Posted on Jun 16, 2020
By Nargis Rahman
It’s been five months since Majeda Ahmed has left the house. She gave birth to her daughter three months ago and has since been trapped in the middle of the coronavirus quarantine. In Michigan Governor Gretchen Whitmer announced a stay-at-home order on March 23 for non-essential workers, which extended to most of the state until June 8. Across the country, states are now opening on a case-by-case basis.
Majeda says, “I’m probably just going to go to my parents house, and that’s it. My husband does the shopping, and we’re still treating it pretty seriously with keeping things clean and disinfected. I probably won’t go to a store or anything until this is gone.”
Health officials echo her concerns, warning about a possible second wave of coronavirus cases which could arise. I asked some public health officials what they thought about states reopening and how people should prepare and behave.
Dr. LaTonya Riddle-Jones, an assistant professor of internal medicine and pediatrics at Wayne State University School of Medicine, has a Masters in public health with a concentration in epidemiology from Harvard. She warns people about “getting back to normal,” saying people should not grow comfortable about the reopenings.
“I don't think we will ever be able to get back to normal after this global pandemic," she says. "Without a vaccine we will not achieve herd immunity. [It’s] imperative we practice sanitation and public health recommendations until we have achieved herd immunity,” allowing many people in the population to be immune to the virus.
Dr. LaTonya Riddle-Jones
The official numbers tell us that people are getting sick from COVID-19 and dying. The CDC COVID tracker reported more than 113,000 deaths in the U.S. to date. On May 24, the New York Times published a front page cover of nearly 100,000 names of Americans who passed away by the end of May 2020, based on national news and obituaries.
The World Health Organization says the second wave may come sooner than expected in the fall during flu season. In fact, several countries may see peaks in COVID cases after reopening. The WHO says they are concerned for those who already have limited health care access and vulnerable populations.
In cities like Detroit, where there are an exponential number of people dying from COVID, and a disproportionate number of African Americans have been impacted. Precautions are needed to prevent an increase of cases. As of June 11, 82 percent of the city’s COVID deaths were African Americans – 1,161 people out of 1,420 total deaths.
Nationally African Americans are dying twice as much as other races in the U.S. according to the COVID Racial Data Tracker. Latinos/Hispanics are a close second in contracting the virus. Dr. Riddle-Jones says, “Most essential workers in large cities, the people who are cleaning up after us, cooking, providing food for us and have to go to work ... are a majority of underrepresented people in America, and a large percentage of those people are African Americans. I attribute that to mortality.” She says systematic racism and comorbidities play a role and shed light to health disparities.
Metro Detroit, where I live, is providing more testing. Najibah K. Rehman, MD, MPH and the Medical Director for the City of Detroit, said testing is necessary to protect vulnerable groups. “We were one of the hardest hit cities. However, our political leaders listened and cared about the people of Detroit. We were able to test our most vulnerable individuals, including all nursing home residents and homeless shelters, adult foster care and senior living facilities that were affected.”
“We are continuously monitoring our high risk facilities, so it is really up to the general population to continue to practice effective hygiene and social distancing to ensure that we do not see spikes moving forward,” she says.
Family nurse practitioner Farzana Noor says that above all, people should not rush to get “back to normal. Especially in a community like in Hamtramck, where literacy level is lower and you have such a large non-English speaking community, we’re really worried about people being under the perception that, ‘everything is opening back, it must be okay to go back to life as usual,’ which is not the message.” She advises a slow and cautious approach to communities nationwide.
Farzana, who mostly sees children and women, says she’s noticed that people who have been vigilant from the start tend to remain vigilant and the same for those who haven’t been taking proper precautions. She said it’s important to follow CDC recommendations ,even if they seem extreme, rather than be at risk.
She says family members should also be mindful of following public health safety even if they don’t show signs of the virus. “Say for instance grandma is high risk. You can have her locked up 24 hours a day but every other person is going out to the beach and … it's the same as if she’s going out.”
It’s hard to know what to do, how careful to be when your own state or county may be opening up after three or more months of sheltering-in-place. It’s important to understand that the corona virus is still there, a global pandemic is still under effect, and in several areas around the United States, cases are rising. While the economy has to open up and we need to resume some semblance of our “regular” lives, there are precautions everyone should be taking. Here is what Dr. Riddle-Jones, Dr. Rehman and Farzana advise:
(Image: Farzana Noor) 1. Continue to observe CDC recommendations to wash hands properly with soap, wear masks and stay socially distant. Dr. Rehman said this may look like schools staggering students into schools, less of the workforce going back to the office and continuing to telework, and dining out with smaller capacities in restaurants or partaking in outdoor seating. She says, “The world is a very different place now. It still feels like a dream, but we just have to muscle through it.”
2. Only reenter society when you’re ready if you’re ready. Dr. Rehman said, “It is okay to take your time readjusting back into society. This is new for all of us and we must remain diligent to ensure we continue to see a reduction in cases. Some people are ready to be outside and socializing for the summer. Others are not ready. It is okay to take care of one’s self, since mental health is going to be key moving forward. It is going to be a balancing act for a while.”
3. Reopenings do not apply to you if you’re high risk or immunocompromised. risk people categorized by CDC means going out and reentering society don't apply to you. She says, “If you’re not sure if you’re high risk, ask your physician. Farzana says primary doctors are the first line of defense for hospitals, and they can discuss your symptoms and risks with you.
4. Wearing a mask. The CDC says everyone (who can) should wear masks. Dr. Riddle-Jones said these measures are to protect those around you - it’s about keeping public health at the forefront. Gather outdoors rather than indoors: In states like Michigan, crowds of up to 100 people socially distanced are allowed, but this is better if done outdoors rather than indoors.
5. Keep wiping things down. Dr. Riddle-Jones says people who may not have bleach solutions or wipes to decontaminate groceries brought into the home or frequently-touched surfaces can make their own solutions at home. She says schools will be required to provide sanitation for students - a step in the right direction for struggling schools that may not have done in the past.
6. Check reliable information from the CDC (in different languages here) and John Hopkins. The city of Detroit has translated COVID information here. Najibah says there is a COVID-19 hotline with translators available in Spanish, Bengali and Arabic for the general public - along with educational webinars for Detroiters in Spanish and Arabic.
7. Keep in mind flu season is around the corner. Experts say flu season will come with unique challenges with no COVID-19 vaccine currently available, limited information to determine between flu and virus symptoms and limited testing. Farzana says while medical clinics are ramping up their hours again, they will take precautions to sanitize and prioritize health for all - meaning longer waiting times should be expected.
For people like Majeda, she says she will continue to take precautions until the end of COVID (whether that means significantly less cases or a vaccine), whenever that is.
Dr. Rehman says it’s okay to enjoy the summer with caution while Dr. Riddle Jones says it’s hard to tell what will happen next, so we should stay vigilant and continue precautions. For now, they all recommend keeping up with the CDC recommendations for staying healthy and wearing masks when out in public to protect oneself and others.