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The Executive Briefing - Tuesday, March 15

Sewage tests point to ⬆️ cases in US, following Europe and China

COVID Recap:

  • The outbreak in mainland China continues to grow with major cities in lockdown. The surge is worrisome given China’s 90% vaccination rate. (NY Times)
  • The FDA has recalled ACON FloFlex Rapid Antigen Tests which were never approved for sale in the US. (FDA)
  • The CEO of Pfizer says that there is no question a fourth dose will be needed, to contain spread and reduce hospitalizations. (The Hill)
  • Meanwhile, the CEO of Moderna says that a fourth dose is probably only needed for those who are immunocompromised. (Axios)
  • The Queen is skipping her first big event after COVID, with British case rates up 40% from two weeks ago. (NY Times)
  • Sewage is showing COVID rising in many cities across the US, a potential warning sign that we’re about to see a rise in cases. (Bloomberg)
  • 99% of close contacts of Omicron-infected patients in a South Korean study who got sick were diagnosed by Day 10, with the average time to diagnosis of 3.7 days, supporting the idea of a 10-day quarantine. (CIDRAP)
  • Severe COVID cases are linked to later depression and anxiety. (USA Today)
  • A quarter of US kids who had symptomatic COVID infections suffered from long COVID. (MedRxiv)

Today’s Health News

  • At ZHH, we’re continuing to see widespread Noro from coast to coast, although some concentration in the Midwest - particularly MN and KS.
  • We’re also seeing some minor scattered Shigella cases, none yet classified as outbreaks.
  • Australian officials have approved a new combination of medications to effectively cure malaria, one of the deadliest diseases. In 2019 alone, there were 229 million new cases and 558,000 deaths (and more in 2020).   (NY Times)
  • In an unexpected effect of the pandemic, nearly 720,000 cases of Dengue fever were prevented in 2020 alone with stay- at-home orders that stopped mosquito bites in Latin America and Southeast Asia. (NY Times)

Best Questions:

If I’ve had Omicron, can I get BA.2?

We don’t fully know.  If you were vaccinated and caught Omicron, odds are pretty good you still have some protection against this new variant.  But the reality is we just don’t know enough about this variant or immunity to know how protected you are, or how long that immunity will last.  A study published this week showed reinfection occurring, but at relatively low rates.  The greater concern is variants that might come later.  BA.2 itself, although 1.5x as transmissible as Omicron (which itself is much more transmissible than Delta), doesn’t appear to be much more severe, luckily.

Should we be alarmed by the new reports from China and Europe?

An increasing number of  experts believe the next surge has started and that we’re next. Previously, COVID has followed a similar pattern - spiking in Asia and Europe before the US. So there’s definitely reason to believe we may see another surge come soon. There’s some chance that the fact that nearly 45% of the entire United States population caught Omicron can help provide some immunity for us, but we’re also vaccinated at a much lower rate than China or Europe where we’re seeing cases spike now. 90% of people in China are fully vaccinated, and 93% of Brits have had at least one dose - we’re closer to 76% with at least one dose. All in all, we are preparing for another surge based on these numbers, even while we hope it doesn’t happen.

Why were flu shots less effective this year and why should I get one next year anyway?

This year’s flu vaccine isn’t a perfect match against the dominant strain circulating this season.  Although this season’s shot does include a version of the main strain that’s circulating this year, it’s picked up some mutations (sound familiar?), leading to a slight vaccine mismatch.  But experts tell us that even a less- than-perfect flu shot gives us protection against severe illness from the flu, and prevents hospitalizations and deaths (you know this drill).

The WHO selects the strains to be included almost a full year ahead of the flu season, and it’s a high-stakes guessing game based on what’s circulating that year in other parts of the world. Flu shots have improved over time - now generally covering four different strains compared to three in previous years.  One theory about this year’s mismatch, according to Dr. William Schaffner of NFID and Vanderbilt University, says that we have less natural immunity to flu this year because of our lack of exposure to it last year during lockdown. Even in a year with a not-so-great match, the flu shot prevents people from getting very sick and dying of the flu, so everyone should get a flu shot to stay safe, keep their workplaces open, and protect their families and communities.

Best Read:

McKinsey - COVID 19:  Where We've Been and Where We're Going

Best Laugh:

'Think of Groundhogs': For Life Advice From a Grade Schooler, Press 2 - The New York Times

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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.