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COVID-19 Briefing - Tuesday, 11/24

Cases skyrocket as we head into Thanksgiving weekend, plus new vaccine news & more...

Today's Recap:

  • COVID cases continue to skyrocket as millions are traveling daily ahead of the Thanksgiving holiday. Over the past week, there’s been an average of 173,165 cases per day, an increase of 49% from the average two weeks earlier.
  • Minnesota is effectively out of ICU beds, and rural areas are sending patients to metropolitan hubs, overwhelming them.
  • Negative tests are not a green light for large family gatherings, health officials warn. We have said this before, but remember that tests are just a snapshot in time. You can test negative on day 4 and positive on day 5 if that’s the day your viral load reaches a detectable threshold.
  • And the average time for symptom onset is over 8 days from infection, according to a new study.
  • The CDC updated guidelines advising overwhelmed contact tracers to start with more recent infections.
  • In good news, the University of Oxford's newest study says reinfection is “highly unlikely” for six months.
  • China says the novel coronavirus originated in Italy, but the authors of that study say it doesn’t dispute the origin in Wuhan, only that the virus was circulating in Italy earlier than previously thought.
  • Flu activity remains low across the US, according to the CDC tracker,  which is good news considering how strapped our healthcare systems are right now.
  • The FDA will meet on December 10th to discuss granting emergency authorization for Pfizer and BioNTech’s vaccine.
  • AstraZeneca’s vaccine is 70% effective, early data show. It’s less dramatic of a stat than the other two leading vaccines, but still a good indicator, especially given the odd news that the most effective group was accidentally given a half-dose for their first dose. We still want to see the data before we make too much of this.
  • The Advisory Committee on Immunization Practices met yesterday to discuss who might get vaccinated first. A workgroup’s proposed order of operations included healthcare professionals and long term care residents receiving vaccine first, with essential workers next, followed by high-risk folks and adults 65 and older.
  • City Winery in NYC is offering $50 rapid tests to attract indoor diners. They’re hoping they may be allowed to continue operating indoors even if NYC moves back to the “orange” phase of opening barring indoor dining.
  • The Australian airline Qantas plans to make proof of vaccination required for travel, their CEO announced this week.
  • And in a reminder that other illnesses still come out to play, Dole recalled some romaine hearts after they tested positive for E.Coli.

Best Questions:

If team members are getting tested in order to go see family at Thanksgiving, do you suggest that we exclude them while they await test results?

No. If someone has no exposure and no symptoms, we consider their test to fall under the category of “curiosity” testing, meaning they have no real reason to suspect they have COVID. If they have exposure or symptoms, we’d keep them out based on those, regardless of the test results.

What does it mean that someone might be tested “too early”?

From the CDC: “You may test negative if the sample was collected early in your infection and test positive later during this illness. You could also be exposed to COVID-19 after the test and get infected then.” It takes days for your viral load to “build” up enough after infection that you show symptoms or test positive. If you’re infected on Sunday and tested Wednesday, you may be negative. But if you get tested again 4 days later, you may test positive at that point. This is further evidence that a negative test isn’t the “holy grail” for resuming normal activity.

If COVID tests are so unreliable, what’s the point in even getting tested?

This is a fair question! The answer is really that if your tests comes back positive, you know you definitely had COVID, which lets you end self-isolation after 10 days if you’re symptom-free, and avoid quarantine if you get re-exposed in the next 90 days. It also lets contact tracers or your employer start doing the necessary contact tracing now that you’re a confirmed case, so that those you had close contact with are quarantined.

If you test negative, there’s really nothing actionable that changes. You can’t return earlier if you were exposed and test negative, because you might test negative on Day 7 but positive on Day 11, for example.

Are other businesses also considering closing locations (or limiting services or hours) because of how many employees are sick or have been exposed?

You are not alone.  One large client shared they have more than 3000 employees excluded across their employee base this week while a much smaller client indicated that their two exclusions impact their ability to operate.  We’re clearly at a crossroads here in the pandemic.  It’s critically important that you don’t let your guard down now.  Follow the CDC’s exclusion guidance and continue to mask, socially distance, and not work sick.  We keep hearing, “I thought it was just a cold, allergies, the hot kitchen”… and then they test positive. Stay the course, and buckle up for what we expect to be a rough week next week after the Thanksgiving fallout.

Best Read:

In the 1918 Flu pandemic, experts also begged people to restrict their Thanksgiving travel. Here’s how it went:

COVID-19 and Thanksgiving: How we celebrated during 1918 flu pandemic

Best Laugh:

Even if Thanksgiving looks a little different this year, we hope yours is safe, healthy, and delicious.

We’ll be taking Friday off after Thanksgiving and will be back with your regularly scheduled COVID Briefings a week from today.  We’ll send alerts through the app and will email if anything urgent happens between now and then.

Have a happy and safe Thanksgiving!

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Disclaimer: This post is meant for general information and educational purposes only and does not constitute, and is not intended as, any form of medical, legal or regulatory advice or a recommendation or suggestion regarding the same.  No recipient of this information should act or refrain from acting on the basis of this information without first seeking legal advice from counsel in the relevant jurisdiction.