Gov: Health workers must get bias training; issues mask plea

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LANSING, Mich. (AP/WOOD) — All Michigan health workers must receive “implicit bias” training tied to their professional licensure under a directive issued Thursday by Gov. Gretchen Whitmer, who said the mandate will help address the coronavirus pandemic’s disproportionate and deadly impact on people of color.

The governor also said at at a press conference that she will soon announce additional steps to ensure compliance with Michigan’s mask-wearing requirement in indoor public spaces.

“It is required that you wear a mask if you go into a public place inside,” Whitmer said. “Wear a mask with a political statement that says, ‘I hate masks.’ Just wear it.”

GRAND RAPIDS AREA SEEING HIGH RATE OF CASES

The state on Thursday announced that 446 more cases of the virus were confirmed in Michigan Wednesday and there were nine more deaths. There have now been a total of 67,683 confirmed cases since the virus was first detected in Michigan in March, as well as 6,024 deaths.

While Kent County did not record any additional deaths, leaving the total at 136, is did confirm 106 more cases over the previous day for a total of 5,120.

The Grand Rapids region now has the highest rate of people testing positive for COVID-19 than any other region in the state, with more than 45 daily cases per million people, according to Dr. Joneigh Khaldun, the state’s chief medical executive. For the last three weeks, the region has seen an increase in the rate of cases.

Outbreaks have been identified at food-processing plants, bars, a casino, religious gatherings and congregate-care settings, Khaldun said, but “there’s also evidence of general community spread.”

Whitmer on Thursday updated a workplace safety order to include specific rules for meatpacking plants.

Hospitalization and death rates have not increased, but there is a lag of several weeks after cases are confirmed, Khaldun said. Testing is up — to 18,000 a day statewide — while positive tests are now 3% instead of 2%.

Eighty-nine of the new cases and one of the deaths were in Wayne County, which has been hit hardest by the virus — it has now had 22,646 cases and 2,623 deaths. Neighboring Oakland County has had 9,323 confirmed cases and 1,055 deaths. Macomb County has had 7,443 cases and 886 deaths.

Within the city of Detroit, Mayor Mike Duggan said the city lately has been recording 20 to 30 new cases a day, compared to 10 a few weeks ago. Many people who have been testing positive have not had symptoms.

“Eighty percent of this is wear a mask. … You’re going to be wearing a mask in October. You’re going to be wearing a mask in December. That’s just the truth,” Duggan said.

Barry, Kalamazoo and Van Buren counties each recorded one more death:

  • Barry County: Three total deaths, 100 total cases.
  • Kalamazoo County: 69 total deaths, 1,095 total cases.
  • Van Buren County: Eight total deaths, 230 total cases.

Labs in Michigan on Wednesday tested 23,555 samples for coronavirus and 842 came back positive. The number of positive tests does not equal the number of confirmed cases because many people are tested twice. That works out to positive test rate of 3.57%, better than the previous day’s rate of 3.77% but still higher than it has been since June 3.

If you want to get tested for the virus, you can go to the state’s website to find a site.

Michigan has the nation’s 12th-lowest rate of COVID-19 infections over the past two weeks. However, it has had a sharp rise of late — with an average of 494 new cases over the last seven days, which is 200 more than two weeks ago, according to Johns Hopkins University.

Health officials continue to remind people to practice 6-foot social distancing, wash their hands frequently and wear masks whenever in public.

“Right now it is required (to wear a mask in public), and for some reason people don’t seem to know that,” Whitmer said Thursday. “You’re supposed to be wearing a mask. That is the law of the land.”

If K-12 schools are going to open in eight weeks, she said, “masking up is so important. We’re asking every Michigander to do their part. We’ve got to get the politics out of this conversation and just do what we know to be the right thing.”

Whitmer’s order exempts violators of the mask requirement from a misdemeanor and fine, unlike people who do not socially distance, who attend outdoor gatherings of more than 100 in much of the state or — in the case of certain business owners — reopen. The restrictions are rarely enforced, however, and Whitmer said the last thing she wants is “to be doling out lots of penalties.”

Also Thursday, coalition of major hospitals, companies and unions announced plans for a multimillion-dollar advertising campaign urging adherence to safety practices. It cited polling that shows residents are less concerned about the virus than before.

“The combination of rising case counts and declining vigilance by many is placing our state at a tipping point in our battle with this disease,” said Wright Lassiter III, president and CEO of Henry Ford Health System in Detroit.

