As Pandemic Toll Rises, Science Deniers in Louisiana Shun Masks, Comparing Health Measures to Nazi Germany

Science denial in America didn’t begin with the Trump administration, but under the leadership of President Trump, it has blossomed. From the climate crisis to the COVID-19 pandemic, this rejection of scientific authority has become a hallmark of and cultural signal among many in conservative circles. This phenomenon has been on recent display in Louisiana, where a clear anti-mask sentiment has emerged in the streets and online even as COVID-19 cases rise.
“Are you a masker or a free breather?” Pastor Tony Spell asked the crowd while speaking from the bed of a pickup truck at a July 4 “Save America” rally in Baton Rouge. At the end of March Spell gained international attention for his refusal to stop his church’s services despite Gov. John Bel Edwards’ stay-at-home order, which was issued to slow the Louisiana’s rapid rise in COVID-19 cases.
 
“It has never been about a virus — it is about destroying America,” Spell claimed, before equating a government whose public health measures restrict church gatherings and require protective face coverings in public to Germany under Hitler. A crowd of less than 200 roared in agreement at the rally that was held across from the governor’s mansion. 

Pastor Tony Spell
Pastor Tony Spell speaking at the “Save America” rally in Baton Rouge on July 4.

Attendees of a "Save America" rally in Baton Rouge on July 4
Attendees of the “Save America” rally in Baton Rouge on July 4 including one holding a fan.

On July 8, another conservative voice, Louisiana State Representative Danny McCormick, posted a video on Facebook making a similar comparison to Nazi Germany. “This isn’t about whether you want to wear a mask or you don’t want to wear a mask — this is about your right to wear a mask or not,” McCormick said. “This is about liberty. Your body is your private property … People who don’t wear a mask will be soon painted as the enemy — just as they did the Jews in Nazi Germany. Now is the time to push back before it is too late.”

 At a press conference the day after McCormick posted his video, Gov. Edwards announced that the state had lost its previous gains against the coronavirus. 

McCormick’s statements come about six months into a public health crisis that has infected 71,884 Louisiana residents and killed 3,247, as of July 9. Despite the pandemic’s accelerating and deadly spread, the complaints by McCormick, Pastor Spell, and the others joining them at a handful of protests in Baton Rouge  illustrate a pervasive disdain for science held by many associated with the Republican Party. 

Louisiana State Rep. Danny McCormick
State Representative Danny McCormick at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

State Rep. Danny McCormick's talking points at an "end the shutdown" rally in Louisiana
State Representative Danny McCormick’s talking points on an index card he held while making a speech during an “End the Shutdown” rally in Baton Rouge on April 25.

A DeSmog investigation found that a number of groups behind protests against pandemic stay-home orders are also part of the climate change countermovement, a term coined by sociologist Robert Brulle. U.S. Sen. Sheldon Whitehouse (D-RI) has called this network of individuals and organizations disputing climate science the “web of denial.”

April and May rallies in Louisiana pushing to open the state followed larger rallies in Idaho, Michigan, and North Dakota. Helping tie together what Trump has called the “liberate” movement is the State Policy Network (SPN). As DeSmog has reported, SPN is “a network of state-level conservative think tanks advancing pro-corporate agendas, [and] has received money from the likes of the Koch family, the Devos family, the Mercer Family Foundation, and others.” 

Woman with a COVID-19 denial sign at an "end the shutdown" rally in Baton Rouge
Woman with a Covid-19 denial sign at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

Woman with a COVID-19 denial sign targeting Bill Gates, a common target of the right wing
Woman with a Covid-19 denial sign sporting a message for Bill Gates, a common target of the right wing, at an “End the Shutdown” protest in Baton Rouge, Louisiana, on April 25.

At an April 25 “End the Shutdown” rally in Baton Rouge, rally-goers, led by Rep. McCormick, marched from the State Capitol building to the nearby lawn across from the governor’s mansion to express their anger with his handling of the crisis. In a speech, McCormick offered talking points to counter Gov. Edwards’ emergency orders meant to address the COVID-19 pandemic. The talking points mirrored a memo sent by GOP political operative Jay Connaughton to Republican State Sen. Sharon Hewitt and shared with GOP state legislators. Hewitt is one of Louisiana’s top conservative leaders. In 2018 she was named “National Legislator of the Year” by the American Legislative Exchange Council (ALEC).

Veronica Lemoa, a stay-at-home mom, at the "end the shutdown" protest on April 25 in Baton Rouge
Veronica Lemoa, a stay-at-home mother, at an “End the Shutdown” protest on April 25, 2020 in Baton Rouge, Louisiana. 

Young girl at an "Open Louisiana" event in Baton Rouge May 2
Young girl at an “Open Louisiana” event in Baton Rouge on May 2 across from the Governor’s Mansion. 

Despite President Trump’s praise for Gov. Edwards, a Democrat, for his handling of the pandemic, anti-mask protesters are equating the governor’s stay-at-home order and mask mandate with the first step to tyranny. Spell, who was arrested for defying the mask mandate, did not stop with his sharp criticism of the governor — and also had some for Trump. While he is glad the Trump administration deemed churches “essential,” in order to reopen them, Spell proclaimed that he doesn’t need the president’s permission, and warned: “If they can give you your right to go to church, then they can take from you your right to go to church.”


Pastor Tony Spell speaking on the July 4 at rally in Baton Rouge. 

At the July 4 rally, many expressed their support for Trump, and saw the upcoming presidential election as the most important in their lifetime. They labeled those who wear protective face coverings “sheep.” Out of the less than 200 rally-goers, I saw only two people with face masks. One was worn by a man that had the words “Dixie Beer” painted on it, which was expressing his disdain over the decision by the owner of the New Orleans beer company to change the beer’s name in response to anti-racism demonstrations. The other mask I noticed at the rally was worn on a woman’s arm. 

The only man wearing a face mask at a "save America" rally on July 4
The only man wearing a mask on his face at a “Save America” rally in Baton Rouge on July 4. He expressed his displeasure that the owner of Dixie Beer is changing the New Orleans beer’s name. 

Woman with a mask on her arm at the "save America" July 4 rally
Woman wearing a face mask on her arm at the “Save America” rally in Baton Rouge on July 4. 

In an April 1 op-ed in Newsweek, Rochester Institute of Technology philosophy professor Lawrence Torcello, and Pennsylvania State University climate scientist Michael E. Mann wrote: “Unfortunately, President Trump has again emerged as a leading source of disinformation. Having called COVID-19, as he previously did with climate change, a ’hoax,’ he now resorts to calling COVID-19 the ‘Chinese Virus.’ In the case of both COVID-19 and climate change, he has outsourced policy decision-making to science deniers. In both cases he is as wrong as he is xenophobic — and in both cases his predictable disinformation endangers lives.”

