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The Executive Briefing - Friday, October 21st

What’s a “variant swarm”? Hint: It’s not great…


  • A “variant swarm” could fuel a winter surge, with Omicron subvariants XBB, BQ1.1, and BA2.75.2 all circulating widely and competing to dodge immunity. (Washington Post)
  • Uninsured kids will still be able to get free COVID vaccines, even after COVID shots move to the commercial market. (CNBC)
  • A false claim that the CDC would require COVID vaccines for school kids went viral on social media and even Fox news. It’s not true - only states and local jurisdictions can determine the mandatory vaccine schedule for school children. (Washington Post)
  • The US cleared Novavax as a booster, creating an option for those who are opposed to using newer mRNA technology since it uses a more traditional protein. (AP)
  • COVID played a role in nearly a quarter of deaths during pregnancy in 2020 and 2021. (Axios)
  • Millions are at risk of losing health insurance, food benefits, and no-cost tests and vaccines if the US ends the COVID public health emergency in January. HHS has promised 60 days notice. (CNBC)

Public Health & MPX News:

  • It’s “Drug-Free Work Week” this week! The Dept. of Labor hopes to educate workers about the risks of alcohol and drug abuse, and ways to get help. (NDWA)
  • There’s an alert for a multidrug-resistant strain of Salmonella Newport in Mexico, and the CDC has issued a travel watch after increased cases in travelers. (CDC)
  • Biden’s plan for the next pandemic includes creating a test within 12 hours of identifying a pathogen, and enough vaccine for the US within 130 days. (STAT)
  • MPX conspiracy theories abound on social media, particularly on TikTok, spreading falsehoods about the origin of the virus. (MedPage Today)
  • Epstein-Barr, a very common virus that nearly all Americans are infected with at some point in their lives, has been linked to MS. Researchers are trying to learn more. (KHN)
  • People of color are hospitalized with the flu at far higher rates than white people, pointing to deep inequities in the healthcare system and distrust after historical discrimination. (CNBC)
  • 70 children in West Africa were killed by contaminated cough syrup produced in India. It’s happened before. (NPR)
  • An elementary school in Groton, CT reopened after sanitizing for confirmed norovirus. (Boston.com)
  • A global shortage of the cholera vaccine during a rising outbreak means there’s a temporary suspension on giving people the standard two doses. (WHO)

Mental Health News:

  • Kids’ mental health care is leaving parents in debt, and lack of data about the problem keeps them from getting government support. (KHN)
  • The Biden administration will try to expand 24/7 mental health care in the US. (AP)
  • Early state lockdowns and restrictions weren’t tied to worse mental health during the first few months of the pandemic. (CIDRAP)
  • First, it was detecting COVID, now tech can analyze your voice for signs of depression and other mental health problems. (Axios)

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 are you hearing about this ‘nightmare’ variant, XBB?

A new variant, XBB, is on the rise in Southeast Asia and is causing cases to skyrocket in places like Singapore. Some people are dubbing it a “nightmare” variant because it seems able to evade immunity. But we’re not panicking just yet, and you shouldn’t either. XBB isn’t very different from the new variants that are here in the US, BQ 1 and BQ1.1, which also have found ways to avoid immunity (from vaccination and previous infection).

We’re hearing some younger people are sicker after getting the updated bivalent booster.  Is that true?

No, there’s no difference in side effects from this booster than from any other COVID vaccine. You’re exactly as likely to feel side effects as you were with your previous two or three shots. Side effects include body aches, fatigue, fever, and pain at the injection site, and generally last less than a day. Many people have no reaction at all. So, if you haven’t already, go out there and get your updated booster ASAP before the next surge hits!

The CDC website still says you can get sick for 14 days after exposure, even though the guidelines all say 10 days? Why?

The CDC pages are confusing! It's technically true that you could develop symptoms up to two weeks after exposure, but it's extremely rare. It's also getting rarer - as the virus mutates and new variants enter the scene, the incubation period (the time between exposure and symptom onset) has gotten shorter. Back in 2020, it was more than 6 days on average, but for Omicron it's averaging between 3 and 4. The vast majority of people will get sick by Day 10. The 14-day references on the CDC are likely a holdover since the original version of the virus had a much longer incubation period than the ones that are currently circulating, and because it's technically still possible, even though the vast majority will be under 10. You can feel confident that using 10 days will catch nearly every case, especially given that Omicron sub-variants make up nearly all cases in the U.S. and most of the world now.

I heard that the COVID vaccine is going to be mandatory for schools. Is that true?

No! It’s not true, even though you may have seen it on social media and Tucker Carlson. The ACIP, the CDC’s vaccine advisory board, met over the last two days where they discussed lots of different vaccines, including the COVID vaccine. They added the COVID shots to the Vaccines for Children program, which allows uninsured children to get vaccines for free, even if the federal government stops purchasing vaccines (which they’ve said they will stop in the new year). The CDC hasn’t and can’t mandate vaccines for school children - that’s determined at the state and local level. Right now, different states have different rules. Most states require Hepatitis B vaccine, but six don’t, while only three require the HPV vaccine. So, some states will likely make COVID vaccines mandatory, and many others won’t.

Best Read:

Next pandemic may come from melting glaciers, new data shows | The Guardian

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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.