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The Executive Briefing - Tuesday, March 22

‘Stealth’ variant now dominant, plus a rise in TB

COVID Recap:

  • BA.2 is already the world’s dominant form of coronavirus, making up a majority of new cases. (Washington Post)
  • Dr. Fauci believes that cases are likely to rise again, but won’t lead to a full-blown surge that requires restrictions to be reinstated. (Bloomberg)
  • The UK has seen a 20% rise in hospitalizations this week, which is concerning for the US, since in the past we’ve followed the UK’s COVID patterns a few weeks later. (Independent)
  • The latest data shows Omicron is contagious for an average of six days (longer than the  CDC’s current five day guidance).  (Medscape)
  • An FDA committee will meet soon to discuss the future of booster shots, including whether variant-specific vaccines will be needed. (FDA)
  • The UK is offering second booster shots to high-risk people including everyone over 75 and those who are immunocompromised. (The Guardian)
  • About 25% of eligible adults are still unvaccinated, with new shots stalled and booster uptake even worse, with around two thirds of eligible adults still not boosted. (CDC)
  • COVID infection can trigger Type 2 diabetes - a large study found that those infected in the past year were a whopping 40% more likely to get a new diabetes diagnosis.  (Wall Street Journal)
  • Getting COVID while you’re pregnant doubles your chance of having severe complications during pregnancy. Meanwhile, getting vaccinated is safe and can even pass protection on to your baby! (ABC)
  • Taking two serial COVID tests caught 94% of COVID cases in asymptomatic NYC workers. (CIDRAP)
  • One WHO official says that COVID cases are rising in Europe because they eased restrictions too soon. (NY Times)

Today’s Health News:

  • GI illnesses were cut in half during the first six months of COVID, according to a recent study from the British Medical Journal - and may have been directly related to increased handwashing. (BMJ)
  • Climate change is extending the allergy season - arriving earlier and lasting longer. (The Atlantic)
  • Another major food recall due to nonedible material in the package, this time Great Value Pancake & Waffle mix sold at Walmart. (NPR)

Best Questions:

Are your other clients also seeing a major uptick in reports of guest illness and guest complaints?

Yes. Clients are reporting complaints up by 50% or more in the past month. While some reports of illness align with community or businesses associated with higher Noro activity, most don’t. There are a lot of single illness reports or single large parties where one of the guests may have arrived already ill and passed it on. Across our client base, without any specific geographic focus, there is much more complaint activity than there has been in the last two years. We will continue to monitor this and report trends.

Why is BA.2 called the “stealth” variant?

Its genetic mutations make it hard to distinguish from the Delta variant using PCR tests, compared to the original version of Omicron, which was very easy to test for because of certain genetic markers. BA.2 does seem more transmissible than the original BA.1 Omicron variant, and it already accounts for a large percentage of new infections in the US. The talk of it being stealth really just implies that it’s a bit harder to identify through variant testing. Considering it’s already making up nearly three quarters of new cases globally, we’d hardly call it stealth at this point.

Why would someone test negative several times on a COVID test before testing positive?

This is unfortunately quite common, and there are a few reasons someone might test negative even though they’re actually sick with COVID. First, they might take the test too soon after exposure. It can take a few days after close contact to build enough viral load to test positive. Some people just have low viral load or take longer to build up to a detectable level. Sometimes it’s a collection issue, where the sample just didn’t get enough of the virus because of how it was swabbed. Even the very best PCR tests (which are the gold-standard for COVID testing) still just miss some positive tests, and rapid antigen tests have an even higher false negative rate. For rapid antigen tests, taking two tests 24 hours apart does catch many more cases - up to 94%

We went two years without a TB case and now we have a few at different locations.  Did it just go undetected during that time?

Likely, the answer is yes - it went undetected (or misdiagnosed). Masks, social distancing, daily wellness checks and better ventilation did reduce some transmission of TB.  However, the WHO believes that a larger number of TB deaths occurred during the first year of the pandemic, in particular, as TB went both undiagnosed and untreated.  According to their data, an estimated 10 million people developed TB in 2021 but only 5.8 million were treated.  TB’s impact on the workplace has increased over the last decade and we expect it will continue to be one of the more difficult workplace health situations to manage.

Best Read:

The 1918 pandemic mistake that changed medicine forever - National Geographic

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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.