In February, before the first COVID-19 cases were identified in Louisiana, Gov. Edwards finally broke away from Trump on espousing climate science denial. 

Louisiana will not just accept or adapt to climate change impacts,” Edwards stated at a news conference in Baton Rouge. “Louisiana will do its part to address climate change.” In a reversal of his previous statements that questioned humans’ well-established role in driving the climate crisis, he said, “Science tells us that rising sea level will become the biggest challenge we face, threatening to overwhelm our best efforts to protect and restore our coast. Science also tells us that sea level rise is being driven by global greenhouse gas emissions.”

But Sharon Lavigne, founder of RISE St. James, a community group fighting petrochemical industry expansion in Louisiana’s Cancer Alley, doubts his sincerity. “If the governor is serious about reducing carbon emissions, he needs to pull the plug on Formosa.” Plastics giant Formosa is poised to start building a petrochemical complex in St. James Parish that has received permits to spew the emissions equivalent of 2.6 million cars. 

Petrochemical companies are one of Louisiana’s top producers of carbon dioxide, one of the globe-warming gases linked to human-caused climate change. However, the governor has not walked back his support of Formosa’s project. 

Edwards was the first governor in the country to point out that African Americans are being disproportionately impacted by the pandemic. But he has yet to address the impact which ongoing pollution from the petrochemical industry plays in the poor health of predominantly Black communities living near existing plants, or future ones, such as Formosa’s in St. James Parish.

Many U.S. leaders have failed to take to heart scientists’ warnings that half-measures to combat climate change and the COVID-19 pandemic won’t work. Meanwhile, temperatures across America are hitting new record highs, and cases of the coronavirus continue to rise exponentially, leading top U.S. infectious disease official Dr. Anthony Fauci to advise states “having a serious problem” with a surge in coronavirus cases to “seriously look at shutting down.” 

Protester across from the Louisiana Governor's Mansion on May 2
Protester across from the Governor’s Mansion in Baton Rouge on May 2 with a protest sign against Anthony Fauci, Bill Gates, and the “New World Order.”  

Protesters across from the Louisiana Governor's Mansion on May 2
Protesters across from the Governor’s Mansion in Baton Rouge on May 2.   

As with climate change, theoretical models have proven essential for anticipating what is likely to happen in the future. In the case of coronavirus, the initial spread of this virus is occurring at an exponential rate as models predicted,” Torcello and Mann pointed out in their Newsweek op-ed. “This means we can anticipate that larger sums of people will become infected in the coming weeks. We know the majority of those infected by COVID-19 will experience mild or no symptoms while remaining highly contagious, and we know that for others, COVID-19 will create the need for ventilators and other emergency medical supports that we do not yet have in sufficient supply. It is worth emphasizing: The fact that most people will experience mild symptoms is irrelevant to a crisis, like COVID-19, which is grounded in the math of large numbers.”

In his 1995 book The Demon-Haunted World, astronomer and science writer Carl Sagan presaged, with trepidation, an America wherein “our critical faculties in decline, unable to distinguish between what feels good and what’s true, we slide, almost without noticing, back into superstition and darkness…a kind of celebration of ignorance.”

After viewing some of my photos from the recent “Save America” rally, Mann wrote in an email: “These people, sadly, are the purest embodiment of Sagan’s chilling prophecy.”

Protester across from the Governor’s Mansion on May 2 with a protest sign that is a variation of the Gandsen Flag. 
Protester across from the Governor’s Mansion on May 2 with a protest sign that is a variation of the Gandsen Flag. 

Trump supporters at a rally across from the Governor’s Mansion on July 4.
Trump supporters at a rally across from the Governor’s Mansion on July 4.

Protesters at an “End the Shutdown" event in Baton Rouge on April 25 march from the Capital Building to the Governor’s Mansion nearby. 
Protesters at an “End the Shutdown” event in Baton Rouge on April 25 march from the Capital Building to the Governor’s Mansion nearby. 

Main image: Woman holding an anti-mask sign at a July 4 “Save America” rally in Baton Rouge. Credit: All photos and video by Julie Dermansky for DeSmog

This content was originally published here.

Airway Perspective on AAO Obstructive Sleep Apnea and Orthodontics White Paper – Spear Education

Author’s note: The topic of the impact of tooth extraction on the airway can be very contentious. My hope is this article serves as a tool to allow collegial discourse between restorative dentists concerned with airway and the orthodontists who they look to for solutions.

Recently, I had a new patient come to see me “looking for some veneers.” She had four bicuspids removed for orthodontics in the early 1970s and was given a headgear, but routinely found it on the floor at night. Also, her tonsils and adenoids were removed when she was very young due to recurrent infections.

She complains of a lifetime of poor sleep and never feeling refreshed. She is on multiple high blood pressure medications and has reflux. Ten years ago, she was snoring so badly her husband requested a sleep study.

The study diagnosed her with snoring and apnea. The treatment was UPPP (palatal surgery) and repair of a deviated septum. She feels that she can breathe better than before the surgery, but the symptoms never cleared. She still snores and has unrefreshing sleep.

My examination revealed multiple teeth with recession, some significant. Generalized pathologic wear and erosion. The maxillary anterior teeth were retroclined with lingual facets from pathway wear. The lower anteriors were over erupted. The tongue volume appeared normal, but the oral volume was limited. Her airway, on examination, was constricted with an exaggerated protective retraction of her tongue during examination of the oropharynx.

I thought to myself, “Could the removal of four teeth and subsequent retraction of the anterior teeth be culpable in her medical and dental history?”

The OSA and orthodontics relationship is relatively new

In 2019, the American Association of Orthodontists (AAO) released its “Obstructive Sleep Apnea and Orthodontics” white paper. It was the culmination of a two-year project by a panel of sleep medicine and dental sleep experts. They were tasked to produce guidelines for the role of orthodontists in the management of obstructive sleep apnea (OSA).

In the end, the group could not develop any formal OSA guidance for orthodontists. This is interesting given that orthodontists are charged with managing the anatomy of the airway and they work with medical providers on airway anatomy issues like cleft palates and orthognathic surgery.

While it was not stated in the paper, in my opinion, the reason for the lack of specificity of recommendations comes from the nature of the science that was being evaluated. When medical colleagues review dental literature, routinely they are struck by the poor quality of the data. Dental research is typically not well funded, the numbers of participants are limited, the follow-up is short, and it lacks untreated control subjects.

Orthodontics takes years to complete and many years to determine any impact. And finally, the relationship between OSA and orthodontics is a relatively new concept that has rarely been tested in sleep laboratories. Instead, most studies on airway change look at cephalometric or CBCT volumetric alteration and infer (all be it incorrectly) that bigger is better. The conclusions of the AAO white paper are, therefore, going to be constrained by this lack of quality evidence.