REQUIRING IMPLICIT BIAS TRAINING

The executive directive on racial inequity in medicine requires the state Department of Licensing and Regulatory Affairs to create rules to mandate implicit bias training standards as part of the knowledge and skills necessary for 368,000 health professionals to renew or get a new license or registration. Only those in veterinary medicine will be exempt.

The agency must consult with relevant industry groups by Nov. 1. Once the rule-writing process begins, it will take six months to a year to complete.

Black people make up 14% of Michigan’s population but account for nearly 40% of its 6,271 confirmed or probable COVID-19 deaths. Although underlying conditions that exist at higher rates in the African American community — heart disease, obesity, diabetes and asthma — make Black people more susceptible to the virus, officials said implicit bias is a factor in health care, too.

“We need to realize that implicit medical bias can be interjected at any point when someone has to make a choice or a decision,” said Lt. Gov. Garlin Gilchrist II, who is Black.

(Below: Watch a replay of the governor’s full news conference from July 9, 2020)

Randolph Rasch, dean of the Michigan State University College of Nursing, said implicit bias is someone’s unconscious, negative classification of individuals or groups of people based on physical attributes.

“Because of how you think of someone, (it) unconsciously shapes how you decide what physical examination to do, how you decide which tests to run, how you decide what plan of care you develop for that person,” he said. Requiring the training “is actually a support for you to provide better care.”

In statements to News 8 Thursday afternoon, both Grand Rapids-based Spectrum Health and Mercy Health and Saint Joseph Mercy Health System, which owns hospitals in Grand Rapids and Muskegon, said they have already been providing various forms of implicit bias and diversity training for at least a couple of years. Kalamazoo-based Bronson Healthcare said it will take whatever steps possible to fight health disparities.

The Michigan Nurses Association said it supported moves to address racial inequity in medicine and looked forward to the opportunity to help shape training programs.

Spectrum Health statement:

We have already been deep in this work. We have been intentionally delivering implicit bias training since 2015 and increased our efforts upon signing the 123forEquity Pledge in 2017. It is a core part of our comprehensive development and not just training to check the box. We are engaged in systemic work that deepens the learning towards behavioral change and concrete actions to make our workplace more inclusive, engaged and innovative. In the past three years, 48% of our team members have been trained on cultural competence which includes implicit bias training. We have plans to scale this to a larger number of our team members in the coming months. We will be examining the Governor’s executive order to determine the details and be sure we are aligned.

Mercy Health and Saint Joseph Mercy Health statement:

“Our communities are facing multiple hardships right now as a result of COVID-19 and social unrest, and we stand together with all those who are suffering. Our mission is to be a compassionate, healing presence in the communities we serve.

Among our efforts are the implementation of a statewide Diversity and Inclusion Council to provide input and direction on the design of new initiatives such as local Diversity & Inclusion Councils and employee resource groups (such as African American, Ability!, Women’s Inclusion Network Resource Groups).

“Over the past two years, we’ve conducted multiple leadership development forums, organized and supported by the Human Resource Organization Effectiveness team. These forums focused on the development of 1,100 leaders through training programs such as unconscious bias, resiliency, zero harm, Just Culture, and colleague engagement. Diversity in the workplace training is also provided to new employees and leaders during their orientation. Additionally, our local board members have all been trained in implicit bias.

“We recognize there’s much more that needs to be done. As a health system, we will continue to advocate for justice in order to change the inequities that exist among people of color.”

Bronson Healthcare statement:

“Bronson Healthcare wants to do whatever we can to eliminate health disparities and we believe implicit bias training is one of the many ways to advance those efforts. The importance of this work is especially highlighted by the disparities more clearly revealed nationally during the COVID-19 pandemic. As a healthcare system, we have been on a journey to address inequities and we look forward to learning more details about the statewide effort.”

Beth Washington, vice president of community health, equity and inclusion at Bronson

Michigan Nurses Association statement:

“Nurses provide the majority of direct health care and the Michigan Nurses Association looks forward to helping shape the implicit bias training program for health professionals. It is important to acknowledge and address the inequalities in our healthcare system. We believe that the governor’s plan is an important step toward ensuring that everyone gets the care they need.”

Jamie Brown, president of the MNA and Ascension Borgess Hospital critical care nurse

Associated Press writer Ed White in Detroit contributed to this report.

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