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The Executive Briefing - Friday, February 10th

Noro rising, bird flu spillover, and long COVID concerns


  • While more than 600 doctors died earlier than expected in the first part of the pandemic, no doctors died unexpectedly after vaccines were widely available. (CIDRAP)
  • NYC will end its vaccine mandate for city workers. (ABC)
  • People who personally know someone who got sick or died from COVID were twice as likely to get vaccinated. (SF Chronicle)
  • Deer could be a reservoir for older coronavirus variants even after they stopped circulating in humans, raising concerns about potential spillover. (NY Times)
  • One of the newest sub-variants is a mutation of the Delta variant and is named Orthrus after the mythical two-headed dog. Since early February, it has been identified in about 12% of new cases in Europe - often a precursor to US trends. (MedPage Today)
  • Monoclonal antibodies have stopped working for newer COVID variants and some infectious disease experts are very concerned about the impact on immunocompromised patients. (Wired)

Public Health News:

  • Norovirus cases started rising towards the end of January, just as COVID and RSV started to slow down. CDC testing data, which lags a few weeks, showcase counts exceeding last year’s March Noro peak and continuing to climb. (Ars Technica)
  • Fabuloso has recalled 4.9 million bottles of cleaning and sanitizing products sold nationally that may be contaminated with pseudomonas after a preservative was omitted. (NPR)
  • Scientists are paying $4000 for patients to participate in an oral shigella vaccine trial.  The problem is you might have one week of severe diarrhea. (Gizmodo)
  • A meningitis outbreak in Mexico has grown to at least 35, and a specific doctor has been arrested under suspicion of distributing infected medicine. (Reuters)
  • When pregnant women get the Tdap vaccine, babies are protected from whooping cough. (MedPage Today)
  • A new UN report says that drug-resistant superbugs are a leading global health threat. (ABC)
  • Colameco’s uncured salami from Daniele International has been recalled due to possible listeria contamination. (USDA)
  • That seemingly big wave of strep we saw earlier in the winter? It turns out it was just a return to pre-pandemic levels. (CBS)
  • Drug-resistant Shigella has been spreading in Washington state. While it can be foodborne (as in the case of a Seattle restaurant that was temporarily closed last month), it’s also increasingly spreading in networks of men who have sex with men. (CIDRAP)
  • Mpox is under control in the US with just 2 new cases per day, but Mexico saw a big spike up to 72 new cases last week. Spikes in other countries could eventually spill back over into the US. (Politico)
  • Scientists are debating what the bird flu jump from birds to minks means for the future. (NY Times)

Mental Health News:

  • New Hampshire is considering mental health days for students. (CBS)
  • Some Latinos don’t trust Western mental health. That’s where curanderos come in. (LA Times)
  • Police departments are pairing up mental health professionals with police officers in at least 12 towns in New Jersey and early indications are it's a win for everyone. (The Gothamist)
  • A recent CDC report found that after two years of declines, the suicide rate rose in 2021 to the highest numbers seen in four years. (ABC News)

If you or someone you know may be considering suicide, call 988 or message the Crisis Text Line by texting HOME to 741741.

Best Questions:

Bird flu is spilling over into mammals. What does that mean for humans?

We’ve been reporting on the growing outbreak of H5N1 bird flu across the US and the world for many months now, and while we don’t want to fearmonger, we think it’s important to keep an eye on what’s keeping epidemiologists up at night. Unfortunately, that’s bird flu. It’s in the news for driving egg prices up after ravaging poultry farms - 58 million chickens have died or been culled because of the current outbreak. It’s spreading rapidly, not just in domesticated farm animals but wild flocks, fueling more spillover into mammals. Foxes, raccoons, skunks, and bears (and even seals and dolphins) have been infected, likely from eating infected birds. A mink farm in Spain saw a massive outbreak of H5N1 last fall, confirming that mammal-to-mammal transmission is possible. This has led some public health experts to call for an end to mink farms, as they’re a particularly good cross-species vector for viral mutation. Still, in this outbreak, no minks or other mammals have spread the virus to humans, and there hasn’t been any evidence of human-to-human transmission. We’re keeping a close eye on it - while a bird flu pandemic is far from inevitable, it’s a real possibility that we need to be prepared for.

What do employers need to know about Listeria outbreaks?

The FDA has announced a major recall by a Baltimore prepared foods company that supplies items to Amtrak and other businesses across the East Coast. While no one has gotten sick from these recalled foods yet, over 250 people die each year from Listeriosis. It’s particularly dangerous for pregnant women and their babies, those 65+ and immunocompromised people. Keep an eye on the most susceptible foods, like sprouts, soft cheese and other unpasteurized milk products, cold cuts and fermented or dry sausages, melons, and refrigerated smoked seafood. When products are recalled, be sure to throw them away even if some of it has been eaten and nobody has gotten sick. Wash and sanitize any areas that the product may have contacted, including prep and storage areas. As always, employees with diarrhea and/or other flu-like symptoms should stay home while sick.

Will boosters be free after the public health emergency ends? Should I get one before it ends in May?

Vaccines, including the updated bivalent booster, will continue to be available for free until the government stockpile runs out. After that, the vaccine will be covered by both private insurance and Medicare and Medicaid. If you’re uninsured, it’s unclear how you’ll access vaccines, though officials have said there will be some way to get cheap or free COVID vaccines moving forward, according to Katelyn Jetelina from Your Local Epidemiologist. If you don’t have the latest bivalent booster, go get that ASAP. If you already got one and are considering whether to get a second (which isn’t currently a recommendation by the CDC), this is an ongoing debate among public health officials, and is expected to be discussed in the upcoming ACIP meeting in two weeks. They may make a recommendation around whether higher-risk people need another booster before the fall.

Is the worst of COVID over?

For this winter, the worst of it is most likely over. It’s a bit hard to tell definitively. When flu and RSV surged so early, there were lots of ways this winter could have gone, and we’re all glad to say that it’s looking like the worst of this winter is behind us. There’s a lot we still don’t understand about the seasonality of COVID. Mara Aspinal from Arizona State summarized the current state earlier this week she wrote “Although we may be entering the endemic phase, it is otherwise known as the ‘we are stuck with this forever’ phase.”

The “immunity wall” that we’ve built from past infections, vaccinations and boosters is helping.  COVID isn’t over, as much as we wish it was. There are still 400 people each day dying in the US, far more than die of the flu. We’re not out of the woods yet - and a new variant mutation could happen anytime (may already be happening) and spike cases again. But barring that, we’re hopeful that this downward trend continues for this winter.

Best Listen:

We return to our old friend Dr. Michael Osterholm's podcast as a best listen today since many of you have raised concerns about the potential impact and costs of long COVID. Give a listen here:

Taking Long COVID Seriously | CIDRAP: Osterholm Update COVID-19

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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.