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The Executive Briefing - Friday, March 17th

Noro or Shigella? 🦠🤢


  • Canada and the UK will offer bivalent booster shots this spring for high-risk people, but here in the US, the FDA has been radio silent about spring boosters. (STAT)
  • The FDA approved Pfizer’s Omicron booster as a fourth shot for kids under 5. (CNBC)
  • The FDA has confirmed what we’ve seen in recent studies: Paxlovid is not associated with COVID rebound. (Axios)
  • The J&J vaccine now comes with an FDA warning about possible increased risk of myocarditis and pericarditis (inflammation in and around the heart), especially in the first week after vaccination. (FDA)
  • Pregnant women are more likely to develop serious COVID and to die from it. Getting vaccinated and boosted can help. (NY Times)
  • A new study suggests a possible link between COVID’s origins and raccoon dogs in the wet market in Wuhan. (The Guardian)

Public Health News:

  • Allergy season is starting earlier due to global temperatures rising. (The Guardian)
  • Wichita, Dallas, and Scranton are the top 3 worst cities in the US for allergies. (Washington Post)
  • Noro is on the rise in the Tampa Bay area. (ABC)
  • Babesiosis, a parasitic disease spread by ticks, is rising in the Northeast. (MMWR)
  • The EPA will limit toxic “forever chemicals” in drinking water. (AP)
  • Managing legionella to protect your employees can be challenging in old buildings. (OHS News)
  • H5N1 bird flu was found in dead skunks in the Vancouver area, evidence of more spread in mammals. (CIDRAP)
  • A bird flu outbreak in seals last summer showed mutations associated with adaptation to mammals, though the risk to humans is still low. (NY Times)
  • A 5-in-1 meningococcal vaccine from GSK had positive results in a phase 3 trial. (Fierce Pharma)
  • Flooding in California’s agricultural centers has created a higher risk for food safety issues, including E. coli and Salmonella. (Food Safety Magazine)
  • In jobs that require them, 4 out of 5 women report having difficulty finding properly fitting personal protective equipment, or PPE. (OHS News)
  • The FDA investigation into Salmonella Hartford, which still hasn’t pinned down a source, has found 16 additional cases, bringing the total to 47. (FDA)
  • Black lung is seeing a resurgence as coal miners are exposed to silica dust. (KHN)

Mental Health News:

  • A meta-analysis shows that the best treatment for depression may be exercise. (British Journal of Sports Medicine)
  • Financial hardship was the leading driver of stress, sadness, and COVID-related anxiety among kids, according to a new survey. (Fox)
  • To prevent gun suicides, some states will consider allowing people to register themselves as a suicide risk so they can’t buy a gun on a whim. (Stateline)

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:

How do you tell noro from shigella?

Shigella is a bacteria and noro is a virus, but they both cause similar GI symptoms including vomiting and diarrhea. Both noro and shigella can spread via contaminated food and contact with infected people, especially if they haven’t washed their hands thoroughly. Noro tends to be quicker, with a fast onset and symptoms resolving within a few days, but shigella can last five days to a week or more. Unlike shigella, there is a season when noro is more common - and we’re coming up on the end of it in April, though cases can and do still occur all year long. Both are high in the US right now, and together they’re the top causes of “stomach flu” outbreaks in schools and childcare settings. At the end of the day, if you’re not sure what kind of stomach bug it is, it’s safest to keep employees sick with noro or shigella-like symptoms home for a full 48 hours after their symptoms end.

We’re seeing high costs associated with long COVID that aren’t declining much. Are other clients reporting the same?

Yes, long COVID is having a major impact on employers everywhere. One Harvard estimate puts the economic costs at $3.7 trillion. Healthcare costs are predicted to be $9000 higher for those with long COVID than those who were infected but don’t have long-term symptoms. It’s primarily affecting employers via labor costs. Long COVID is a major underlying factor in the labor shortage - over half with long COVID who were working before they got sick are now working fewer hours or are out of work. The number of leaves of absence and employees requiring accommodations has increased across nearly all of our clients. And long COVID patients have a 3.6 greater likelihood of missing work for medical reasons. The good news is that recent studies have shown that long COVID symptoms do get better for the majority of people over time, with most recovering within six months, and less than 10% still feeling symptoms after a year.

The CDC is recommending that adults get screened for Hepatitis B. How should we do that? Should employers get involved?

Hepatitis B testing is done via blood tests, so it’s not likely something that an employer would offer directly. You can certainly let your employees know that it’s recommended. If you offer Hep B vaccines to your new employees, that could be a good time to share with them that a Hep B test is recommended by the CDC. At the end of the day, Hep B is less of a workplace issue unless your employees come into contact with blood or needles. Most of our clients aren’t changing their policies now that the CDC recommends an adulthood Hep B screening.

I’ve never gotten COVID (that I know of). Am I immune?

Congratulations! You’ve managed to dodge COVID up until now. There’s a possibility that a small percentage of the population has genetic mutations that make them less likely to get COVID. But it’s also likely luck. Most people in the US have gotten it at this point - 60% of the population at least, though the actual number is likely significantly higher from those that never tested or never reported that test. Remember, COVID can be asymptomatic, which means you may have had it and simply not had any symptoms. Still, there are people who managed to dodge testing positive for COVID until just this month - including a few on our own ZHH team! That said, there’s some research linking specific genes with those who only had asymptomatic COVID, and there’s certainly the possibility that some people are genetically more likely to be immune. Still, it’s wiser to assume that you’re not the very rare super-immune and instead just very, very lucky. In time, you may be infected and should still take precautions to limit your exposure.

Best Read:

West Nile, Lyme, and other diseases are on the rise with climate change. Experts warn the U.S. is not prepared | STAT

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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.