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The Executive Briefing - Friday, November 11th

Handwashing is key for RSV 🧼👏


  • COVID cases are up 11% in the past two weeks, and the true number of cases might be higher than that. ZHH has seen a 10% increase in sick calls over the past week, as well. (NY Times, ZHH)
  • Worldwide COVID deaths have dropped 90% in the past 9 months. (AP)
  • Lower blood pressure reduces the risk of severe COVID. (CNN)
  • Paxlovid rebound may be more common than initially thought. (ABC)
  • People with long COVID are having difficulty accessing government disability benefits. (KHN)
  • Lifting mask requirements in Boston schools last year was responsible for 45 more cases for every 1000 students and staff. (NEJM)
  • COVID can hurt your sleep - causing insomnia and many other sleep issues. (National Geographic)
  • Reinfection can be dangerous - the more times you get COVID, the higher your chances are for acute illness and long-COVID. It’s not always milder the second or third time around. (Nature)

Public Health & MPX News:

  • A listeria outbreak in 6 states has been linked to deli meats and cheeses. (NPR)
  • Flu activity is highest in the southeast and south-central US right now, but cases are expected to rise nationally. Flu shots are down 15% compared to last year. (NAIIS)
  • Four measles cases were reported at a daycare in Columbus, OH. (Columbus Dispatch)
  • Haiti’s cholera outbreak is getting worse, with the death toll now at 136. (CNN)
  • Toronto’s public health board is asking the city to “urgently” consider reinstating the school mask mandate among a surge of respiratory viruses in kids. (Toronto Star)
  • France is on high alert for bird flu as Europe continues to be hit hard. (Reuters)
  • Uganda ended their school year early to try to curb the spread of Ebola. (NPR)
  • Prescribing certain drugs - like ADHD meds - after online-only visits will come to an end when the pandemic public health emergency ends, likely in January. (STAT)

Mental Health News:

  • Health workers’ mental health is an invisible crisis that most experts agree needs to be addressed, and quickly. (STAT)
  • Meditation worked as well as a popular medication to reduce anxiety in a recent study. (NPR)
  • Veterans’ mental health challenges can make employment more challenging. (Fast Company)
  • The first 988 crisis line specifically for Native people has gone live in WA, staffed entirely by Native and Indigenous people. (Seattle Times)

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:

What exactly is RSV and why is it so bad right now?

RSV is a very common virus that mutates quickly and normally spreads during the winter months. When we say it’s very common, we mean it. Nearly a quarter of adults are infected every year (in normal years) and virtually ALL children have antibodies by the time they’re toddlers. For most, it’s like a common cold, but for very young kids and for older adults, it can be very dangerous. It’s so bad right now because, in normal years, kids and adults alike are out and about, being exposed, developing antibodies, and getting sick throughout the winter. But right now, all those people have been taking COVID precautions for three years, which all but eliminated other viruses like RSV from circulation for that time. It’s back now, and all these kids (and adults) have no immunity built up over the past few years, so they’re all getting infected around the same time, which is stressing hospitals to the max, especially those with pediatric emergency departments.

Do we need to do anything different to prevent RSV than COVID or the flu?

Actually, yes, there is a difference. RSV is spread via larger droplets and particles, so washing hands and the surfaces of children’s toys really can prevent the spread of RSV, much more so than for COVID. With COVID, we discovered a while back that it’s primarily spread through aerosolized respiratory droplets that are much smaller and spread through the air, which means that disinfecting surfaces and handwashing doesn’t do nearly as much as a mask in terms of preventing the spread of the virus. RSV is different, so disinfecting high-traffic touchpoints and washing your hands is more important than ever.

If an employee has the flu, why do they need to stay out for five days?

We are continuing to recommend a five-day work exclusion for anyone with a specific set of symptoms, including new fever, shortness of breath, cough, both GI and cold symptoms together, or three or more significant flu/COVID/cold symptoms. The reality is that there’s very little practical difference between flu and COVID in terms of whether it’s safe to work sick - it’s not! And like with COVID, there are relatively few people with the flu who will feel well enough to work much before their fifth day, anyway. We’ll continue to evaluate this year’s flu strains and how they’re affecting symptoms, but until we know more, it’s safest and simplest to keep the same exclusion length for COVID and the flu, especially since it’s very hard to tell them apart without testing.

Is there any way to reduce the risk of long COVID?

There’s only one way to eliminate the risk of long COVID, and that’s never getting COVID at all. Barring that, there are a few ways to reduce your risk of having long-term effects. First, getting vaccinated and staying up to date on boosters reduces the risk of long COVID by up to 50%. And getting treated with Paxlovid can also reduce your risk of long COVID by up to 26%. If you’re COVID positive and worried about long COVID, talk with your doctor about whether treating it with Paxlovid is right for you.

Best Read:

Annual COVID Shots Mean We Can Stop Counting - The Atlantic

To all Veterans, we thank you for your service.

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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.