Coronavirus: U-M experts can discuss health, economic, societal impact

EXPERTS ADVISORY

The World Health Organization called countries to "pull out all the stops” and warned "this is not a drill,” as new coronavirus infections surpass the 100,000 threshold worldwide. As the outbreak unfolds, nearly three dozen University of Michigan experts can discuss its societal, economic and public health impacts.

Ravi Anupindi is a professor of technology and operations at the Ross School of Business and faculty director for the Center for Value Chain Innovation.

"It is important to recognize that virus outbreaks are different from other types of disruptions like fires, floods and earthquakes,” he said. "COVID-19 and other virus outbreaks, depending on the scale and severity of the event, prevent people from coming to work and disrupt supply chains. Unlike natural disasters, viruses like COVID-19 spread geographically, making the scale of supply chain impacts highly unpredictable.”

Faculty Q&A: Coronavirus’ impact on business

Aradhna Krishna , professor of marketing at the Ross School of Business, can discuss demand shortages on consumer products and how those might affect different populations.

"Raising prices and rationing-possible techniques to deal with demand shortages of sanitizers and disinfectants-will both end up hurting the poor,” she said. "Higher prices may limit the purchase of these products by lower income groups, whereas rationing can create black markets which could again raise prices. Higher prices are an especially bad idea, since the lower income may find it more difficult to isolate themselves from public interaction and are in greater need of these products.”

Jeremy Kress , assistant professor of business law at the Ross School of Business, is an expert on financial regulation, with an emphasis on financial institution corporate governance. He can discuss how businesses can face regulations in the current changing environment.

"In the face of a global pandemic and fears of a macroeconomic slowdown, now is the time to strengthen oversight of financial markets, not roll back regulations as the big banks insist,” he said.

Mary Gallagher , professor of political science at the College of Literature. and the Arts, and director of the Lieberthal-Rogel Center for Chinese Studies, is an expert on Chinese politics, U.S.-China relations, labor and workers in China, and employment and labor law in China. She can discuss the political and economic implications of the epidemic in China, and how they may play out in other countries.

"The key for China’s government now is to get the economy running again, but this will require local governments to relax restrictions on the movement of the millions of migrant workers who power China’s factories, construction sites and restaurants. Many localities remain wary of lifting restrictions and with the virus now spreading overseas, there’s also the possibility that workplaces could be infected from people coming from abroad.”

Linda Lim , professor emerita of corporate strategy and international business at the Ross School of Business, focuses her research on the political economy of multinational and local business in Southeast Asia. That includes the changing international trade and investment environment, and the influence of domestic politics, economic policy and culture on business structure, strategy and operations.

Peter Jacobson , professor emeritus of health management and policy at the School of Public Health, can discuss the legal issues involving the spread of infectious diseases, including quarantine. His research focuses on the relationship between law and health care delivery, law and public health systems, and health equity. He has looked at previous cases including the 2014 Ebola outbreak, when several states imposed quarantines exceeding guidelines from the federal Centers for Disease Control and Prevention.

David Hutton is an associate professor of health management and policy and global public health at the School of Public Health. His research focuses on the cost-effectiveness of new public health policies and has written about pandemic influenza policy response cost-effectiveness. He can address questions on health care costs in the U.S. and the effect they might have when facing an epidemic, as well as deterring people from seeking preventative treatment when/if available.

Krista Wigginton is an associate professor of environmental engineering. Her research interests include the detection and fate of viruses in water and air, and on how to better control the environmental transmission of viruses. She led a team that studied the fate of coronaviruses in municipal wastewater.

"While the major route of transmission is through respiratory droplets and fomites, feces or urine could serve as another transmission route,” she said. "Research is necessary over the next months and years to identify the specific risks of transmission by fecal matter, sewage, surface waters and drinking water.

"In the meantime, drinking water and wastewater utilities will likely be under increased scrutiny and will need to address public questions about water safety. Wastewater utility and building janitorial workers may want to employ extra safety measures (e.g., personal protective equipment) if they regularly come into direct contact with human waste and untreated sewage.”

Brian Zikmund-Fisher is a health communications expert and associate professor of health behavior and health education at the School of Public Health. His research and teaching focus on health risk perceptions of enabling everyone to share scientific information in meaningful ways.

"The risks of COVID-19 are psychological as well as medical,” he said. "How we talk about this virus affects whether people do what they need to do (such as really washing hands consistently) and whether they do counterproductive behaviors like hoarding masks. Effective COVID-19 communication has to go beyond sharing information to acknowledging and addressing the public’s emotions.”

Jon Zelner , assistant professor of epidemiology at the School of Public Health, is a social epidemiologist focused on understanding and targeting the joint social and biological drivers of infectious disease risk. Among his recent research, he’s looked at modeling racial disparities in tuberculosis mortality in early 20th century America. He can discuss how disparities have affected different populations in the past, when lower income populations have been at greater risk than wealthier peers.

