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The Executive Briefing - Tuesday, August 9th

Stretching doses as monkeypox case in daycare raises concerns


  • The CDC has not made any changes to exclusion guidance despite some reports last week that changes were imminent. Our sources at the CDC say that it’s indefinitely on hold based on COVID case rates and hospitalizations right now. (CDC)
  • Low demand for the new Novavax COVID vaccine has caused the company to adjust their sales projections down. (WSJ)
  • Only 10% of kids ages 5-11 are up to date with their vaccinations. (CDC)
  • Thousands are stranded in a Chinese resort city during a COVID outbreak and subsequent lockdown. (AP)
  • Senator Tim Kaine has long COVID, but that’s not enough to push Congress to act. (Politico)
  • A group of 23 attorney generals are challenging the CDC’s authority in Federal court to set mask guidelines. (Reuters)

Monkeypox News:

  • 99% of the 7500 monkeypox cases in the US are in men. (CIDRAP)
  • A person working at a daycare center in IL tested positive for monkeypox, raising concerns that it could spread to kids who might be more susceptible to the virus. (Washington Post)
  • The COVID sewage surveillance lab is joining the hunt for monkeypox. (KHN)
  • The administration will move forward with the plan to stretch the available monkeypox vaccine supply 5x by using a different injection method under the skin. (NY Times)
  • San Francisco, which makes up 36% of California’s cases, has all but given up on contact tracing for monkeypox. (SF Chronicle)
  • A viral meme is spreading the false claim that monkeypox is airborne and can spread 15 feet through the air - it’s not true. (Poynter)

Public Health News:

  • A staggering one in five Americans struggled to get access to care when someone in their home had serious illness. (NPR)
  • Pfizer is beginning a Lyme disease vaccine trial. (USA Today)
  • Climate hazards like flooding, heat waves, and droughts make 58% of known infectious diseases worse. (AP)
  • The CDC is sending a team to New York to investigate polio there after one confirmed case and wastewater indicating that there are multiple people shedding the virus in at least two counties. (ABC)

Mental Health News:

  • A new children’s study reveals a ‘mental health pandemic’ in kids, with particular  increases in anxiety and depression. (OBP)
  • Tween girls, in particular, are struggling. (Washington Post)
  • Researchers are investigating the role that social media plays in the mental health crisis. (EdSurge)

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

Best Questions:

An employee’s family member has monkeypox. When can they return to work?

First, double check to make sure that the employee’s family member has actually tested positive for monkeypox. Sometimes, we’re finding that they have other symptoms or just suspect that they might have it. If they have legitimate monkeypox symptoms, keep any family members or people who have a sexual relationship with them out until the results are back. If they test positive, the person will likely get instructions from the clinic or health department about when they can return to work. In most cases, we’re seeing 14 days right now. If the person hasn’t gotten any info from the health department, keep them out until you get a note from a doctor or health department clearing them to return to work.

What should we know about polio now that it’s back in the US?

Polio is caused by a very infectious virus that lives in a sick person’s throat and intestines. It affects children under five most severely, and spreads when it enters the mouth through droplets from a sneeze or cough, or more commonly, miniscule particles of fecal matter – part of why it was so common in kids. Nearly three quarters of cases are asymptomatic, and most of the rest involve flu-like symptoms. A much smaller percentage of cases involve the brain and spinal cord, including a feeling of pins and needles, meningitis or paralysis. Some children who seem to recover fully from polio develop post-polio syndrome 15-40 years later, marked by muscle weakness or paralysis.

How did polio resurface in the US?

The polio vaccine was invented in the 50s, and until this recent case in New York, there hadn’t been any polio in the US since 1979. The vaccine prevents 99-100% of cases, and the one used in the US is an inactive vaccine that can’t cause infection because it doesn’t contain any live virus. The confirmed case in New York was in an unvaccinated 20-year-old who had contact with someone who had recently received the oral vaccine that’s still used in much of the rest of the world, which does contain weakened live virus and is capable of infecting unvaccinated people for a short period of time after vaccination. It’s very important that kids get the polio vaccine, with the first dose usually starting at 2 months old. If you or your kids aren’t yet vaccinated for polio, it’s a good time to go get that (safe and inactive) vaccine.

When is someone infectious with monkeypox? What’s the incubation period?

Believe it or not, we still don’t actually know when a person’s infectious period starts with monkeypox. We know for sure that a sick person is infectious when they have a rash or lesions on the skin, mouth, genitals or anus. We think it’s possible that they’re infectious during the flu-like symptoms stage, when they have a fever, headache, or other often mild flu symptoms. And we just don’t know if they’re infectious earlier than that, in the 1-2 week period after they were infected but before symptoms start. For now, the CDC’s guidance is that anyone with monkeypox symptoms should isolate for 2-4 weeks until their lesions are healed over with a fresh layer of skin and scabs have fallen off.

Best Read:

A California Man's 'Painful and Terrifying' Road to a Monkeypox Diagnosis - KHN

Looking ahead:

Is a 'twindemic' headed our way and what can you do to prepare?

Experts are warning that a 'twindemic' of COVID and the flu might finally be upon us this coming fall. So far, we in the US have been able to avoid this, but with flu cases already rising in July, and COVID cases surging again, health experts are worried we will be following in Australia and New Zealand's footsteps straight to a twindemic.

The key is simple: make sure no employee works sick.

If you don't have an employee health monitoring program, now is a great time to start. And you can help prevent a 'twindemic' from hitting your business hard by providing a flu shot and/or COVID booster program for your employees. Keeping employees (and customers!) healthy is not just good practice, it protects your bottom line.

Learn more about starting a program by scheduling a 15 minute chat with us here.

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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.