The number of coronavirus cases across the country continues to rise. More than 15 million people have been infected. Here in Michigan, restrictions on various businesses have been extended in an effort to slow the infection rate.

Michigan’s Chief Medical Executive, Dr. Joneigh Khaldun, talks candidly with Stephen Henderson about the spread of COVID-19 in the state, the restrictions placed on businesses to reduce the risks, the importance of the impending vaccines, and when life could possibly return to normal.


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Stephen Henderson  There’s a lot of confusion about why certain businesses remain closed while others remain open.  And why given the tremendous effort that was made by so many businesses, we did have the economy open to be safe, that we still ended up having to go back to at least a partial closure.  Walk us through how you are making that determination.

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  Absolutely so I can tell you, this has been a very tough year for everyone, and it’s because of the virus.  The public health threats are very related to the economic threats, there’s no question.  And the better we can get this virus under control, the more we’ll all be able to get back to some sense of normalcy if you will.  So, I can tell you the way we think about it. And from the public health perspective, it’s all about levels of risk and looking at the numbers and the data at the same time.  So, as you all are aware, we had an incredible, terrible surge of cases in the spring.  We were one of the hardest hit states in the entire country, of course it was concentrated in the southeastern part of the state.  We were able to bring that curve down and we did it really primarily by people doing the right thing.  We did have to limit some businesses being open, but again that’s all based on risk.  So, when you think about it from a public health perspective, there are some things that are just riskier than others and things that are associated with outbreaks, whether it’s in the state of Michigan or based on the data that we’re seeing across the country.  So being indoors, not having on mask, having poor circulation gathering in groups, pretty much if you add those things all into an equation, that makes some things more risky than others.  And as we’ve seen this terrible, awful surge this fall that we all really dreaded and we’re in the middle of it right now.  When we started seeing these cases increase exponentially, even more so than where we’re at, where we were in the spring, we had to start making really tough decisions about how we decreased risk.  And that is how we’re making decisions about how we determine which businesses are able to operate fully at this time.

Stephen Henderson  So a lot of criticism I see about this is that it’s arbitrary and restaurants are closed, but gyms aren’t.  One kind of business gets closed another doesn’t; how do you answer that?

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  You know, I don’t think it’s arbitrary, again, it’s based on risk.  There’s plenty of data.  You can, there’s all kinds of studies there’re national experts, international experts, quite frankly, the CDC.  There’s no question the data is quite clear that indoor restaurant dining is associated with outbreaks again across the entire world.  So that data is actually quite clear, and that is why under the current order, unfortunately, we had to limit indoor dining because that is the riskiest thing.  And again, gyms are actually open right now, it’s just those groups with the fitness classes.  Again, you’ll see these themes of public health and groups and people not wearing masks and being indoors.  Those are the types of things that differ by business just based on the type of activity that occurs in that particular business.

Stephen Henderson  Let’s talk about what’s coming in in the next few months. We are starting to see at least the initial rollout of the vaccination in Britain and seen here in the United States.  How much is that going to change for us in Michigan?  How soon are we going to see those things? There’s a lot of anticipation about what a vaccination actually means.  None of us though, really knows how quickly we can get back to the world.

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  Yeah, I’ll tell you, Vaccines are a game changer.  I am very hopeful, pretty confident that 2021 will look very different than 2020.  And so hopefully right now there are two vaccines, one made by Pfizer, the other by Moderna, and they’re both already at the FDA.  They’ve applied to be approved to be used throughout the country.  We still don’t know when they’ll be approved.  We hope that Pfizer will be approved even as early as December 15th.  Moderna if all goes well, will be about a week or so after that.  We still don’t know how much vaccine will be allocated to the state of Michigan, but I can say it will be very limited quantities in the very beginning.  So, what we’re going to see is that, again, maybe as early as next week we will start seeing a slow rollout of vaccines in Michigan.  We’ll have to focus on high priority populations, which are health care workers, essential workers, people who have underlying health conditions, the elderly.  Those populations initially will be targeted to receive the vaccine and then hopefully by late spring, it will be available to the general population.  My hope is that by late 2021, the vast majority of adults in the state of Michigan will receive the vaccine and will really at that point start seeing things go back to normal.  In the meantime, it’s still going to be about wearing, wearing your mask, washing your hands and maintaining your distance.  We’ve got to keep these case numbers down at the same time as we roll out these vaccines so we can really get a handle on this pandemic as quickly as possible.

