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The Executive Briefing - Friday, September 17th

Which rapid tests are right for you? Plus, waiting on OSHA & booster decisions

Flash Briefings:

Everything You Need to Know About the New COVID Testing + Tracking Guidelines

The White House’s new rules are an effort to not only limit the spread of COVID, but to create friction and encourage people to get vaccinated, rather than deal with the logistics of weekly testing. While there are still many details up in the air, we do know that you will be required to test non-vaccinated employees weekly. We’re discussing how it will work, as well as showing you the tools we have to implement this and track it seamlessly.

We've scheduled 3 separate briefings for next week for your convenience:

Sign up for whichever is convenient, and feel free to share with colleagues!

COVID Recap

  • One out of every 500 Americans has died from COVID-19. As we reflect on that and how unnecessary so many of those deaths were, we’re humbled and even more motivated to get people vaccinated and help keep your employees healthy. (CNN)
  • And the pandemic isn’t just affecting those who are unvaccinated. One of many stories about our slammed healthcare system: a boy’s appendix burst this week in an ER packed with COVID patients. (ProPublica)
  • And while the virus surge might be declining in some states, deaths are still increasing. (New York Times)
  • As we await OSHA rules around vaccination and testing mandates, some say that OSHA doesn’t have the bandwidth to enforce whatever they require. (Business Insider)
  • Nicki Minaj tweeted misinformation about the vaccine and fertility this week, prompting Dr. Fauci (and Trinidad’s health minister) to set the record straight. (Washington Post)
  • Both Alaska and Oregon have joined Idaho in rationing care. They’re delaying surgeries and cancer care, and not able to offer high-quality care to all their patients under the strain. (NPR)
  • A hospital in Arkansas is asking its employees who have claimed religious exemption due to the use of fetal cells in development to actually prove it - by signing an affidavit agreeing that they won’t use 30+ medications, including Tylenol. (Newsweek) 
  • U.S. immigration will start requiring applicants to be vaccinated. (NPR)
  • The FDA is meeting today to discuss Pfizer booster doses for healthy Americans. (New York Times)
  • And while local health departments are planning for a potential rollout of boosters, there’s still a lot of confusion about the logistics of third doses. (CNN)
  • Seattle’s new health order goes into effect October 25th, and while it requires customers for most indoor activities (including dining) to be vaccinated or show proof of a negative test, it doesn’t require vaccines for employees. (Seattle Times)
  • Move over Ivermectin….Some people are now gargling the (toxic) antiseptic Betadine to try to cure COVID. Please don’t try this at home. (Newsweek)


Today’s Health News

  • The filming of the next Indiana Jones’ movie is on hold (again).  There’s a widespread Norovirus outbreak on the UK set. (Portland Sun)
  • Six states have now reported deaths due to West Nile Virus. Be sure to get rid of any standing water to help prevent its spread via mosquitoes, and don’t forget your bug spray. (Newsweek)
  • The CDC has officially declared the E. coli outbreak (linked to cake mix) over.  (CDC)


Best Questions

If my local health department is offering on-site COVID vaccinations, should we schedule them?

Yes!  When we’re asked what we do now while awaiting the OSHA rules, the answer is focus on getting employees vaccinated.  And on-site vaccinations are an excellent option if they’re available in your area. The actual vaccine is free.  Some local and state health departments are doing free on-site vaccinations.  There are many private providers doing on-sites as well - but unfortunately, they can get quite expensive. There is some significant profiteering, minimum participation commitments and some other issues come up like when the provider wants to invite others into your worksite for vaccinations. 

We know, from our 30+ years of administering on-site flu shots, that the more convenient you make it, the higher your participation rate.  Years ago, when we offered on-site flu shots in five separate buildings for a GE Capital (now Synchrony) complex, they had excellent participation rates.  And when they cut back to offering them in only 3 buildings (so some employees had to walk next door via a skyway), participation dropped by 20%.  Ease of access and convenience remove obstacles for your vaccine hesitant employees. 

 

How long should we exclude employees who experience a fever or other vaccine side effects after vaccination?

We’re excited that some folks who have been holding out are finally getting vaccinated! Some people will experience fever or other vaccine side effects for 24 hours or so, but those side effects can occasionally last up to four days. Our clinical team generally excludes people one day at a time if they’re experiencing side effects, since many feel sick for less than a day and fully recover by the next.

An employee took two rapid tests that were positive and two that were negative, all within a short time frame. Is it a false positive?

Unlikely. It should be treated as a positive. The false positive rate on rapid antigen tests is extremely low for rapid antigen tests - much less than 1% in most cases. If someone tests positive even just once, it’s 99% likely they have a true COVID+. If they test positive twice, the chances of this being a false positive drop to basically nonexistent. Negative test results are much less reliable - they miss a large percentage of positives, so we can disregard the negative results and assume this person is COVID positive. 

Which rapid tests are approved by the FDA? Can we trust them?  

There are seven over-the-counter rapid tests and two that require prescriptions that are approved under emergency use authorization (EUA) by the FDA.  If the test was an approved rapid antigen test, then you should always consider any positive result a true positive, since the rate for false positives is extremely low.  The risk of not doing so is too high. Any negative result should be taken with a grain of salt - rapid tests (even the best ones) miss positive results, especially in asymptomatic people. 

Which rapid test should we use if we need them? 

As you think about what rapid tests are best, the name of the game right now is availability. We’re starting to see widespread scarcity of rapid tests, and expect that this could get worse if OSHA releases guidance around weekly testing for unvaccinated workers. If you can get them and have some choices, there are some other factors to consider. Some rapid tests need a healthcare professional to administer them, and others can be self-administered. Some are easier to use than others, and that’s even before we get into the wild wild west of interpreting rapid test results, which often look like pregnancy tests (but even less clear to interpret!).  Arizona State provides excellent resources on which tests are approved, and which are best for you: Arizona State Rapid Testing Guide.

We do anticipate seeing additional brands of rapid antigen tests approved, reduced pricing and federally-negotiated discounts through Walmart and Amazon for about three months. 


Best Read

Beyond 'vaccinopia': Employ rapid tests to fight Covid-19 (Opinion)

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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.