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The Executive Briefing - Tuesday, July 12th

BA.5 the ‘reinfection wave’ & monkeypox vaccine update


  • Pulse oximeters, widely used during the pandemic to determine how much oxygen to give a patient, provide less accurate readings for people with darker skin. This may be one part of why Black and Hispanic ICU patients were more likely to have limb loss and death in the ICU. (STAT)
  • The Biden administration may soon expand a second booster to all adults. (Politico)
  • The US bought 3.2 million doses of Novavax, a fourth brand of COVID vaccine thought to soon be approved for emergency use by the FDA. It’s a two-dose initial series that uses much more traditional techniques than the mRNA vaccines. (CIDRAP)
  • The CDC will improve data collection for contact tracing on international flights. (Reuters)
  • The public health emergency will be extended again, allowing millions to keep access to healthcare and telehealth options. States will be given 60 days notice before it expires. (Bloomberg)
  • BA.5 is being considered the “reinfection wave” by some experts. (The Atlantic)
  • Anecdotally, more people are complaining of night sweats with the newest BA.5 variant. (The Independent)
  • NYC is advising indoor masking as cases rise. (NBC)

Public Health News:

  • The CDC issued a health advisory to doctors today about recent reports of parechovirus (or PeV), a virus that primarily affects young children with symptoms including fever, neurological symptoms, and sepsis. (CDC)
  • VL, a dangerous disease spread by sandflies, is even nastier for those with HIV. New guidelines hope to help. (NPR)
  • Ghana has two cases of Marburg virus, a highly contagious disease in the same family as Ebola. (WHO)
  • The CDC is worried that Big Olaf ice cream, the cause of a Listeria outbreak, may still be in people’s homes or on grocery store shelves. (CDC)
  • HHS and the Biden administration say that doctors must provide an abortion if the mother’s life is at risk. (AP)
  • Patients with autoimmune diseases like rheumatoid arthitis and cancer are being denied access to a crucial drug that is also used off-label for some types of abortion. (LA Times)

Mental Health News:

  • One in six calls to the National Suicide Prevention Lifeline end without reaching a counselor – either because they were abandoned or disconnected before the counselor could respond. (WSJ)
  • Some states are struggling to prepare for calls with the new 988 mental health hotline that launches later this week. (NPR)
  • Advocates are calling for more autism training for suicide hotlines. People with autism are more likely to have suicidal ideations, and some are concerned that without training, 988 could unecessarily increase the number of people hospitalized involuntarily. (WUSF)
  • A new study shows that mental health and drugs are not primary causes of homelessness – housing availability is, though. (LA Times)

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:

Who’s at highest risk for reinfection?

People who are unvaccinated, who had an asymptomatic or mild first infection (with a lower viral load), and those who are younger are at highest risk for reinfection. That said, reinfections are rising across all age groups, with roughly 1 in 4 reported cases being reinfections right now.

Should I get a monkeypox vaccine if I’m eligible?

Yes! There is a new version of a vaccine that works for monkeypox called Jynneos. It’s for those 18 and up, and it’s two shots given a month apart. It’s safe, effective, and has many fewer side effects than the old smallpox vaccine, called ACAM2000. The new one is what’s being given out in the US right now, which is great news. If you are eligible for the vaccine and have the opportunity to get it, run - don’t walk! Vaccination is the best way to prevent this from becoming a major epidemic.

I think I was exposed to monkeypox. What should I do?

First, call your doctor or if you don’t have one, get yourself to a sexual health clinic right away. Monkeypox isn’t exclusively a sexually transmitted disease, but because of the way this particular outbreak is acting with the first lesions sometimes showing up in the genitals, sexual health clinics tend to be best-equipped to handle monkeypox cases. If you go early, there’s still a chance that you can get vaccinated in time to prevent symptoms – you’ll need to get the shot within the first four days after exposure. Your doctor or healthcare provider will give you instructions about whether you need to isolate and any other precautions to take to prevent the spread.

I caught COVID while traveling. What should I do?

Unfortunately, this is the reality of returning to travel while case counts continue to rise and BA.5 causes more reinfections. Before you travel, especially internationally, consider buying travel insurance. It will pay for itself many times over if you need to be medically evacuated, and some policies cover quarantine expenses if you need to stay where you are when you test positive. You should always bring a few tests and masks, and think through what you’ll do if you test positive at each leg of your trip.

Once you’re positive - please, don’t get on that plane when you’re sick! Isolate for a minimum of five days from your symptom onset, and wear a mask if you have to come into contact with anyone. If you’re driving distance from home, that’s an option by rental car, which some companies can deliver, though the reality of getting home without coming into close contact with others can be tricky. You don’t need to test negative before you travel home, since you might test positive for weeks, but you should be at least 5 days out and with symptoms improving - and wear an N95-type mask on the plane!

Best Read:

Monkeypox outbreak was avoidable and we ignored the warning signs, expert says: NPR

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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.