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The Executive Briefing - Tuesday, January 25th

Reinfection may be more common than we thought 😬

COVID Recap:

  • OSHA withdrew its ETS requiring vaccination or weekly testing, though may still move forward through its official rule-making process. (NY Times)
  • There’s a new subvariant of Omicron which seems to be slightly more transmissible, and it’s already in the US. So far, it seems very similar to the original strain. (Washington Post)
  • Omicron appears to kill faster than previous variants, with patients dying 2-4 weeks after hospitalization, compared to about five with Delta. (SF Chronicle)
  • Even as we’re seeing case counts fall, parts of Michigan, Ohio, Idaho and Alaska are being hit so hard that their ICUs are full, they’re turning certain people away, and they’re getting help from federal medical teams and the National Guard. (KHN)
  • Anecdotal reports of Covid reinfection in the UK are growing, including people testing positive just weeks apart, or having had the virus three or even four times. (The Guardian)
  • Apple’s newest policy of requiring boosters for all as its next generation vaccine mandate is being lauded as a model for businesses navigating the OSHA  uncertainty.  (Inc.)
  • The FDA approved the use of Remdesivir for certain out-patients, both adults and kids 12 and up.  Previously it was only administered in a hospital setting. (DG Alert)
  • The WHO Chief warned not to assume Omicron is the pandemic’s endgame and become complacent.. (Reuters)
  • Canadian postal workers are at odds with their bosses who are requiring branded cloth masks rather than more protective surgical or N95 ones.  (The Guardian)
  • Free N95s are becoming available this week at health centers and pharmacies nationwide, including CVS and Walgreens. Most stores have a limit of about 3 per person. (CNN)
  • The FDA paused use of certain monoclonal antibodies that aren’t effective against Omicron. (NBC)
  • One in five negative PCR results may actually be false negatives. (MedPage Today)
  • A third dose of mRNA vaccine was highly effective at preventing COVID-associated ER visits (94%) and hospitalizations (90-94% depending on the vaccine). (MMWR) 

Today’s Health News:

  • Bird flu is back in the US, after spreading throughout Asia, Europe and parts of Africa. Scientists are watching closely about what it means for poultry and for risk of human transmission. (Wired)
  • Antibiotic resistant superbugs are on the rise, and now kill more people each year than HIV/AIDs or malaria. (NPR)

Best Questions:

How do you determine the ZHH-Zedic Exclusion Chart?

The CDC doesn't have any guidance for employers about when to exclude symptomatic employees from work. The only resource they have is a list of possible COVID symptoms. We've developed our Exclusion Chart working closely with our own team of public health experts, doctors, epidemiologists and our contacts at the CDC to make a clear and operationally useful chart that balances our client’s needs and public health.  In the winter, for example, this chart helps us differentiate between someone who gets a runny nose when they walk outside in subzero temperatures (probably not an issue!) versus someone who has a new runny nose, sore throat, and cough (very likely COVID at this point!). Another common one is headache - the CDC just says "Stay home if you have symptoms" and lists headache as a common COVID symptom, but millions of people have regular headaches every day, so we use this chart to help differentiate between someone who just has a headache versus someone who has multiple or telltale COVID symptoms. 

How are other clients managing repeated close contact exclusions for unvaccinated employees?

That is the most frequent question that we’re getting and clearly a major point of frustration across all industries.  We’ve seen the same unvaccinated employees excluded three and four times for close contact and then getting sick. And if they don’t get tested and test positive, then they will continue to require close contact exclusions and not have the 90 day exemption.  There is no easy solution to this one… and worth discussing appropriate policy modifications with your legal advisors.

Can someone get COVID twice within 90 days? 

Unfortunately, yes, though it’s relatively rare. We are seeing some reports from the UK showing more reinfections with Omicron, some in as few as 28 days. The CDC still recommends that those who have had a recent COVID infection are exempt from exposure-related exclusions for 90 days, but with the rise of Omicron, we are seeing more instances of people getting what appear to be reinfections within that 90 day window. We’re also seeing people get COVID, start to feel better, and then feel worse again with new and sometimes different symptoms. While the first may be true reinfection, which is happening more as the virus mutates, the latter may be something more akin to long COVID. It’s very hard to determine which is true, but either way, the recommendation is to stay home if you have symptoms, even if you’ve had COVID in the past 90 days. 

Is the worst behind us with Omicron? 

It’s really hard to say for sure. It does look like Omicron has peaked in many parts of the US where it hit hard early on, though case counts haven’t dropped back to what they were two months ago before this surge started. While places like New York are seeing a massive decrease in cases from the horrible height of this surge, others are still being slammed. Hospital admissions are down a bit from the peak, but those were record highs and hospitals across the country are at full capacity. Deaths are still incredibly high, at nearly 2000 per day. In many places, thankfully, case counts are dropping precipitously, just like they shot up sharply. We’re hopeful that means we can catch a break, at least for a while. We’ll continue to keep an eye on new variants, and encourage people to get vaccinated and boosted to help keep those numbers headed downward.

Best Read:

NPR: Why rapid tests aren't more accurate and how scientists hope to improve them

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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.