Bicuspid extraction addressed

Curiously, section 12 of the AAO white paper, “Fallacies About Orthodontics in Relation to OSA,” addresses the issue of bicuspid extraction. It begins, “Conventional orthodontic treatment never has been proven to be an etiologic factor in the development of obstructive sleep apnea. When one considers the complex multifactorial nature of the disease, assigning cause to any one minor change in dentofacial morphology is not possible.”

This conclusion is true, but the key word is “proven.” There is also a lack of proof orthodontics is not a factor in the development of OSA. The disease is multifactorial but minor changes in oral volume, vertical dimension, and mandibular protrusion have been shown to change the airway and sleep apnea significantly. To argue that removal of four teeth is an unremarkable change is, at least, questionable given available data.

The paper continues, “The specific effects on the dental arches and the muscles and soft tissues of the oral cavity following orthodontic extractions can differ significantly, depending on the severity of dental crowding, the amount of protrusion of the anterior teeth and the specific mechanics used to close the extraction spaces.”

Zhiai Hu1 published a systematic review evaluating the effect of teeth extraction on the upper airway. It included only seven articles. They were divided by the reason for treatment:

The Class I bimax group all had anterior tooth retraction without boney changes. Three of the four articles showed a reduction in upper airway dimension, the last showed a reduction but not to the level of significance.

The one article on crowding differed because the orthodontic technique allowed the molars to move forward ~3mm. That created an increase in the airway dimension.

Finally, the unspecified group did not provide a discussion of the direction of movement (retractive or molar movement) and found small increases for both extraction and non-extraction groups. A conclusion that can be reached from this review is if you retract the anterior teeth, the airway size reduces and if the molars move forward, the airway improves or remains the same.

Impact of volumetric change

The white paper goes on to state, “The impact that orthodontic treatment with or without dental extractions may have on the dimensions of the upper airway also has been examined directly, first with two-dimensional cephalograms and more recently with three-dimensional CBCT imaging…

“In discussing orthodontic treatment to changes in the dimensions of the upper airway, it also is helpful to understand that an initial small or subsequently reduced or increased size does not necessarily result in a change in airway function.”

This is one of the issues medicine has with dental literature. Dental researchers rarely study the actual impact of the volumetric change. It is not enough to say the space is smaller. It needs to be quantified with sleep data. It also needs to be followed over time.

However, Christian Guilleminault highlighted a reduction in the ideal size of the upper airway can lead to abnormal breathing over time, initially with flow limitation, then with a progressive worsening toward full-blown OSA.2> Rarely would testing at the completion of orthodontics demonstrate a compromise. It is the stressful breathing night after night that compromises the airway and makes people more prone to breathing issues during sleep.

Existing evidence suggests the opposite

The AAO white paper does highlight a paper that attempts to answer the question about compromise later in life.

“One such study assessed dental extractions as a cause of OSA later in life with a large retrospective examination of dental and medical records… The study concluded that the prevalence of OSA was essentially the same in both groups, and that dental extractions were not a causative factor in OSA.”

A.J. Larsen3 reviewed insurance records for 5,500 patients between the ages of 40-70. Dental radiographs determined if the subjects were missing four bicuspids or had a full complement of teeth. They matched the two groups for age, BMI, etc. Then they reviewed their medical records to see if the subject had received a diagnosis for apnea.

The results showed that 9.56% of the non-extraction and 10.71% of the extraction group had a diagnosis of OSA. This was not significantly different. Thus, the authors’ conclusion was there was not a relationship between OSA and premolar extractions.

It is currently estimated that 80-90% of OSA patients are undiagnosed. Larsen’s paper states because the subjects all have insurance, they would expect physicians would note the symptoms and get them a sleep study and diagnosis.

There is absolutely no evidence to support that assertion and the existing evidence suggests just the opposite. From pediatricians to primary care, physicians are not diagnosing apnea effectively. The conclusion of the article should be extraction and non-extraction individuals are underdiagnosed at almost the same rate.

Orthodontic literature is not conclusive

The AAO paper goes on to state, “Overall it can be stated that existing evidence in the literature does not support the notion that arch constriction or retraction of the anterior teeth facilitated by dental extractions, and which may (or may not) be the objective of orthodontic treatment, has a detrimental effect on respiratory function.”

Once again, it is true existing evidence does not support that position because there is no quality evidence at this time, not that the relationship does not exist. This should, in my opinion, be a call for more research rather than posturing the topic as a fallacy.

Orthodontic literature is not conclusive on whether premolar extractions impact the airway. A weakness of all the studies is they are based on CBCT or cephalometric radiographic measurements and not sleep data. How a patient uses the existing airway volume is more critical than the size and that’s never measured.

Is there ever a time when I agree with an orthodontic recommendation of extractions? Absolutely. I will, however, ask my specialist:

The most important take away should be the need to intervene earlier. Attempting to direct craniofacial development may keep us from ever needing to know the answer to, “Does the extraction of four bicuspids impact the airway?”

Jeffrey Rouse, D.D.S., is a member of Spear Resident Faculty.

1. Hu Z, Yin X, Liao J, Zhou C, Yang Z, Zou S. The effect of teeth extraction for orthodontic treatment on the upper airway: a systematic review. Sleep and Breathing. 2015;19(2):441-451.

2. Guilleminault C, Huseni S, Lo L. A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. ERJ Open Research. 2016;2(3):00043-02016.

3. Larsen AJ, Rindal DB, Hatch JP, et al. Evidence Supports No Relationship between Obstructive Sleep Apnea and Premolar Extraction: An Electronic Health Records Review. Journal of Clinical Sleep Medicine. 2015;11(12);1443-1448.

This content was originally published here.

Millions Have Lost Health Insurance in Pandemic-Driven Recession – The New York Times

The White House and Congress have done little to help. The Trump administration has imposed sharp cuts on the funding for outreach programs that assist people in signing up for coverage under the health law. And while House Democrats have passed legislation intended to help people to keep their health insurance, the bill is stuck in the Republican-controlled Senate.

Rather than expand access to subsidized insurance under the Affordable Care Act, Mr. Trump has promised to directly reimburse hospitals for the care of coronavirus patients who have lost their insurance. But there is little evidence that has begun.

“Helping people keep their insurance through a public health crisis surprisingly has not gotten much attention,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “This is the first recession in which the A.C.A. is there as a safety net, but it’s an imperfect safety net.”

The Families USA study is a state-by-state examination of the effects of the pandemic on laid-off adults younger than 65, the age at which Americans become eligible for Medicare. It found that nearly half — 46 percent — of the coverage losses from the pandemic came in five states: California, Texas, Florida, New York and North Carolina.