"People have incentives that pull them in different directions,” he said. "Nobody wants to go sick to the workplace or out to the community or at school but the less ability you have to make those choices, to take time off, the more likely you are to go to work, to ride the bus, to go to places where you could transmit to other people.”

Joshua Ackerman , associate professor of psychology at the College of Literature. and the Arts, can discuss how people respond to and cope with ecological threats, including those related to mortality, infectious disease and social rejection.

"Situations such as this one with coronavirus are a perfect storm for generating fear,” he said. "They involve a high degree of uncertainty about who is sick and how to prevent infection, an invisible threat and alarming news reports that overwhelm consideration of informative statistics. Concerns about disease also trigger a number of downstream effects, including heightened attention to atypical behavior and more prejudice expressed against other groups.”

Judi Policicchio , clinical professor of nursing at the School of Nursing, specializes in community health and can discuss school nurses and their response to coronavirus. School nurses can and will play a large role in education and prevention efforts in schools, she says.

Lona Mody , professor of internal medicine at Michigan Medicine and associate director for clinical and translational research at the U-M Geriatrics Center, is a leading expert on infection transmission and prevention in nursing homes and long-term care facilities. She leads the Infection Prevention in Aging research group, which mainly focuses on bacterial hazards, but she can comment on viral disease transmission as well.

Christopher Friese , professor of nursing at the School of Nursing and professor of health management and policy at the School of Public Health. He is an expert on health care worker safety and leads a research team focused on health care delivery in high-risk settings.

"Ongoing training is essential to keep our workforce safe,” he said. "In the current situation, I recommend health care workers-regardless of setting-ask their employer to conduct respirator fit testing and review procedures to safely apply and remove protective equipment. Make sure the equipment is readily available and there is clarity as to what equipment should be used in what circumstance.”

Faculty Q&A: Health care workers must protect themselves even if employers won’t

Sue Anne Bell , assistant professor of nursing at the School of Nursing, is a disaster response expert who has responded to and studied major disasters around the country.

"Many people are reading the news with worry and wondering what they can do now to protect themselves,” she said. "Here are some of the best things you can do: Wash your hands. Practice the ’elbow bump’ instead of shaking hands. Get your flu shot. Plan ahead-within reason. Be kind to others. As for the last one, research shows that social cohesion-or how individuals are connected in society and willing to support each other-- is a strong indicator of how well a community can respond and recover from a community-wide emergency like COVID-19.”

Listen to Bell discuss the role of nurses in providing accurate information about the coronavirus.

Duane Newton , associate professor of epidemiology and pathology at the School of Public Health and director of the Clinical Microbiology Laboratory, can discuss issues around testing for SARS-CoV2 and the development of molecular assays for the diagnosis and management of infectious diseases.

Herek Clack , associate professor of civil and environmental engineering at the College of Engineering, has studied airborne disease transmission and has developed a technology-a nonthermal plasma reactor-that can remove and inactivate airborne pathogens by electrically charging them.

news release about his technology. Watch a video about his technology being tested for use in agricultural settings.

Prachi Agarwal , professor of radiology at Michigan Medicine, teamed up with a counterpart in China to examine the appearance of COVID-19 in CT scans. While COVID-19 can present similarly to other respiratory illnesses clinically and on imaging scans, they found imaging anomalies that can alert radiologists the new coronavirus may be present prior to confirming diagnosis with a RT-PCR test.

"As COVID-19 continues to evolve on a global scale, it is important for radiologists to be familiar with the imaging appearance of the virus in patients,” she said. "Radiologic work is crucial when it comes to making diagnoses for patients.”

Blog post: How Does COVID-19 Appear in the Lungs?

Aubree Gordon , assistant professor of epidemiology at the School of Public Health, works on infectious disease epidemiology and global health, particularly the epidemiologic features and transmission of influenza and dengue fever. She is an investigator with the Centers of Excellence for Influenza Research and Surveillance.

Gordon’s recent articles in The Conversation: When will there be a coronavirus vaccine? and How can we prepare for the coronavirus?

Listen to Gordon as she discusses transmission and spread of the coronavirus.

Wally Hopp is professor of technology and operations at the Ross School of Business and professor of industrial and operations engineering at the College of Engineering. He studies the design, control and management of operations systems, including health care systems.

"From an epidemiology modeling perspective, the most important thing I can say is that we should be acting as if everyone around us is sick,” he said. "Many people with COVID-19 are nearly asymptomatic, which means they won’t get tested or stay home. But they will be contagious. This feature of the virus is going to make it nearly impossible to contain, and my fear is that it will lead to a high average number of transmissions per infected patient.

"It is still too early for an accurate estimate, but I’ve seen numbers between two and four transmissions per patient. That’s bad because those numbers are high enough to sustain and spread the outbreak. The 1918 Spanish Flu pandemic wound up infecting something like 30% of the world’s population and killing 3%. Without intervention, COVID-19 could impact us on that scale.

