Coronavirus Update for Detroit Michigan

As of April 16th, 2020 at 3 pm, there have been 673,215 cases of Coronavirus in the United States and 34,384 deaths from the Coronavirus in the US. This is a case fatality rate of 5.1%.

There have also been 29,263 Total COVID-19 cases in Michigan and 2,093 deaths in Michigan, for a case fatality rate of 7.15%. Further, Detroit has seen 7,383 Coronavirus cases and 546 Coronavirus deaths, for a case fatality rate of 7.3%.

Racial Disparities in Health Outcomes for the Coronavirus

There have been and there continue to be racial disparities in health outcomes related to the Coronavirus. Here in Michigan, African Americans make up only 14% of our state population, but account for 41% of the deaths due to Coronavirus statewide.

Here in Michigan, African Americans make up only 14% of our state population, but account for 41% of the deaths due to Coronavirus statewide.

In other regions, the disparities are even more evident. In Chicago, where African Americans make up only 30% of the population, they account for 52.1% of the COVID-19 cases, and 68.6% of the COVID-19 Deaths. You can read more about Chicago specifically, here.

In Louisiana, the disparity is similar. Louisiana’s population is 33% African American, according to 2019 U.S. Census data. According to the Governor of Louisiana, 70% of Louisiana’s coronavirus deaths are African Americans.

In Chicago, where African Americans make up only 30.1% of the population, they account for 52.1% of the COVID-19 cases, and 68.6% of the COVID-19 Deaths. You can read more about Chicago specifically, here.

When these stats are brought up, some people point to disparities in underlying health conditions as the reasons for these disparities in death rates among African American communities. And yes, that is the point - there are huge underlying health disparities between African American people, Caucasians, and other minority populations, and if we as a society want to stop pandemics from disproportionately affecting minority communities in the future, we will have to work tirelessly to address these health disparities.

Comparing Coronavirus and Influenza

Both Coronavirus and the Flu are spread by droplets, but Coronavirus may also be airborne, making transmission that much easier for Coronavirus. The incubation period for Coronavirus can be 1 to 14 days. This makes transmission of the Coronavirus much easier because during that incubation, the person who is infected may not have any symptoms, but they may be infecting others by shedding virus. This paired with the Transmission rate or R0, leads to a greater rate of spread and infection. This is why our stay-in-place orders statewide here in Michigan are so critical - we’re saving lives by staying at home and preventing the virus transmission.

Unlike the Flu, there are no available antiviral treatments and there are no vaccines for the Coronavirus. For the Flu, we have Oseltamivir (Tamiflu) and the Flu Shot to help us treat and prevent the Flu from spreading, but we don’t have these options for Coronavirus.

The hospitalization rate is much higher for Coronavirus, at 12 to 20%, whereas the hospitalization rate is only 0.6% to 1% for the Flu. Death rates are also very high for the Coronavirus. As discussed above, the case fatality rate for the US is 5.1% and the case fatality rate for Michigan is 7.15%. This makes the Coronavirus 50 to 70 times more deadly than the Flu.

How Much Does Coronavirus Care Cost?

The President has worked with health insurance companies to make Coronavirus testing free, but there are other costs that patients incur when seeking care for the Coronavirus. If you’re uninsured, you can be charged $149 for a 15 minute visit with your doctor, $86 for flu A and flu B testing, and $94 for some basic lab work.

Compare that with the cost of care in a direct primary care practice, where you pay a monthly membership of $49 to $99 monthly and all of your visits - in person and telemedicine - are included in the membership package. The membership also allows you to get steeply discounted labs, medications, and imaging services.

Comparison of Coronavirus care costs between those who are uninsured, those who have insurance, and those who are members of a direct primary care practice.

What is antibody testing for Coronavirus?

Antibody testing will become increasingly important as we as a Nation confront and manage the Coronavirus pandemic.

Currently, we as a medical community are offering RNA testing, which involves a nasal swab or a posterior pharyngeal swab. This test helps us identify those who actively have the virus and are shedding RNA. This is a good test and it tells us who is actively infected with the Coronavirus. The downside to this test is that there is a relatively short window of time when this test will detect the Coronavirus.

Soon, more and more private labs and hospitals will roll out Coronavirus antibody testing. The procedure looks like taking a prick of blood from the finger and testing that blood for antibodies, or proteins that your immune system makes to fight off this virus. First, your body makes IgM, and then your body makes IgG. IgG gives you long-term immunity to the Coronavirus, and immunologists anticipate that we will carry this immunity for 1 to 3 years.

So, if you test positive for IgM, only, you likely have only recently recovered from Coronavirus. If you test positive for IgM and IgG, you may have had Coronavirus approximately 14 days ago.

The only downside to these antibody tests is that we’re relying on the test manufacturers to produce an accurate test. That being said, this is the best tool that we have right now to find out who has had Coronavirus and who has built a robust immune response to Coronavirus.

What Can you do to Prevent the spread of Coronavirus?

Stay at home
When you go outside of your home, wear a mask and keep 6 feet between yourself and other people. Only go to the grocery store once each week to minimize unnecessary contamination and spread of the virus.
Donate extra supplies to hospitals or your primary care doctor’s office - we currently are running low on masks, so if you have them, we would appreciate a donation to keep our staff, patients, and community safe.
- Unused N95 Masks
- Unused Nitrile Gloves
Donate Blood
Donate Plasma if you’ve had Coronavirus and recovered - your plasma could be used to save a life.
DO NOT congregate in large groups
DO NOT visit elderly or vulnerable relatives, even if you feel fine
Act as though you have the virus

Thanks for reading and watching, and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

Coronavirus Update: What's Up With Antibody Testing?