In Texas alone, the number of uninsured jumped from about 4.3 million to nearly 4.9 million; three out of every 10 Texans are uninsured, the research found. In the 37 states that expanded Medicaid under the Affordable Care Act, 23 percent of laid-off workers became uninsured; the percentage was nearly double that — 43 percent — in the 13 states that did not expand Medicaid, which include Texas, Florida and North Carolina.

Five states have experienced increases in the number of uninsured adults that exceed 40 percent, the analysis found. In Massachusetts, the number nearly doubled, rising by 93 percent — a figure Mr. Dorn attributed to a large number of people losing employer-based coverage there. Across the country as a whole, more than one in seven adults — 16 percent — is now uninsured, the analysis found.

To generate the estimates, Mr. Dorn examined the number of laid-off workers in each state and calculated how many had become uninsured based on coverage patterns since 2014, when the central provisions of the Affordable Care Act went into effect. The underlying data for those patterns comes from work published by the Urban Institute in April.

This content was originally published here.

Virginia Health Dept Urges Citizens to Snitch on Churches and Gun Ranges | Dan Bongino

Virginia’s Department of Health is joining others who have encouraged their state’s citizens to snitch on each other – but only for select reasons.

As the Washington Free Beacon’s Andrew Stiles reports:

The Virginia Department of Health is encouraging citizens to lodge anonymous complaints against small businesses for violating Gov. Ralph Northam’s (D.) coronavirus-related restrictions on public gatherings.

Virginia residents can report alleged violations of Northam’s executive orders regarding the use of face masks and capacity requirements in indoor spaces via a portal on the health department’s website, a practice commonly known as “snitching.” 

The webpage gives snitchers several options regarding the “type of establishment” on which they are intending to snitch. These include “indoor gun range” and “religious service,” among others. Republican state senator Mark Obenshain expressed concern that churches and gun ranges were “specifically” singled out, noting, “there is nothing to prevent businesses from snitching on competitors, or to prevent the outright fabrication of reports.”

Meanwhile, when protesters were out in full force in the tens of thousands earlier in the month, VA’s health department merely encouraged them to wear masks and wash their hands. They also recommended social distancing, which would obviously be impossible in such an environment. “We support the right to protest, and we also want people to be safe” they said.

What do they think is going to do more to spread the virus, a dozen people at a gun range, or tens of thousands in the streets? Even if those at the gun range transmitted the virus at a higher rate, the latter would still infect more people due to sheer volume.

It is indeed the case that coronavirus cases are on the rise nationally (as you’d expect after weeks of mass protest), but not all cases are created equal. The vast majority of cases are mild and asymptomatic, and the median age of those infected is drastically lower than it was months ago (meaning most new cases are among those least likely to die of the virus).

That’s evident in Florida, where cases are exploded – but the death rate has precipitously declined because the average person infected is now only 37 years old. In March it averaged in the mid fifties.

In many states more people above the age of 100 have died of the virus than those under 40. On the day coronavirus deaths peaked, for every person aged 24 or younger that died of the virus, 319 people above the age of 85 died of it.

This content was originally published here.

Henry Ford Health study: Hydroxychloroquine lowers COVID-19 death rate

Hydroxychloroquine lowers COVID-19 death rate, Henry Ford Health study finds

Sarah Rahal and Beth LeBlanc
The Detroit News
Published 6:42 PM EDT Jul 2, 2020

A Henry Ford Health System study shows the controversial anti-malaria drug hydroxychloroquine helps lower the death rate of COVID-19 patients, the Detroit-based health system said Thursday.

Officials with the Michigan health system said the study found the drug “significantly” decreased the death rate of patients involved in the analysis.

The study analyzed 2,541 patients hospitalized among the system’s six hospitals between March 10 and May 2 and found 13% of those treated with hydroxychloroquine died while 26% of those who did not receive the drug died.

Among all patients in the study, there was an overall in-hospital mortality rate of 18%, and many who died had underlying conditions that put them at greater risk, according to Henry Ford Health System. Globally, the mortality rate for hospitalized patients is between 10% and 30%, and it’s 58% among those in the intensive care unit or on a ventilator.

An arrangement of hydroxychloroquine pills.
John Locher, AP

“As doctors and scientists, we look to the data for insight,” said Steven Kalkanis, CEO of the Henry Ford Medical Group. “And the data here is clear that there was a benefit to using the drug as a treatment for sick, hospitalized patients.”

The study, published in the International Society of Infectious Disease, found patients did not suffer heart-related side effects from the drug. 

Patients with a median age of 64 were among those analyzed, with 51% men and 56% African American. Roughly 82% of the patients began receiving hydroxychloroquine within 24 hours and 91% within 48 hours, a factor Dr. Marcus Zervos identified as a potential key to the medication’s success. 

“We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring,” said Zervos, division head of infectious disease for the health system who conducted the study with epidemiologist Dr. Samia Arshad. 

Other studies, Zervos noted, included different populations or were not peer-reviewed.

“Our dosing also differed from other studies not showing a benefit of the drug,” he said. “We also found that using steroids early in the infection associated with a reduction in mortality.”

But Zervos cautioned against extrapolating the results for treatment outside hospital settings and without further study. 

Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services, respond to the study Thursday by noting “prescribers have a responsibility to apply the best standards of care and use their clinical judgment when prescribing and dispensing hydroxychloroquine or any other drugs to treat patients with legitimate medical conditions.”

Dr. Marcus Zervos identified administering steroids early in the infection as a potential key to the medication’s success.
Zoom screenshot

The study found about 20% of patients treated with a combination of hydroxychloroquine and azithromycin died and 22% who were treated with azithromycin alone compared with the 26% of patients who died after not being treated with either medication. 

Henry Ford Health has been working on multiple clinical trials of hydroxychloroquine, including one that is testing whether the drug can prevent COVID-19 infections in first responders who work with coronavirus patients. The first responder clinical trial was trumpeted by Trump administration officials early in the pandemic.

Many health care institutions, including the World Health Organization, suspended clinical trials of the drug touted by President Donald Trump after a faulty study was published in the British medical journal The Lancet on May 22. The WHO restarted the trials in June.

The study is vital, Zervos said, as medical workers prepare for a possible second wave of the virus and there is plenty of research that still needs to be conducted to solidify an effective treatment.

In this May 18, 2020 file photo, President Donald Trump tells reporters that he is taking zinc and hydroxychloroquine. Results published Wednesday, June 3, 2020, by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the COVID-19 coronavirus. The drug did not seem to cause serious harm, though – about 40% on it had side effects, mostly mild stomach problems.
Evan Vucci, AP, File

Still, use of the malaria drug became highly controversial.

Doctors at Michigan Medicine, the University of Michigan’s health system, remain steadfast in their decision not to use hydroxychloroquine on coronavirus patients, which they stopped using in mid-March after their own early tracking of the treatment found little benefit to patients with some serious side effects.

