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The Executive Briefing - Friday, October 22nd

Boosters explained, plus more on rapid testing

New Podcast Episode: How Bartaco Got to 92% Vaccinated

Marc Hinson is the VP of People at Bartaco, a local ZHH favorite. Marc joins us to talk about the amazing work that they've done to achieve a 92% vaccination rate in their workforce, all while growing the business above pre-pandemic sales.

Listen now wherever you get your podcasts!

COVID Recap:

  • The CDC endorsed boosters for Moderna and J&J this week, and said that you can ‘mix and match’ vaccines for the booster dose, though they recommend sticking with your original brand. Moderna, like Pfizer, is still for specific high-risk groups, but the J&J booster is for anyone who got their first shot more than two months ago. (CNN)
  • Citing workplace COVID failures, OSHA has moved to assume workplace safety authority in three states (AZ, SC and UT).  (NYT)
  • Delta Airlines reports its policy of requiring unvaccinated employees to pay a $200 per month surcharge towards their employee benefits is working - more than 90% of employees are now vaccinated.  (Cheddar)        
  • GE is now requiring vaccinations for it’s 56,000 US employees, and Apple is requiring all non-retail employees who are unvaccinated to be tested daily.  (NYT, Engadget)
  • Some workers want COVID recovery to substitute as proof of immunity rather than requiring vaccination. (WSJ)
  • As of Wednesday, pediatricians can now pre-order vaccines for kids ages 5-11, ahead of final approval of pediatric vaccinations - which should significantly reduce employee absences caring for kids home for exposure at school. (KHN)
  • An In-N-Out Burger in San Francisco was temporarily shut down by the DOH after refusing to ask customers for proof of vaccination.  It was later re-opened for take out and delivery. (QSR)
  • The Pfizer vaccine is over 90% effective in kids under 12. Plus it was 93% effective in keeping vaxxed teens out of the hospital with COVID. (MedPage)
  • Religious exemptions for vaccine mandates have real potential to undermine their overall effectiveness and request templates are widely available. (The Guardian)
  • The CDC has a new tool which tells you your chances of getting COVID if you’re vaccinated by location and brand. (Fast Company)
  • Women who got COVID while pregnant are sharing their stories to encourage other pregnant women to get vaccinated - many regret their choice not to do so. (AP)
  • A new disinformation campaign linked to China is attributing the pandemic to...Maine lobsters? The crackpot story is making its way around social media. (NBC)

Today’s Health News:

  • As we alerted on earlier this week, the CDC is recommending that people throw away or stop selling whole onions if they’re from Chihuahua, Mexico, distributed by ProSource, Inc., or if you don’t know their origins. (CDC)
  • Upending conventional wisdom, researchers in South Africa found that breathing alone contributes to transmission of TB even more than actual coughing. (NYT)
  • The FDA has proposed new rules for hearing aids, which would make them over the counter and result in real cost saving. (Yahoo)

Best Questions:

Should we require or pay for employees to get antibody tests?  

It’s tempting to try to quantify someone’s immunity levels through antibody tests, but unfortunately, the reality is that we just don’t know enough about what level of antibodies protects someone from getting or spreading COVID. We still aren’t able to say exactly what level of antibodies is protective, or how long that protection will last, so while taking an antibody test can be interesting, it’s still far too early to use that information to make any kind of medical or public health decision. In short, we don’t recommend requiring or paying for employees to get antibody tests since it won’t affect their requirements for vaccination or testing in any way. 

While our COVID cases are finally trending down a bit, our absences for other illnesses seem to be rising. Are you seeing that across your client base?

Yes, we’re seeing Noro-like illness, flu, RSV, colds and even some E.coli and Hep A, too.  These were all illnesses that were greatly reduced last fall and winter when we were social distancing, masking, washing our hands, and not working sick.  We know staffing is challenging everywhere, but no one wants to be near anyone sick these days, for very good reason.  We need to be sure we don’t let our guard down… especially since it’s nearly impossible to tell a cold from COVID without a COVID test.

When rapid tests first came out, we were told they’re very inaccurate, but now we’re leaning heavily into them.  How accurate are they? 

A few early studies about rapid antigen testing showed that they were only about 40% sensitive, meaning up to 60% of negative results might be false negatives. But as we learn more about the virus, how it spreads, and when someone is shedding the most virus, most rapid antigen tests are closer to 80% sensitive. That still leaves about 1 in 5 positive cases missed, but it means that rapid antigen tests, which are quicker, cheaper, and easier to administer, are still an incredibly useful tool, especially for catching asymptomatic or mildly symptomatic people before they come to work. Even though they give out some false negatives, rapid tests are incredibly accurate when it comes to positives - a positive result on a rapid test is more than 99% likely to be a true positive. PCR testing is still the more accurate of the two types, but it can take a day or two, which isn’t very helpful in preventing outbreaks if the person in question is going to work while they wait for their test results. There’s absolutely an important role for rapid tests in getting COVID positive people out of the workplace in a timely manner. 

Are we the only ones having trouble identifying what kind of test we’re looking at, or whether the result is positive or negative?

One of the most frustrating things about our pandemic response in the US has been the unreliability and variability in testing and results. Even tests from the same lab can look different if they’re accessed on patient portals versus email, or on mobile versus desktop. Tests can be divided into two main categories: point of care (POC), and laboratory. POC tests are done at or near the site where they’re collected, while laboratory tests are sent off to be processed in a lab. If a test was done at a lab, you can be fairly certain that it’s a molecular test with a higher sensitivity (meaning there’s a lower chance of a false negative). Rapid tests are always done on site and results come within 15 or 20 minutes, and come with a higher chance of false negatives. 

When interpreting results, you’ll generally see “Positive” or “Detected” when there’s virus found in the sample, and “Negative” or “Not Detected” for when there isn’t. You may also “Abnormal” next to the Positive/Detected result. A really tricky part of COVID test results is that there’s almost always a reference range, sometimes also called an expected result, where it will say “not detected” or “negative.” This refers to the result that is ‘normal’ or ‘expected’ (AKA not having the virus). That can be sneaky since every result, even positive ones, have this reference range listed, which to the untrained eye can look a lot like the real result. 

Best Read:

EXPLAINER: Is it time to get a COVID-19 booster? Which one?

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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.