, when Rep. Ilhan Omar (D.-Minn.), herself a Somalian refugee who had spent years in a refugee camp in Kenya, said: “Every time I hear conversations around war, I find myself being stricken with PTSD.” Rep. Jim Banks (R.-Ind.), a veteran of the war in Afghanistan, found these comments “offensive to our nation’s veterans who really do have PTSD.” As an expert in research and treatment of PTSD, and a psychiatrist working with refugees and victims of torture, I hope to provide insight into this illness and its presentations in different populations.”

Wayne State University President M. Roy Wilson today announced the appointment of Mark Schweitzer, M.D., as dean of the university’s School of Medicine and vice president of Health Affairs for the university. Schweitzer, a preeminent radiologist and chair of the Department of Radiology at the Stony Brook University School of Medicine in New York, will join the university and School of Medicine on April 27. “We conducted in-depth interviews with a number of outstanding candidates during a yearlong national search, and Schweitzer’s experience, enthusiasm and vision made him a perfect fit for Wayne State University,” Wilson said. “Our faculty, our students, and the people of Detroit and the surrounding region will see great advances with Schweitzer’s leadership and energy. He will quickly become a leading contributor to our great city’s ongoing renaissance.” In addition to his leadership role in the School of Medicine, as vice president of Health Affairs, Schweitzer will work with the deans of WSU’s College of Nursing and the Eugene Applebaum College of Pharmacy and Health Sciences on clinical training issues. In this role, he will develop avenues to strengthen collaboration between the three schools to advance interprofessional, team-based approaches to healthcare. “I attended inner-city public universities during my undergraduate and medical school training, and I served at public safety net hospitals,” Schweitzer said. “My passion throughout my career has been education at all levels. The DNA of Wayne State University and the city of Detroit are intertwined, and the university’s national reputation is illustrious. I’m very much looking forward to serving the people of greater Detroit and Michigan.” An outstanding medical scholar and educator, Schweitzer is a talented administrator who has served in many hospital and medical practice roles, including vice chair for clinical practice and chair of the Information Management Group for Thomas Jefferson University Hospital. Extensively published and a lecturer for Harvard University Medical School, he holds a number of medical patents. “The Board of Governors is extremely pleased to be hiring someone the caliber of Dr. Mark Schweitzer to assume what is a critically important leadership position,” said Marilyn Kelly, chair of the board. “Wayne State’s health-related education and community programs are a vital part of the university’s identity and mission, and we think that Mark is the right person to lead us into the future.”

Rep. Ilhan Omar (D-MN) fled civil war in Somalia when she was 8 years old, then spent four years in a refugee camp in Kenya. As a result, she says, she has post-traumatic stress disorder as an adult. But when she mentioned the condition publicly this week in the context of conflict between the U.S. and Iran, she got pushback from a Republican member of Congress. But psychology experts as well as some veterans say Rep. Jim Banks’s remarks are based on a misconception about PTSD, a mental health condition that can cause flashbacks, insomnia, nightmares, and other distressing symptoms. Though it was long associated with soldiers coming home from war, PTSD is also common among children and other civilians who live through war, as well as people who experience sexual assault and other forms of violence. Syrian refugees living in the United States, for example, have rates of PTSD comparable with those among Vietnam veterans, Arash Javanbakht, a psychiatrist and trauma specialist who has worked with refugees, told Vox. In addition to nightmares and flashbacks, the disorder can also cause people to avoid anything that reminds them of the trauma, Javanbakht said. People with PTSD also often develop depression as well. PTSD is unfortunately common — around 8 percent of the US population lives with the disorder, Javanbakht said. Rates are much higher among combat veterans, with around 30 percent of soldiers who served in Vietnam developing the condition over the course of their lives. They are also very high among refugees, who “are exposed to a lot of trauma and stress in a cumulative way,” he explained.