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The Executive Briefing - Tuesday, December 21st

Biden announces more testing, plus more on OSHA's mandate ⚠

COVID Recap:

  • The 6th circuit lifted the stay on OSHA’s vaccination or test mandate, which will go into effect on January 10th, though they won’t issue citations for the testing component until February 9th. (Forbes)
  • President Biden announced that 500 million at-home test kits will be available to ship to Americans for free starting in January, plus free federal testing sites starting this week in NYC. (NPR)
  • A new study out of London shows that Omicron evades two doses of vaccine or earlier infection, and debunks the idea that Omicron is more mild than Delta - instead, it’s roughly the same level of hospitalization as the previous variant.  (Imperial College)
  • Restaurants are closing once again amid staff outbreaks fueled by Omicron. (Washington Post)
  • The NHL postponed all games for a week, Hamilton cancelled performances this week, and a slew of other concerts and events are being postponed amid the rise in cases. (NY Times)
  • Meanwhile, the NFL had to delay multiple games due to over 100 positive tests in a week. Their solution is to test less to avoid disruptions... (WSJ)
  • Rapid tests are hard to come by ahead of the holidays, with major pharmacies sold out and long lines forming at testing sites. (Washington Post)
  • Yale, Harvard, and Duke joined a growing list of colleges and universities who will require boosters to attend classes next semester. (Forbes)
  • The EU effectively changed the definition of fully vaccinated, adopting a rule saying that you must have a booster to be considered fully protected if their original doses were more than 9 months ago. (Washington Post)
  • France found over 180,000 fake vaccination passports, and Italy arrested those involved in faking inoculations. (NY Times)

Today’s Health News:

  • A performance of ‘Company’ on Broadway was halted mid-show due to food poisoning. (NY Post)
  • Up to 15 million people could lose Medicaid coverage when the Families First Coronavirus Response Act expires in January. (MSN)

Best Questions:

What do we need to do to prepare for the OSHA ETS?

The OSHA vaccine or test mandate will go into effect January 10th (unless the Supreme Court intervenes), at which point employers with over 100 workers will need to have a vaccination policy, know the vaccination status of every employee, and require masks for anyone who’s unvaccinated. Starting on February 9th, employers will need to be able to provide proof that all employees are either vaccinated or testing weekly. To prepare, you’ll need to determine your vaccination policy - you can either mandate vaccination for everyone, or prepare for weekly testing.

If you choose to go the testing route, you’ll need to decide if you’re offering the tests, which isn’t required by the law - but the fact that folks can’t do unsupervised tests at home makes it a real challenge unless offered by and/or proctored by the employer. The reality is that most employers only have two options: mandate vaccines for everyone, or offer free on-site rapid testing for unvaccinated people. Most other options are much more challenging, since off-site testing is either cost prohibitive for proctored at-home tests, or too difficult to manage. Many of our clients are planning on tests proctored on-site by a trained manager or testing coordinator (it doesn’t need to be a medical professional!). You can bulk purchase rapid tests, which can be found from medical supply companies like McKesson, Henry Schein, first aid supplies like Cintas, and major retailers like Amazon Business, Target, CVS, Walgreens, and Walmart. It’s a good idea to document your attempts to buy rapid tests, since it shows a “good faith” effort required in the OSHA guidance.

If you don’t already have information on employee vaccination status, we suggest that should be your top priority right now, either way!

We heard that vaccinated people might be able to isolate for a shorter time. Is that true?

Clinically speaking, there’s some strong evidence that fully vaccinated people might be able to end isolation earlier than 10 days with testing, since their viral load is likely much lower and they’re much less likely to spread COVID after four or five days. Dr. Fauci mentioned on Tuesday that the CDC is considering the possibility of reducing the recommended exclusion for vaccinated people who are COVID positive. Our best guess is that it would allow vaccinated people to test out of isolation after Day 5, though we’ll have to wait and see what the CDC says. Ultimately, we expect that like most CDC recommendations, there will be variation across state and local health departments, with some still requiring 10 days and others following whatever new recommendation the CDC might share. We’re watching this closely, since we know it will help with staffing shortages.

Some employees are concerned after watching TikTok videos warning about ethylene oxide on nasal swabs. How can we respond?

Since the summer, we’ve seen videos on TikTok and Facebook that spread misinformation about a common sterilizer, claiming the gas used to sterilize nasal swabs causes altered DNA or cancer or other harmful effects. It’s not true at all. Ethylene oxide is commonly used in medical supplies of all kinds, every day. It’s also in many shampoos and laundry detergents. About half of all medical devices in the US are sterilized with it - so basically everyone has come into contact with other things sterilized this way that are completely safe. There is no ethylene oxide left on swabs after they’re sterilized - they’re exposed to the gas briefly, then removed from that gas, which dissipates, leaving no ethylene oxide on the item once it’s packaged.  There’s no risk of anything harmful from ethylene oxide - cancer or otherwise - after swabbing with a nasal swab because there’s effectively no trace of ethylene oxide left on the swab after the sterilization process. WA State’s Dept. of Public Health has a great resource on this, available here.  

 

Do rapid tests detect Omicron?

Yes! Rapid and PCR tests can all detect Omicron, luckily. While there are a few mutations that make it different from the original virus that the tests were designed to catch, we know they work to detect Omicron because those mutations either don’t affect the part of the virus that the test “looks” for, or those same mutations were already present in the Delta variant and we know the test worked for that. We’ve had a huge spike in cases due to this new variant, and we’d certainly know by now if rapid tests didn’t work to catch those, and we’re very grateful that they do detect Omicron!



Best Read:

How to Think About the Risks of Omicron | The New Yorker



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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.