"The only way to prevent this is to reduce the average number of transmissions per infected patient to below one, and doing that will hinge on mundane things like hand washing, mouth covering and use of sanitizer. Unfortunately, compliance with simple guidelines like these is extremely difficult to achieve, both in hospitals and in daily life. But even a small reduction in the transmission rate from measures like these can vastly reduce the total number of people who will ultimately be infected.”

Arnold Monto , professor of epidemiology and global health at the School of Public Health, is an internationally known expert on the transmission, prevention, mitigation and social response to outbreaks and pandemic planning including transmission modes. He has served as an adviser for the World Health Organization, consulted with the U.S. Department of Defense on communicable diseases, and visited Beijing during the SARS coronavirus episode in 2003.

He says as testing becomes more available in the U.S., the public should be prepared to see more cases confirmed.

"Previously, you couldn’t demonstrate spread in the community because tests could only be used on travels or their contacts,” he said, adding that stopping the spread of the virus is still the top priority for health authorities. "The reason we’re so vigorous in trying to contain it is that containment and social distancing worked for SARS. This virus seems to be more transmissible than SARS but still does not behave like the flu.”

Emily Toth Martin , assistant professor of epidemiology at the School of Public Health, is an infectious disease epidemiologist with a focus on virus epidemiology and the use of vaccines and therapies to prevent and treat infection. Her research includes optimizing the use of diagnostics for viral diseases.

Joseph Eisenberg , professor of epidemiology at the School of Public Health, is an expert on infectious disease epidemiology and has 20 years of experience in microbial risk assessment work focused on water quality. He is part of a group of scientists from around the country who are involved with the Modeling Infectious Disease Agents Study, an NIH-funded program that focuses on infectious disease transmission modeling with a particular focus on waterborne pathogens. Their work has informed recent Ebola projections about infection rates and deaths.

Eisenberg’s recent article in The Conversation: How scientists quantify the intensity of an outbreak like coronavirus and its pandemic potential.

Faculty Q&A: Coronavirus: Is it time to panic yet?

Listen to Eisenberg as he discusses the coronavirus versus the flu.

Michael Imperiale , professor of microbiology and immunology at Michigan Medicine, studies virus replication, virus-host cell interactions and science policy. He serves as U-M’s associate vice president of research-policy and compliance and has served on the National Science Advisory Board for Biosecurity and on various policy-related committees of the National Research Council and the National Academies.

Adam Lauring is associate professor of microbiology and immunology, and infectious diseases, at Michigan Medicine. He studies RNA viruses, which include coronaviruses, evaluating their rapid mutation rate and implications for human disease. He collaborates with researchers at the School of Public Health to study how the influenza virus changes in home and clinical settings.

Blog post: The Wuhan Novel Coronavirus: Should You Be Worried?

Theodore Standiford is a professor of medicine and interim chief of the Division of Pulmonary and Critical Care Medicine.

Blog post: The Wuhan Novel Coronavirus: Should You Be Worried?

Sandro Cinti , professor of infectious disease at Michigan Medicine, is involved in preparation for bioterrorism and emerging infections at the national, state and local levels. In addition to treating infectious disease patients and training medical students and residents in the identification and care of infectious conditions, he helps lead biopreparedness activity at Michigan Medicine and coordinates with colleagues across the metro Detroit area and beyond.

J. Alexander Navarro , assistant director of the Center for the History of Medicine, is a historian who helped lead the center’s projects studying the history of U.S. cities’ efforts to contain the 1918-19 influenza pandemic, and the 2009 H1N1 "swine flu” epidemic. He can discuss the findings conveyed in the Influenza Encyclopedia , which details individual communities’ efforts in 1918 and 1919, and the results of school closures and other nonpharmaceutical interventions used to contain H1N1.

Preeti Malani is chief health officer advising U-M’s president on matters affecting the health and well-being of U-M students, faculty and staff, and professor of infectious diseases at Michigan Medicine. She has authored coronavirus guidance for clinicians published in JAMA , where she is an editor. Her background in geriatrics and current position leading health issues at a large global research university community makes her especially able to comment on how the epidemic could affect older adults and academic institutions.

Howard Markel , professor and director of the U-M Center for the History of Medicine, has studied epidemics over history and the effectiveness of efforts to contain their spread. He can speak on issues related to quarantine and travel.

His collaborative study with the Global Migration and Quarantine division of the U.S. Centers for Disease Control and Prevention on the 1918-19 influenza pandemic has played a major role in shaping the policies of the federal government, nations around the globe and the World Health Organization as they consider how to mitigate future pandemics. He is the author of "When Germs Travel: Six Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed.”

Stacy-Lynn Sant is an assistant professor of sport management at the School of Kinesiology. Her research focuses on sport event impact, destination marketing, and event-based strategies for social and economic development. She can discuss travel to the 2020 Tokyo Olympics, where to get information and how people make travel decisions. She can also discuss the 2016 Zika virus and the Rio Olympics.

Judith Grant Long , associate professor of sport management at the School of Kinesiology, can discuss how the coronavirus may impact the host city and surrounding areas during the Tokyo Olympics. Her research focuses on the intersection of sports, tourism, city planning and economic development.


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