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The Executive Briefing - Tuesday, June 14th

Today's new normal: COVID reinfections & monkeypox false alarms

COVID & Health News:

  • A new test may more accurately determine if you’re immune to COVID by creatively using T-cells. Not yet available in the US, it may help figure out when you really need a booster. It’s currently licensed in the UK. (Time)
  • Researchers are making headway in understanding the loss of smell associated with COVID, especially early COVID, and using this information to help develop better treatments for it. (Nature)
  • There continue to be high profile reinfections, some in as few as 30 days after first infection. HHS Secretary Becerra and Canadian Prime Minister Trudea are counted among them. (AP News)
  • The CDC has put Mexico back into level 3 “high” risk category for traveling. Other popular travel destinations also currently considered a high risk include Canada, Brazil, and most European countries. (CNN)
  • Despite worries of “COVID rebound” after taking the drug Paxlovid, a new study shows that developing rebound symptoms only occurred in 0.8% of patients. (US News)
  • The CDC Director warned that monkeypox is particularly tricky to properly diagnose. (CIDRAP)
  • A huge proportion of the world’s population, up to 14% of the world, may have had Lyme’s disease. (KCN)
  • Authorities in China are testing millions in Beijing to trace a COVID outbreak tied to a single 24 hour bar. (Retuers)
  • FDA has approved a drug that can help restore hair growth in patients with alopecia. (New York Times)
  • Canada has approved a new medication to treat ALS; US’ FDA is also reviewing the medication, but says that more evidence that it slows the progression of the disease is needed. (Wall Street Journal)

Mental Health News:

  • The new 988 national mental health crisis line, scheduled to go live in July, is struggling to hire call center staff. (Slate)
  • Fewer kids experienced debilitating headaches during COVID, attributed to reduced external stressors that may trigger migraines, according to a new study from Northern Italy. (Frontiers in Medicine)
  • For the first time in a decade, the American Psychiatric Association released a new version of it’s DMS-5 Manual - the Diagnostic and Statistical Manual of Mental Disorders -  and is surprisingly the #1 best seller on Amazon. (Axios)
  • A study done in the UK has shown a direct link between loneliness and mental health distress, with folks aged 16-34 at highest risk of chronic loneliness. (News Medical)
  • Using telehealth for mental health appointments remains significantly higher than pre-COVID although the growth rate has slowed. It is still 1000s of times greater than prior to March 2020 and demand continues to rise and fall with surges. (Yahoo Finance)

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:


Are you seeing false alarms of monkeypox?

Yes. We’ve had several employees report possible (or alleged) monkeypox this past week.  And no, none of them have actually been diagnosed with it (yet). There does seem to be some level of monkeypox hysteria among some medical providers (generally not MDs). One of the related issues (see bullet above) is that monkeypox isn’t particularly easy to diagnose and testing is a rather slow and challenging process.  


As of earlier this week, there have only been 65 diagnosed cases of monkeypox in the US and very few did not know where or when their exposure occurred. And several had simultaneous diagnoses of sexually transmitted diseases (which is often the original reason for the medical visit).  


The more likely diagnosis for someone who may be suspected of having monkeypox is chicken pox or shingles, both of which are far more common. Symptoms include rash, fever, headache, muscle aches, swollen lymph nodes and fatigue. There is a new Q&A in both the ZHH Crisis app document library and the Zedic app’s Knowledge base under the Basics tab.

Do we still need testing to return to the US from abroad?

No. You might have missed it over this past weekend, but the US finally dropped testing requirements for entry into the US (as of midnight this past Sunday evening). With that said, some countries and airlines may have specific requirements, continue to do temperature checks, and ask you to certify you are not ill. Traveling while sick poses a risk for everyone around you, and could lead to your being quarantined very inconveniently while en route.  

Although the travel industry advocated for dropping the testing requirements, not everyone is in favor. Long haul travelers, especially those on flights greater than 12 hours such as flights from Asia, remain wary and some are doing their own testing before seeing family and friends on arrival.

Can I stop isolating even if I’m still testing positive for COVID?

This question is shockingly hard to answer given that we’ve now been living with this virus for over two years. Most people will stop testing positive on rapid tests at some point during the first 5-10 days after their infection. But some people can test positive for a long time after they’re infected, and it’s not always an indicator that they’re infectious. In lab tests, scientists weren’t always able to grow more virus in a culture from patients who were testing antigen positive, meaning they probably weren’t infectious. The CDC’s isolation calculator says that you can stop isolating after five days if your symptoms are improving, but buried deeper on their isolation page, they say that if you choose to test and you test positive “toward the end” of your five days, you should continue isolating until Day 10.

Our best advice is that you should wait at least five days from when your symptoms started, and if you still have symptoms (other than loss of taste or smell, which can linger for a while), you should wait until those have cleared up for about 24 hours before you end your isolation. If you do test positive toward the end of your five days (we define that as Days 3-5), it’s best to continue isolating until Day 10, even if your symptoms have improved.

How long does COVID immunity last?

Great question and unfortunately, the answer is we really don’t know. Before Omicron, experts generally said immunity lasted at least 90 days (and the CDC guidance reflected that). But now, with the newest Omicron sub-variants, which are far more infectious and still evolving, increasing your likelihood of re-exposure, it appears that immunity is much shorter. The length of time between your prior infection and subsequent exposure remains a factor (the longer the time, the more likely you are to be re-infected). You should treat any new symptoms, including a fever, sore throat, runny nose or change in taste or smell, as a potential case of COVID, and get tested to confirm if you are positive again.

Best Read:

Bloomberg:  We're fighting COVID with faulty data

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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.