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The Executive Briefing - Tuesday, February 28th

Will Narcan be free for businesses?


  • Some good news - nearly 80% of US counties have low community transmission levels right now. (SF Chronicle)
  • There’s not enough evidence to support multiple boosters per year for COVID - instead, the CDC’s advisory committee recommends one per year. (Reuters)
  • The FDA finally approved an at-home combo Flu and COVID kit, but the manufacturer is going bankrupt, so it’s unclear if or when it will hit the shelves. (STAT)
  • The Energy Department says a lab leak most likely caused the pandemic, though the confidence level is “low” and other US spy agencies are split. (NY Times)
  • The rule that travelers had to test before entering the US led to a 52% reduction in positive tests upon arrival. (MMWR)
  • A nasal COVID vaccine is showing promise in early clinical trials. (NBC)
  • Doctors who touted Ivermectin for COVID are now pushing it for flu and RSV, but there’s no clinical data to support it. Multiple studies prove it doesn’t work against COVID. (Washington Post)
  • Republican lawmakers in Lee County, Florida are hoping to pass a statewide law that would ban all COVID vaccines. The legislation contains falsehoods and disinformation about the safety of vaccines. (Forbes)

Public Health News:

  • The CDC issued a warning about an increase in drug-resistant Shigellosis, which causes severe diarrhea and is a concern for restaurants if the sick person prepares food. (CDC)
  • A boil-water order was issued for Roberts, Idaho after E.coli was found in the drinking water. (East Idaho News)
  • The human cases of bird flu in Cambodia appear to be the endemic clade, which means they weren’t caused by the new strain that’s fueling the massive outbreak this year. (Reuters)
  • A person in Florida was recently infected with the so-called “brain-eating amoeba,” likely after a sinus rinse with tap water instead of distilled. (WGCU)
  • A man suspected to have Marburg disease in Spain ended up testing negative, a relief to public health professionals there. (Reuters)
  • A measles case in an unvaccinated Kentucky resident is linked to a large Christian revival that drew thousands of visitors to the two-week service. (USA Today)
  • The CDC has identified a persistent strain of E.coli that’s caused over 600 illnesses in 14 outbreaks, including from water, romaine lettuce, leafy greens, and ground beef. (CDC)

Mental Health News:

  • Layoffs or losing a job can be harmful for mental health and bring up grief and financial stress. There are supports to help. (Seattle Times)
  • Teens are turning to TikTok to diagnose their mental health concerns, which can be dangerous. (CBS)
  • Bosses say they care about their employees’ mental health, but some feel that they can’t trust them. Workplace culture, HR support, and manager training are key. (LA Times)

If you or someone you know may be considering suicide, call 988 or message the Crisis Text Line by texting HOME to 741741.

Best Questions:

Will businesses get Narcan for free after it becomes available OTC?

Whether Narcan will be free is likely to vary state by state and even city by city, barring some sort of currently unannounced federal program. Right now, for example, Ohio, Delaware, and Iowa provide free Narcan for anyone, and cities like Philadelphia and Chicago distribute it free at public libraries, while NYC has dozens of city and partner-based options. We think that there are likely to be some cities or states that allow businesses to get naloxone for free or at a heavily reduced price to help prevent overdoses, but we doubt that all of them will be the same.

Many of the producers of naloxone (Narcan brand included) have reduced-price bulk purchasing options for community groups and even individual community members, so reduced-price bulk purchasing options are almost certain, while free options will probably depend on state or city programs.

Should we be worried about the bird flu now that people have died in Cambodia from it?

While the deaths in Cambodia are tragic, they’re not from the same clade of bird flu that we’ve heard so much about lately. Instead, those cases were from a strain that’s endemic to the area and most likely resulted from direct contact with an infected bird. Most public health experts are wary of the bird flu and see it as a real threat, but aren’t panicked - at least not for humans. The human cases we’ve seen so far of the specific clade causing mass bird casualties (H5N1 clade have all been mild. And while the fact that it’s spread to and between minks is cause for alarm because they’re more similar to humans than other mammals, it would still take a big leap for the virus to mutate so that it’s easily infectious in humans. Instead of panic, we should be ramping up monitoring to keep an eye on this and preparing our influenza pandemic plans.

Can you actually get sick from going outside in the cold?

Our clinical team gets this one a lot! In the past, we thought it was mostly because cold weather forces people to spend more time indoors, which allows easier viral transmission. But there’s actually some new evidence that the cold actually does hamper your body’s immune response, especially the cells in your nose, which are a first line of defense for fighting respiratory viruses. There’s also some evidence that certain viruses can survive and reproduce better in the colder, dryer winter air. That said, it’s not the cold itself that’s making you sick - it’s probably a virus that you picked up, though the cold might be the reason it made you feel bad.

What is POTS and is it the same as long COVID?

POTS stands for postural orthostatic tachycardia syndrome. It’s a disorder of the autonomic nervous system that causes rapid heart rate, fainting, and dizziness, particularly among young women. Nearly a million new patients have been diagnosed with POTS after COVID infections. It’s not synonymous with long COVID, but it’s certainly one of many possible symptoms and effects. POTS has often been dismissed in the past as anxiety-related, especially since the young women it affects most often can look well on the outside. But POTS is a real disorder with life-altering effects, just like other symptoms and effects of long COVID, and it needs more research and more focus from the medical field.

Best Read:

Norovirus, a gross stomach bug, appears to be hitting NYC. Good luck finding out where. - Gothamist

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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.