Michigan’s largest system of hospitals, Southfield-based Beaumont Health, also stopped using the decades-old anti-malarial drug as a coronavirus treatment after deciding it was ineffective. 

St. Joseph Mercy health system has also backed away from the treatment. The system has St. Joseph hospitals in Ann Arbor, Chelsea, Howell, Livonia and Pontiac, as well as the Mercy Health hospitals in Grand Rapids, Muskegon and Shelby. 

Heidi Pillen, director of pharmacy at Beaumont Health, confirmed on Thursday that the health system is not using hydroxychloroquine to treat COVID-19 patients. 

A recent United Kingdom study evaluating hydroxychloroquine in hospitalized patients with coronavirus was stopped after preliminary analysis found it didn’t have any benefit. About 26% of patients in the trial using the drug died, compared with about 24% receiving the usual care, according to the Oxford University study. 

But doctors at Detroit Medical Center’s Sinai-Grace told The Detroit News in April, when the hospital was overloaded with senior COVID patients, that they were giving the drug to anyone they could.

srahal@detroitnews.com

Twitter: @SarahRahal_

This content was originally published here.

California is reopening too quickly, posing ‘very serious risk,’ health officer warns

A key architect of the nation’s first coronavirus shelter-in-place order is criticizing California’s increasingly fast pace of lifting stay-at-home restrictions.

In particular, Dr. Sara Cody, health officer for Santa Clara County — home to Silicon Valley and Northern California’s most populous county — said she was concerned by the decision to allow gatherings of up to 100 people for religious, political and cultural reasons.

“This announcement to authorize county health officers to allow religious, cultural and political gatherings of 100 people poses a very serious risk of the spread of COVID-19,” Cody told the Santa Clara County Board of Supervisors on Tuesday.

Even if just one infected person showed up to such an event, the virus could easily be transmitted to many people and overwhelm local health officials’ ability to investigate all related cases, she warned.

Cody has been credited with helping to spearhead the San Francisco Bay Area’s regional shelter-in-place order. Issued March 16, the mandate that affected 6.6 million people in six counties initially stunned the nation. But it quickly became a model for the rest of California and other states, with Gov. Gavin Newsom enacting a statewide stay-at-home order March 19 and New York state following suit three days later.

Santa Clara County, with a population of 1.9 million people, is not required to relax its order — among the strictest in California — to the state standard. When local and state orders differ, the stricter standard applies. But Cody expressed concerns that California risks a surge in cases if it reopens too many sectors of society too quickly.

Since early May, “the state has shifted away from the stay-at-home model and has made significant modifications with increasing frequency,” Cody said. “The pace at which the state has made these modifications is concerning to me.”

Gov. Newsom said California barbershops, hair salons, nail salons and other grooming services could reopen under Stage 3 of his reopening plan.

Cody said it’s important to wait at least 14 days — the time it can take for an infected person to show symptoms — after easing restrictions to see what effects the relaxed policy has on increased coronavirus illnesses. It would be even better to wait 21 days, she added.

Reopening so fast, she said, means there isn’t enough time to implement new procedures to make reopened activities safe.

Within hours of Newsom’s announcement Tuesday allowing counties to reopen hair salons and barbershops, some stylists already had customers in their chairs.

“Making changes too frequently leaves us blind. We can’t see the effect of what we just did,” Cody said. “Our social and economic well-being are best served by a more phased approach that allows activities to resume in a manner that allows people to actually be relatively safe while engaging in the newly open activity.”

Experts say the Bay Area’s early action dramatically slowed the spread of the highly infectious coronavirus in the region, which had been one of the nation’s earliest hot spots of the virus.

As of Tuesday night, the six Bay Area counties had reported a coronavirus death rate of six fatalities per 100,000 residents; Los Angeles County has a death rate of 21 fatalities per 100,000 residents. Statewide, California has a death rate of about 10 fatalities per 100,000 residents. Across the nation, New Jersey’s rate is 126 fatalities per 100,000 residents, while New York’s is 149 fatalities per 100,000 residents.

The latest rules issued by the California Department of Public Health this week say churches that choose to reopen and in-person political protests must limit attendance to 25% of building capacity or a maximum of 100 attendees, whichever is lower.

New Jersey, by contrast, limits such gatherings to 25 people, and New York, 10, Cody said.

Newsom said Tuesday that he understood he would be criticized in deciding to allow religious gatherings to resume on a restricted basis.

“I know some people think that’s too much too fast too soon. Others think, frankly, that it didn’t go far enough,” the governor said. “But suffice it to say, at a statewide level, we now are affording this opportunity again with a deep realization of the fact that people will start to mix … and that is incumbent upon us to practice that physical distancing within these places of worship.”

The Board of Supervisors unanimously approved a resolution supporting the resumption of in-person religious assemblies starting this weekend.

Newsom has come under political pressure to allow churches to reopen. On May 18, he said rules to allow church congregations to meet were “a few weeks away … if everything holds.” Later that week, the U.S. Department of Justice sent a letter to the Newsom administration warning that the state’s stay-at-home order may discriminate against religious groups and violate their constitutional rights.

Also last week, more than 1,200 pastors vowed to hold in-person services May 31, Pentecost Sunday, intending to defy Newsom’s stay-at-home order.

President Trump then made an unexpected announcement that he was designating churches “essential” businesses so they could immediately reopen. Hours after Trump’s comments, Newsom vowed Friday to provide plans on Memorial Day that would allow in-person religious services.

In addition to dine-in restaurants and in-person shopping, Riverside and San Bernardino counties are resuming in-person worship services.

The U.S. Centers for Disease Control and Prevention has said that large gatherings played a major role in the early widespread transmission of the virus across the nation. In particular, the CDC said Mardi Gras celebrations in Louisiana, a biotech conference in Boston with about 175 attendees and a funeral with more than 100 attendees in small, rural Dougherty County in Georgia played an outsize role in the illness’ spread.

Churches have also been the site of outbreaks large and small. In Washington state’s Skagit County, one symptomatic person attended a 2½-hour choir practice at a church attended by 60 other people; local officials later documented that 52 people fell ill, including two who died — a virus attack rate of 87%, according to the CDC. Singing can easily spread infected droplets from one person to another.

In another outbreak, pre-symptomatic tourists from Wuhan, China — the global epicenter of the pandemic — visited a church in Singapore on Jan. 19 and started showing symptoms several days later. Three other people who attended the same church on the same day also got sick, including one who sat in the same seat as the tourists, according to the CDC.

Newsom defended his administration’s actions in moving quicker than the pace Cody suggested. The governor said he was guided by what his health officials were telling him was appropriate. He said the state has the time to test the theory behind the relaxed orders and “to make adjustments if, indeed, we need to dial it back, or loosen them more into the future.”

