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The Executive Briefing - Tuesday, August 31st

Tests in short supply, plus a new variant?


  • The US topped 100,000 daily COVID-related hospitalizations. (CIDRAP)
  • Hurricane Ida slammed Louisiana, cutting power to hospitals brimming with COVID patients. Louisiana has some of the highest case rates in the country.  (AP)
  • COVID tests are once again in short supply and taking longer at labs now that schools are open and the surge continues. (MedScape)
  • An unmasked, unvaccinated teacher worked for two days after their symptoms started. Half of the class got COVID. (MMWR)
  • Booster shots are likely to stay at the eight month mark for now, despite some rumors they would be recommended sooner, according to Fauci. (Politico)
  • A FL judge struck down Gov. DeSantis’ ban on mask mandates in schools. (NBC)
  • And a FL radio host who called himself “Mr. Anti-Vax” died of COVID this weekend. (The Hill)
  • Europe is likely to impose travel restrictions for the unvaccinated from the US amid rising case rates. (AP)
  • Britain is focusing on testing and contact tracing, rather than masking, for young kids in school. (New York Times)
  • A judge in OH ordered a hospital to provide Ivermectin (an anti-parasite most commonly used in horses) to an ICU patient, against the best judgement of their medical directors. (USA Today)
  • A new variant has been identified in South Africa with multiple mutations that are being studied carefully. (Yahoo)
  • The British Medical Journal, the Lancet, reports that the Delta variant doubles the risk for a need for hospitalization with COVID. (NYT)

Today’s Health News

  • An e.Coli outbreak in OR has sickened 16, with 12 hospitalized. Officials still haven’t identified the source. (NBC)
  • A new study shows that drinking between ½ and 3 cups of coffee daily cuts cardiac risk significantly. (MedScape)
  • The pandemic has caused a major shortage of the primary drug used to treat Rheumatoid Arthritis. (CNN)
  • Eating a hot dog could take 36 minutes off of your life (really…). (CNN)

Best Questions

Can we ask new hires if they’re vaccinated?

First, this is a legal question and, as always, you should consult with your legal counsel to handle company policy, hiring, and vaccination status issues. Here’s our general understanding, not intended as legal advice. You can include questions about vaccination status as long as you don’t violate ADA and religious considerations. If you have a company policy around vaccination and masking, you can inform new hires of that policy. You’ll need to make sure it’s a vaccine mandate for all employees, and that it’s listed in the job posting and application, as well. You’ll need to engage in an interactive process, according to our friends over at Messner Reeves, LLP, if someone mentions anything that might require accommodations related to a disability or religion. Here’s a good quick article about this subject from Fisher Phillips, too. Again, consult with your legal counsel to handle these tricky legal situations.

Can you get a flu shot and COVID shot at the same time?

Yes!  We’ve heard a lot of misinformation about this, but the CDC and doctors agree that you can get any routine vaccination - including the flu shot - at the same time you get the COVID vaccine (and within 14 days). If you’re due for a COVID booster (8 months after your second dose) in September or October, you can absolutely ask the pharmacy or clinic to get both at the same time and most will say yes! What you shouldn’t do is delay getting your flu shot past October in order to get both together. Waiting could leave you unprotected at the height of flu season, and our overrun hospitals definitely don’t need a flu “twindemic” on top of COVID.

If employees don’t show proof of their positive test, should we still exclude and contact trace?

Generally we recommend that you treat any reported COVID+ as a true positive, even if they don’t have proof of their positive test. While it’s true that testing has improved and most people have photos or screenshots of their positive test results, we are seeing more at-home tests where people don’t take a picture of the results, or where the results are hard to read. Some people also prefer not to share their test results as personal information. It’s a tough call if you think an employee might be lying, and you can decide on your company policy on what to do if they can’t provide proof or if you find out they’re not actually positive after saying they were. But the vast majority of people who chat in to our daily employee wellness check program saying they’re COVID+ share pictures of their results that are legitimate, and we’d much rather do the proper contact tracing and exclusion than skip it and find out later it was legit.

If Delta is so infectious, should we still be using 6ft and 15 minutes for close contact?

First thing to keep in mind is that 6ft and 15 minutes were never magic numbers. They’re just good general rules of thumb to help people think about their risk of exposure. Six feet was the distance chosen because of some old studies showing that most big droplets expelled when speaking or laughing hit the ground before six feet. And 15 minutes was a general estimate for how long someone would need to be in close proximity to a sick person before it was very likely they inhaled some respiratory droplets. There have always been exceptions - if you were coughed or sneezed on (even in passing), if you shared drinks or utensils, if you hugged or kissed, you would be excluded even if you didn’t meet the 15 minute mark because your contact was so close that you’d likely exchanged respiratory droplets.

It’s true that there’s some evidence that the Delta variant is much more easily transmitted than the original version of the virus we dealt with early on, and that even fleeting contact has been shown to be enough to transmit the virus. The CDC hasn’t changed the definition of close contact, so you can still use 6ft and 15 minutes for exclusion and contact tracing in most cases, but it’s also important to consider how well ventilated the space is, whether the sick person was singing or exercising and therefore exhaling more forcefully, and whether you did anything else that might bring into close contact with the sick person’s respiratory droplets (like hugging and kissing). We’re keeping a close eye on this as scientists continue to study the Delta variant and its transmission, and we wouldn’t be surprised if some local jurisdictions shorten the time period that they use to define close contact.

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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.