Stephen Henderson  I want to talk to you about a recent poll that I saw of Detroiters, which, was really depressing.  It suggested that a majority of Detroiters are skeptical of the vaccine and may not want to take it.  Now, of course, we all know that there are very spectacular historical examples that drive that kind of suspicion in our community.  What would you say as the state’s public health officer to African Americans and other people in Detroit about why we should trust, why we should go ahead and take this vaccine?

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  Well, let me just acknowledge, again, as a black woman, I completely understand why African Americans and other minorities may be skeptical of the health care system.  And I certainly recognize that racism does exist in the health care system, so there’s no question about that.  But I also think it’s important that we look at the process and we understand the data and the facts and that we use that to inform our decisions on what we want to do.  I can tell you that even though it appears that the vaccine approval process is fast, it actually, no steps have been skipped at all in the vaccine approval process.  So, all of that data, all the facts about these trials, again, tens of thousands of people have been involved in these trials for this vaccine.  It will not be approved, and quite frankly, I will not allow it to be distributed throughout the state of Michigan unless there is data that shows that it is safe and effective.  So, I think it’s really important that people understand the data.  Also say people should know what to expect for the Pfizer and the Moderna vaccine.  The two who are the kind of frontrunners right now?  You’ll need two shots, so you’ll need to get one initially and then you need to come back and either three or four weeks, depending on the vaccine, to get another one.  It’s also important that you know how vaccines work.  For example, you might get some mild side effects from the vaccine, you might feel a mild fever, you might feel a little malaise, that’s actually a good thing.  The vaccine does not introduce the virus to your body.  What it does is prime your body so that it can make a response so that if it comes in contact with the real virus, it can fight it off.  So, it’s important to start learning about the process, learning about what to expect, and then hopefully making a good decision, which I hope again will be to get this vaccine.  This virus has devastated minority communities across the entire country.  And this is the one tool that we have that will help bring that curve down and eliminate that disparity, so it’s really important that we take a strong look at getting this vaccine.  And I will say, especially for minority communities, we don’t want to expand that disparity any more than it already exists.

Stephen Henderson  And sort of a companion question, an issue is, so how quickly then do we see a return, a relaxing of the restrictions that we’re living with now, the public health restrictions to try to control the virus?  If we can get vaccines, go early in the year, maybe by spring, to give us an idea of a timetable we are working with.

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  So that’s right. I’ll tell you, if we want to get back to normalcy, I tell you, if everyone just wore their mask every time they’re around someone outside of their household, everyone washes their hands.  If no one gathered and everyone decided to get this vaccine when it becomes available to them, I’ll tell you, by next fall we’ll be okay.  Life will look a lot normal, most businesses, if not all, again I’m projecting, predicting here, but most businesses if not all will probably be able to be open by next fall.  But all that depends on our behaviors and the choices that we make.  I think it’s important that everyone understands they have a role to play in ending this pandemic.  If we want our businesses open, our restaurants, our sports, our schools, if we want to potentially stop wearing masks everywhere, we all can do something about that right now to get our cases down.  But we have to be mindful.  This is overwhelming, our health care systems are getting close to it.  If you go to a hospital and there’s so many covid cases that you don’t have a bed for you or a loved one, it’s very concerning.  So, I think it’s important we all kind of understand the role that we individually have to play and getting back to the sense of normalcy in society.

Stephen Henderson  Okay, Dr. Joneigh Khaldun it was great to have you here and of course we hope for better times soon.  So, thank you for being with us.

Dr. Joneigh Khaldun, Chief medical Executive, Michigan Department of Health and Human Services  Thank you for having me, stay safe.