But Santa Clara County and its neighbors in the Bay Area have chosen a different approach. After the Bay Area counties of Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara jointly decided to allow the resumption of all construction and businesses such as gardening and landscaping to resume May 4, the counties waited a full two weeks before allowing the reopening of many retail businesses for pickup service in the week of May 18.

California allows some retailers to open with curbside service, including bookstores, florists and toy stores. Many parks will reopen Saturday.

By contrast, most other California counties have moved more quickly to reopen businesses as soon as Newsom has allowed it. Los Angeles County, for instance, joined most other California counties in reopening retail businesses for pickup service on May 8, the first day it was allowed.

Los Angeles County has also begun allowing the reopening of houses of worship and in-person political protests, shortly after state rules were relaxed. Retail stores and malls got the green light to in-person shopping in L.A. County but must operate at 50% of capacity.

By contrast, the six core Bay Area counties are still allowing retail stores to be open for pickup service only.

Cody also noted that the pandemic is disproportionately affecting communities of color and those who are most affected by poverty and overcrowded housing. For example, Latinos make up 26% of Santa Clara County’s population but comprise 40% of its coronavirus cases and 32% of deaths. Disease rates are particularly high in East San Jose, which is lower income and largely Latino.

Black people make up 2% of Santa Clara County’s population and account for 6% of the county’s coronavirus deaths.

“COVID-19 has unmasked some very severe preexisting inequities in our community. If we let the virus just go and don’t stay on top of it, the people that are going to be hurt the most are people who are living in places where they’re working low-wage jobs, they live in crowded households, they may have less access to care,” Cody added in remarks broadcast Wednesday on Facebook.

Reopening too quickly will disproportionately risk the lives of people of color and those with lower incomes, Cody said. “That is the group of people that will be disproportionately in the hospital and that will see disproportionate numbers of deaths. And that’s not acceptable.”

“We are going to suppress the level of transmission to the lowest levels that we can, with every ounce of our energy, and we are going to stay at it. We’re going to go slow, and we’re going to be safe, and we’re going to protect the people that most need to be protected,” Cody said.

She said if the overall rate of disease transmission remains stable in the Bay Area, officials will be able to continue easing restrictions on a regular schedule with at least two weeks between each phase.

“We all want to reopen our economy, get back to our lives, get back to work,” Cody said. “But the truth is: We are in the greatest global crisis since the Second World War…. We want to be able to reopen safely.”

Times staff writers Phil Willon, Eli Stokols, Matthew Ormseth and Alex Wigglesworth contributed to this report.

This content was originally published here.

Quarantine for 14 Days If You Attended Protests or Gatherings, Chicago Health Officials Urge – NBC Chicago

Chicago health officials urged anyone who attended a protest or gathering over the weekend to self-quarantine at home for 14 days if possible, warning residents that the coronavirus pandemic is not over – even if it’s not at the top of mind.

“While we continue to make progress, I am concerned we may see ourselves take a step backward down the line against COVID-19,” Chicago Department of Public Health Commissioner Dr. Allison Arwady said at a news conference Monday with Mayor Lori Lightfoot and other city officials to discuss the protests, looting, vandalism and unrest that gripped the city over the weekend.

“That’s because COVID-19 is caused by a virus, and that virus doesn’t care about what’s going on in the city,” Arwady continued, adding that COVID-19 still does not yet have a cure or effective treatmeant and “still takes every opportunity it can to spread.”

May 29, 2020: More than 1,600 new coronavirus cases were reported in Illinois as nearly all of the state eases restrictions, entering a third phase of reopening Friday.

“Still here in Chicago we are seeing hundreds of new cases of COVID-19 every day,” she said. The number of coronavirus cases in Illinois surpassed 120,000 on Sunday, state health officials said, with a death toll of 5,390 statewide.

“If you’ve been in any kind of gathering this weekend – protests, social, if you reached out for contact during this time – you are at increased risk for having contracted COVID-19,” Arwady said, asking that those who gathered in groups, particularly those who did not keep a 6-foot distance from others, self-isolate at home for 14 days.

“I especially want to ask that if you have been in close contact with people outside of your household this weekend, please avoid close contact with those at the highest risk for serious outcome and death from COVID,” she continued.

“If you start to develop any symptoms, you must stay home except to get tested and you must get tested,” Arwady said, asking everyone “now more than ever” to continue practice physical distancing and follow health guidelines.

“Get testing if you have any concern that you might have been exposed to COVID and please continue to stay safe as we look ahead to rebuilding Chicago,” she added.

The weekend’s events – protests, looting, vandalism, violence and unrest that spanned the city and suburbs – brought into question whether Chicago will move into the third phase of its reopening plan on Wednesday as scheduled.

Lightfoot said Monday that she and other officials were “in conversation” on that topic and had not determined whether the city can move into the next phase.

“We will make a determination whether or not we can go forward on June 3 as planned,” Lightfoot said. “We haven’t made that determination yet.”

She announced on Thursday that Chicago would enter phase three of its reopening plan on June 3, days after the rest of Illinois moved forward with loosening restrictions meant to curb the spread of the deadly coronavirus.

Chicago’s third phase of reopening is slated to allow several businesses to reopen with new guidelines and limitations, and small non-essential gatherings of up to 10 people. Some of the businesses allowed to reopen include restaurants for outdoor dining with appropriate social distancing and sanitary measures.

Chicago Department of Public Health Commissioner Dr. Allison Arwady breaks down the city’s latest coronavirus data with less than one week until phase three begins.

Lightfoot mentioned some of those businesses looking to reopen after being closed since March soon were in the downtown areas hit hard by vandalism and looting Saturday night.

“It’s a terrible thing that after being shut down for so long, and these businesses were preparing for opening on June 3, putting out patio furniture and doing other things to get themselves ready, that now instead of a moment of celebration, what they’re doing is experiencing a moment of despair,” Lightfoot said.

“I think it’s going to take some time for us to assess what the impact is going to be on those businesses all across the city that were preparing,” she continued. “Certainly in the downtown area, there has been a negative impact. And we’re in conversations with those businesses to determine what that will mean for them this weekend and into the future.”

In announcing a date for the city to enter the third phase of reopening, Lightfoot warned that she and other officials stood prepared to move backwards if reopening leads to another surge in COVID-19 cases.

“Let’s be clear: under no circumstances should our move to phase three be confused with this crisis being over, because it’s not,” she said.

This content was originally published here.

ClearCorrect vs Invisalign: Benefits, Before and After, Safety, and Cost

Contents

If you’ve been thinking of getting your teeth straightened, you probably know how difficult it is to find a treatment option that’s tailor-made to your unique goals. Traditional braces have been proven effective, but there’s a host of downsides, too — they’re bulky, uncomfortable, and not the most attractive option.

