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The Executive Briefing - Friday, August 12th

NEW exclusion chart, CDC guidelines

Updated COVID Exclusion Chart:

  • The CDC ended quarantine recommendations for exposed people, instead recommending 10 days of masking and testing on Day 6 for everyone, regardless of vaccination status. Only those who have had COVID in the past 30 days are exempt from testing.
  • See the latest CDC guidelines here.
  • We’ve updated our exclusion chart to eliminate exposure-related exclusions based on this guidance. See our updated exclusion chart here.


  • The FDA now recommends taking 3 (versus the previous 2) at-home rapid antigen tests for asymptomatic people who have been exposed to COVID, with tests spaced 48 hours apart. For those with symptoms, they recommend 2 tests 48 hours apart. (FDA)
  • New false claims are circulating again on Twitter about preclinical trials being halted after animals died. They’re not true. (MedPage Today)
  • T-cells play a major role in the immune response to the J&J vaccine, another reminder that protection isn’t just antibody levels. (Science Immunology)
  • Long COVID treatments are still elusive, but trials are taking off and researchers are hopeful that they’ll find out more this year. (Nature)
  • With more than 6 million people dead from COVID, memorials have taken shape around the world to honor their memories. (NY Times)

Monkeypox News:

  • We’ve passed the 10,000 case mark for monkeypox in the US, with cases continuing to rise. The highest case counts are in NY, CA, and FL. (CBS)
  • The FDA officially issued an Emergency Use Authorization for the monkeypox vaccine, including for the intradermal application which allows up to 5 times as many doses per vial. (FDA)
  • America’s new plan for stretching vaccine doses rests on a single study. (The Atlantic)
  • Jynneos, the manufacturer of the monkeypox vaccine, is concerned about the plan to inject intradermally, saying there’s not enough safety evidence. (Washington Post)
  • Colleges and universities are preparing for monkeypox outbreaks, and hoping for college-specific guidance from the CDC. Five colleges already have cases. (STAT)
  • The US will buy more Tpoxx, including $26 million worth of the IV version of the drug, which is available in pill form now. (Reuters)
  • A homophobic assault on a gay couple in D.C. is being investigated as a hate crime, with the attackers using monkeypox as a slur. (NBC)
  • HR may be the front line in the battle against monkeypox misinformation. (HR Brew)
  • Queer communities are turning to one another to support with monkeypox in the absence of easy or quick treatment and diagnosis from healthcare systems. (STAT)

Public Health News:

  • A new virus, the Langya virus, has been discovered in China. It likely spilled over from shrews, though human-to-human transmission hasn’t yet been detected. (Washington Post)
  • Hotter nights could increase mortality rates worldwide, up to 60% by the end of the century. (NPR)
  • Tens of thousands of people are exposed to bat coronaviruses each year. (Nature)
  • There’s a cure for Hepatitis C, but less than one third of infected people actually get it - and that number is even lower for those on Medicaid or without insurance. (CDC)
  • America has a maternal mortality crisis. A new plan hopes to change that. (Washington Post)
  • The CDC is contemplating poliovirus boosters for kids and high-risk adults after wastewater shows that the virus could be in up to hundreds of people in New York. (CNN)
  • London is offering polio boosters for kids under 10 after polio was found in wastewater there, too. (AP)

Mental Health News:

  • Social media posts criticize the 988 hotline for calling the police. 988 does call the police if a caller cannot or will not agree to a safety plan and the counselor considers self-harm imminent. In 2021, that was about 2% of calls. There are other warm lines and options available that are less likely to contact the police. (KHN)
  • People are reporting health-related anxiety more than ever as they determine if symptoms are COVID, monkeypox, other illness or nothing at all. (USA Today)
  • Mental health can - and many argue should - be viewed as a public health issue. (Psychology Today)

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

Best Questions:

Do you expect local health departments to follow the latest CDC guidelines?

We do expect most local and state health departments to fall in line with the latest CDC guidance, which removes quarantine requirements for all exposed people, regardless of their vaccination status. When we consider how health departments will react, we often look to California, who has some of the most stringent rules in the country. In their case, they actually preceded the CDC by removing quarantine requirements for exposed people, so we feel fairly confident that the majority of local jurisdictions will follow suit. The realities of contact tracing at this stage in the pandemic have proven challenging for health departments, and with monkeypox creating new challenges for them, we think most will choose the option that reduces pressure on them. There may be a few holdouts, but we’ve found that nearly all of them aligned with CDC guidance within a few weeks after past changes. It’s always important to check your local guidance.

Why does the FDA now recommend 3 at-home tests instead of 2? How does this match with the new CDC guidelines?

The FDA updated its site on Thursday, now recommending three at-home rapid tests for those who have no symptoms but have been exposed to COVID, with each test 48 hours apart. Those who have symptoms can stick with two, since at-home tests are much more accurate for people with symptoms. This new guidance is confusing when taken hand in hand with the latest CDC changes, which eliminate quarantine for those who are exposed, regardless of their vaccination status. The CDC recommends testing on Day 6, or at least 5 days after the last exposure. To follow both new guidelines, if someone has a negative test and no symptoms, they should test again on Day 8 and again on Day 10. During that time, they can continue to work and be around others, but should wear a mask.

Can monkeypox be stopped now, or is it going to be an epidemic in the US or even another global pandemic?

The monkeypox can be stopped, but it would require a lot of government intervention. There is a vaccine, and it’s not very easily transmitted compared to COVID, which are good things. But the vaccine supply is very limited, with just one company making it and not nearly enough doses for all of the people who need it. Right now, outside of Africa, the vast majority of the spread is within a very specific group of men who have sex with men, so theoretically stopping the spread in that group could stop it overall. And the UK says they’re seeing early signs of it easing up, which could be good news considering that their COVID case rates often signal what will happen in the US in a few weeks. That said, cases are rising exponentially in California this week, so it’s hard to say how things will go. We’ll be keeping a close eye on case counts and hoping that we continue to increase vaccine and test availability, and ease of access for treatment.

Can you catch monkeypox from touching money or door handles?

No, it’s extremely unlikely. In the current outbreak, only 0.2% of cases have been due to touching infected surfaces, like a door handle, POS system, money, or countertop, according to a new study by the WHO. The vast majority (over 95%) of the spread is through sexual routes right now. Nearly all non-sexual transmission in this outbreak has been with people who live with a person who has monkeypox. The chances of getting monkeypox from touching an infected surface in a public area are incredibly low.

Best Read:

Three Possible Futures of the Monkeypox Epidemic | WIRED

Looking ahead:

Is a 'twindemic' headed our way and what can you do to prepare?

Experts are warning that a 'twindemic' of COVID and the flu might finally be upon us this coming fall. So far, we in the US have been able to avoid this, but with flu cases already rising in July, and COVID cases surging again, health experts are worried we will be following in Australia and New Zealand's footsteps straight to a twindemic.

The key is simple: make sure no employee works sick.

If you don't have an employee health monitoring program, now is a great time to start. And you can help prevent a 'twindemic' from hitting your business hard by providing a flu shot and/or COVID booster program for your employees. Keeping employees (and customers!) healthy is not just good practice, it protects your bottom line.

Learn more about starting a program by scheduling a 15 minute chat with us here.

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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.