Since late 2019, SARS-CoV-2 has differentially impacted geographies and population demographics as it spread. As of June 30, 2020, two hotspots within the United States of America—the states of Georgia and Michigan—exhibited similar numbers of cases while Michigan had over twice the case fatality rate (CFR) of Georgia. Given the similar populations, land areas, and pandemic timelines of these states, such a large difference is unexpected. The primary goal of this paper is to examine why Michigan experienced much higher COVID-19 mortality than Georgia, which may point to at-risk comorbidities and vulnerable populations. We examined publicly available data on demographics, rates of comorbidities, environmental factors, and other population differences at the state and local levels (the cities of Detroit, Michigan; Atlanta, Georgia; and Albany, Georgia) that have known or identified associations with health outcomes. We also outlined the timeline of the pandemic in each state to determine if the actions of state governments may have contributed to the observed difference in CFR. While the difference in state CFR may imply that Michigan handled the pandemic poorly, the data show that inherent characteristics of Detroit may have led to the higher statewide CFR. Notable differences between the states include elderly populations, agricultural statistics, and drinking habits. Notable differences between the cities included population density, health system quality, per capita income, race, education, media access, and air pollution. Hypertension (among blacks), diabetes (at the city level), chronic kidney disease, asthma, heart disease, and cancer differed in prevalence by location and were associated with increased severity and/or mortality of COVID-19. There were more deaths due to COVID-19 in African American communities and nursing homes in Michigan. A combination of these factors likely explains the differential impact between these two states.
Introduction & Objective In March 2020, medical schools around the country had to quickly transition from in person cadaveric anatomy curricula to an online distance learning format due to the COVID‐19 pandemic. This posed a challenge for students who had acclimated to learning anatomy inside the laboratory for the majority of their first year of medical school. The purpose of this study was to assess student perceptions of the abrupt transition from in person anatomy dissections and practical exams to an exclusively online format. Materials and Methods An anonymous survey was distributed to medical students from the Class of 2023 at the Medical College of Georgia at Augusta University (n=191) in February 2021. The survey assessed student perceptions of the impact of COVID‐19 shutdowns on their medical education. In total, 45 responses were recorded, and survey data was analyzed using SPSS software. Nonparametric methods were used due to the ordinal nature of the Likert scale responses. A Wilcoxon signed rank test was performed. In addition, focus groups were conducted with 11 medical students who had completed the survey. Results A majority of respondents (82.55%) stated that their learning and understanding of anatomy was worse after cancellation of in person anatomy lab dissections. In contrast, understanding of didactic lecture material was split, with 37.5% stating that online lectures had no impact on their learning and understanding of the material, 31.25% stating understanding was worse, and 25% stating it was better following transition to online‐only lectures. The results from the Wilcoxon signed rank test of Likert scale responses indicated that students perceived impact of cancelling in person anatomy lab as significantly worse compared to the impact of cancelling in person lectures (p<0.001). Focus group responses echoed this theme, with the loss of 3‐dimensional visual and tactile learning in laboratory cited most frequently by participants as a challenge with the transition to online anatomy. Conclusion Medical student respondents in the class of 2023 perceived online anatomy as inferior to in person laboratory sessions after the COVID‐19 shut‐down in March 2020. The transition from in person to online anatomy was more impactful on student understanding of material than the transition from in person to online didactic lectures. Of note, the students surveyed had completed the majority of their anatomy curriculum in person prior to the transition online. Significance/Implication The medical school shutdowns that occurred in March 2020 due to the COVID‐19 pandemic highlighted the importance of in person interaction with cadaveric specimens in anatomy education, especially in the context of how students were initially exposed to content. When possible, consideration should be given to learning approaches that students are familiar with and how changes to the curriculum will impact them.
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