Enter invisible braces. Chances are you’ve already heard about Invisalign, but there’s another company that’s out to revolutionize the way we smile. ClearCorrect invisible braces are a new kind of orthodontic treatment that promises straight teeth with the least amount of fuss.

Bonus points: these industry-disrupting braces are made in the United States by a socially conscious company that uses recycled and eco-friendly packaging. These details, coupled with the fact that they’re more affordable than the competition, make ClearCorrect a popular choice among millennials.

What is ClearCorrect?

ClearCorrect aligners are a unique alternative to traditional metal braces. The primary benefit is that they’re totally invisible — in theory, they’ll give you a straight smile without anyone even noticing. They’re also removable, which means you can take them out before eating or during special occasions.

Like most clear aligners, ClearCorrect braces provide gradual adjustments to the teeth. Your orthodontist will first take photos and x-rays of your smile and then submit your prescription to ClearCorrect. Next, the company will create a set of custom aligners just for you. Occasionally, your orthodontist will request new sets that change along with your teeth.

Most people are required to wear their clear braces for up to 22 hours a day until an orthodontist deems the treatment plan complete. Treatment time varies from person to person, but most people see full results within one to two years.

Orthodontists recommend this treatment for both adults and teenagers to correct crowded teeth, spacing, underbites, overbites and crookedness.

Does ClearCorrect work?

ClearCorrect has been proven effective in a wide range of orthodontic studies.

One study showed that it was a valuable tool in correcting anterior crossbite, a condition where the top teeth rest behind the bottom teeth when the mouth is closed. Another showed that it was a great option for treating the correction of crowding, an issue that makes it hard to floss between teeth and compromises a perfectly straight smile.

Not only that, but ClearCorrect can be used in instances where traditional orthodontics failed. For example, some orthodontists use ClearCorrect as a solution to issues caused by traditional orthodontic bonding. In other words, clear braces are as good as — and in some cases even better — than traditional methods that are commonly used to straighten teeth. There’s even evidence to suggest that they’re just as effective at treating severe crowding as standard methods.

What’s better, ClearCorrect or Invisalign?

ClearCorrect and Invisalign are often compared, primarily because they both provide clear, custom-fit aligners that are more appealing to those who don’t want to fuss with traditional braces.

Both are excellent options with successful track records for mild to extreme cases of various dental issues. In either case you will be required to wear your custom-fit aligners for the majority of the day, except when you’re eating, drinking, flossing or brushing your teeth.

Still, there are some differences. The most significant reason why many orthodontists and patients are beginning to favor ClearCorrect over Invisalign is the cost: since ClearCorrect only charges the dentist a third or less of the cost of Invisalign, many dentists feel that it’s a more profitable option.

What’s more, many people report that ClearCorrect aligners are more comfortable than Invisalign. This is because ClearCorrect fabricates several trays at a time to ensure that they fit perfectly. Some patients also prefer ClearCorrect because their aligners are made in America.

>>To learn more frequently asked questions about Invisalign, check out our article on how Invisalign works

Does ClearCorrect hurt?

Doctors often recommend the use of ClearCorrect and other invisible braces as a more effective treatment option for patients who have “appliance-phobia.” This means that people who have fears associated with fixed appliances on the teeth (i.e. traditional braces) tend to do better with removable aligners that aren’t permanent.

Metal braces can be uncomfortable and even painful, which is why many people are hesitant to go the traditional route. On the other hand, ClearCorrect is virtually pain-free. A multi-stage polishing process ensures that no sharp or rough edges are found on the aligners, making ClearCorrect a relatively comfortable experience, even when worn for long periods of time. And while most patients do experience some mild discomfort in the first couple of days of wearing ClearCorrect aligners, this typically fades away relatively quickly.

When you’re wearing ClearCorrect aligners that are properly fitted to your teeth and gums (achieved through a 3D model that perfectly matches your teeth), you shouldn’t feel a thing. With that said, some patients do complain of sore gums. You should see your orthodontist if this persists for more than two days — he or she will be able to tell if your aligners are not the ideal size and shape for your mouth.

Are ClearCorrect aligners safe?

Most people aren’t too keen on the idea of having a foreign object inside their mouth for most of the day. That’s totally understandable.

The good news is that ClearCorrect aligners are designed to be safe for long-term use. They contain no BPA or phthalates, and have been approved for use by the FDA. Because of this, ClearCorrect is generally considered safe for use by pregnant or nursing patients. Nevertheless, you should speak with your primary care physician and orthodontist if you become pregnant while using ClearCorrect.

How much does ClearCorrect cost?

As mentioned above, the cost of ClearCorrect makes it one of the most desirable orthodontic treatment options on the market for those who dream of straight teeth.

ClearCorrect treatment costs less than Invisalign and other clear aligner treatments because the company itself charges ClearCorrect providers significantly less.

There are several different treatment plans which differ in terms of cost. Your customized treatment will help you determine the right option for your budget and dental needs. The company offers Flex (limited) and Unlimited pricing options. Those who require the full treatment option can expect to pay anywhere between $4,000 and $5,000 for the best results. The Flex option is a good choice for those who don’t have severe crowding or crookedness, and costs between $2,500 and $3,500 total.

Will my insurance cover it?

Another great thing about ClearCorrect is that many dental insurance companies cover the procedure right alongside traditional braces and other orthodontic treatments.

Make sure to check with your insurance provide to see whether or not this type of treatment — which typically falls under the category of clear aligners — is covered. Those who do qualify for some relief under insurance may be able to save up to $3,000 on ClearCorrect braces.

Is ClearCorrect better than traditional braces?

As modern dentistry advances, it’s becoming more and more apparent that clear braces have the capacity to do all of the same things that metal braces can and more. In fact, one of the biggest myths associated with clear braces is that they move teeth more slowly than their metal counterparts. This just isn’t true. A good straightening treatment will work as quickly (or as slowly, depending on your perspective) whether the aligners are made of metal, ceramic or plastic.

Metal braces aren’t the most economical option — a full treatment rings up for as much as $6,000 — but they are almost always at least partially covered by insurance. However, metal braces are by and large considered the most durable solution out there.

The fact that metal braces last longer than other types makes them appealing for people who have to wear braces for long periods of time. Make sure to talk to your orthodontist or ClearCorrect provider about all of your different treatment options before committing to one.

This content was originally published here.

Minnesota Board of Dentistry Recommends Only Emergency Procedures Amid COVID-19 Pandemic – Fox21Online

Minnesota Board of Dentistry Recommends Only Emergency Procedures Amid COVID-19 Pandemic

Dr. Daniel Loban of Loban Dental Speaks Out About the Order from the Minnesota Board of Dentistry

DULUTH, Minn. – Dr. Daniel Loban, the owner of Loban Dental, is speaking out regarding the closure of dental offices unless procedures are for emergency purposes.

“I can tell you my propensity is to help people and putting myself at home and understanding how serious this is kind of draws a line in the sand so I can be a little more proactive in taking steps to keep myself away from other people,” said Loban.

Loban understands this is a difficult time for many people in our community.

He said as the owner of a dental office, he is also working around the clock to figure out steps necessary to protect his small business, including the employees in his office.

“If we were to treat everybody as if they potentially have this virus, we’re vastly unprepared because we typically don’t typically care respiratory devices and goggles,” said Loban.

Loban said he has contacted other dental offices in the region. Many offices are operating with few employees to answer phones and take care of emergency procedures as they come in.

If you’re having a dental issue or have concerns, Loban recommends calling your dentist. He says at this time, they should be able to help your needs and resolve the situation.

Currently, Minnesota health department officials say the state’s 89 confirmed cases as of Thursday represent only “the tip of the iceberg” and they believe there’s widespread transmission across Minnesota.

This content was originally published here.

Public Health Experts Have Undermined Their Own Case for the COVID-19 Lockdowns – Reason.com

In theory, the mass protests following the alleged murder of George Floyd put public health officials who have ceaselessly inveighed against mass gatherings in a difficult position. They have called for a moratorium on most types of public activities, but particularly gathering in large crowds where increased aerosolization from loud talking and yelling could spread the COVID-19 virus to massive groups.

But when it comes to the protests against police brutality, many medical experts think there should be an exemption to the COVID-19 lockdown logic.

More than a thousand public health experts signed an open letter specifically stating that “we do not condemn these gatherings as risky for COVID-19 transmission. We support them as vital to the national public health and to the threatened health specifically of Black people in the United States.”

The letter conceded that mass protests carried the risk of spreading coronavirus, and offered some good—if naive—advice for people who are going out anyway: wear masks, stay home if sick, attempt to maintain six feet of distance from other protesters. Many protesters are wearing masks, but others are not. And while we can blame the police for forcefully corralling people into close quarters, it’s a bit rich for public health experts to endorse protesting under conditions that they know are impossible for protesters to meet.

Indeed, for the purposes of offering health care advice, the only thing that should matter to doctors is whether their harm-reduction recommendations are being followed: how big is the event, is it outdoors, are masks being worn, etc. However, the letter distinguishes police violence protesters from “white protesters resisting stay-home orders,” as if the virus could distinguish between the two types of events. While I am not a doctor, my understanding is that it cannot.

The letter led a Slate writer to claim that “Public Health Experts Say the Pandemic Is Exactly Why Protests Must Continue.” The argument here is that coronavirus is more deadly for black people because of systemic racism and that protesting systemic racism is a sort of medical intervention.

“White supremacy is a lethal public health issue that predates and contributes to COVID-19,” the letter continues.

There is much truth to this! Black people in America do have worse health outcomes, but so do low-income people of every race and ethnicity. Is it medically acceptable for a poor person to protest against lockdown-induced economic insecurity? For people who live paycheck to paycheck to protest looming evictions and foreclosures? What about people experiencing loneliness, depression, and bereavement? Again, my understanding is that the virus does not think and thus does not choose to infect us based on what we’re protesting.

Many people all over the country were prevented from properly mourning lost loved ones because policymakers and health officials limited public funerals to just 10 people. For months, public health officials urged people to stay inside and avoid gathering in large groups; at their behest, governments closed American businesses, discouraged non-essential travel, and demanded that we resist the basic human instinct to seek out companionship, all because COVID-19 could hurt us even if we were being careful, even if we were going to a funeral rather than a nightclub. All of us were asked to suffer a great deal of second-order misery for the greater good, and many of us complied with these orders because we were told that failing to slow the spread of COVID-19 would be far worse than whatever economic impact we would suffer as a result of bringing life to a complete standstill.

People who failed to follow social distancing orders have faced harsh criticism and even formal sanction for violating these public health guidelines. To take just one extreme example, New York City Mayor Bill de Blasio threatened to use law enforcement to break up a Jewish funeral.

After saying no to so many things, a significant number of public health experts have determined that massive protests of police brutality are an exception to the rules of COVID-19 mitigation. Yes, these protests are outdoors, and yes, these experts have encouraged protesters to wear masks and observe six feet of social distance. But if you watch actual footage of protests—even the ones where cops are behaving badly themselves—you will see crowds that are larger and more densely packed than the public beaches and parks that many mayors and governors have heavily restricted. Every signatory to the letter above may not have called for those restrictions, but they also didn’t take to a public forum to declare them relatively safe under certain conditions.

“For many public health experts who have spent weeks advising policymakers and the public on how to reduce their risk of getting or inadvertently spreading the coronavirus, the mass demonstrations have forced a shift in perspective,” The New York Times tells us.

But they could have easily kept the same perspective: Going out is dangerous, here’s how to best protect yourself. The added well, this cause is important, though, makes the previous guidance look rather suspect. It also makes it seem like the righteousness of the cause is somehow a mitigating factor for spreading the disease.

Examples of this new framing abound. The Times interviewed Tiffany Rodriguez, an epidemiologist “who has rarely left her home since mid-March,” but felt compelled to attend a protest in Boston because “police brutality is a public health epidemic.” NPR joined in with a headline warning readers not to consider the two crises—racism and coronavirus—separately. Another recent New York Times article began: “They are parallel plagues ravaging America: The coronavirus. And police killings of black men and women.”

Police violence, white supremacy, and systemic racism are very serious problems. They produce disparate harms for marginalized communities: politically, economically, and also from a medical standpoint. They exacerbate health inequities. But they are not epidemics in the same way that the coronavirus is an epidemic, and it’s an abuse of the English language to pretend otherwise. Police violence is a metaphorical plague. COVID-19 is a literal plague.

These differences matter. You cannot contract racism if someone coughs on you. You cannot unknowingly spread racism to a grandparent or roommate with an underlying health condition, threatening their very lives. Protesting is not a prescription for combatting police violence in the same way that penicillin is a prescription for a bacterial infection. Doctors know what sorts of treatments cure various sicknesses. They don’t know what sorts of protests, policy responses, or social phenomena will necessarily produce a less racist society, and they shouldn’t leverage their expertise in a manner that suggests they know the answers.

It’s clear that we’ve come to the point where people can no longer be expected to stay at home no matter what. Individuals should feel empowered to make choices about which activities are important enough to incur some exposure to COVID-19 and possibly spreading it to someone else, whether that activity is reopening a business, going back to work, socializing with friends, or joining a protest against police brutality. Health experts can help inform these choices. But they can’t declare there’s just one activity that’s worth the risk.

This content was originally published here.