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The Executive Briefing - Tuesday, March 7th

Noro hotspots in the Midwest and South


  • COVID levels are remaining steady, with 82% of counties in the US at “low” community transmission levels. (SF Chronicle)
  • 1 in 4 parents lied about their kids’ COVID status, most often by not telling someone who would be spending time with their child that they suspected or knew they had COVID. (CIDRAP)
  • Five residents of a Cape Cod nursing home died after a COVID outbreak caused 90+ cases there. (Boston Globe)
  • Long COVID patients are more likely to have GI problems in the year after infection than those who didn’t get the virus. (NY Times)
  • Arkansas Tyson workers are suing over a lack of COVID protections in the early months of the pandemic. (AP)
  • COVID was the leading cause of line-of-duty death for US police officers for the third year in a row. (The Guardian)
  • The state of Washington is resuming free telehealth appointments for COVID. (Seattle Times)

Public Health News:

  • The rate of positive norovirus tests has exceeded last year’s peak, with about 17% positive last week and hotspots in the Midwest and South. (NBC)
  • While norovirus on cruise ships has been reduced through excellent operating practices and state-of-art sanitizing, there have been at least two large cruise ship outbreaks this year. (Cruise Law News)
  • The US is considering vaccinating chickens as the worst bird flu in US history continues to kill millions of them, driving up egg prices and raising concerns about spillover to humans (though the risk is still low). (NY Times)
  • A new mRNA vaccine for HPV-related cancers may work for the many millions of Americans who were infected with the common virus before getting the (very effective) HPV vaccine. (STAT)
  • A promising mRNA vaccine may finally help prevent TB. (NPR)
  • Legionnaires’ disease was found in two people who had stayed in a hotel off the Las Vegas strip in December and January. (AP)
  • Florida residents were warned against using tap water for washing their face or sinus rinses after a man died of the brain-eating amoeba Naegleria fowleri. (Fox)
  • The CDC has warned travelers of a chikungunya outbreak in Paraguay. The disease is spread by mosquitoes. (CIDRAP)
  • Less than half of Americans have a “great deal of trust in the CDC” or their local health departments. A perception of political influence and too many conflicting recommendations were cited as reasons for lower levels of trust. (Health Affairs)
  • Walgreens won’t sell abortion pills in 21 states where the attorneys general threatened legal action against them. California has cut business ties with the pharmacy chain in retaliation. (LA Times)
  • “Sushi terrorism” is forcing conveyor-belt sushi restaurants in Japan to take action after viral videos showed people licking communal bottles and touching passing food. (The Guardian)

Mental Health News:

  • The DEA’s new rules on prescribing controlled substances to treat substance abuse are causing confusion and consternation for behavioral health professionals. (Axios)
  • Jamaica has moved away from institutionalization and instead focuses on community and home-based care for mental health, though funding challenges remain. (The Guardian)

If you or someone you know may be considering suicide, call 988 or message the Crisis Text Line by texting HOME to 741741.

Best Questions:

How can you tell the difference between norovirus and other stomach bugs?

Most stomach bugs are characterized by vomiting and diarrhea, sometimes with stomach pain, fever, and body aches, so it’s hard to tell what kind of illness you have based on symptoms alone. But norovirus tends to have a rapid onset and short duration - typically lasting 1-3 days max. Other stomach bugs last longer - rotavirus lasts up to 8 days for example. More so than other viruses, noro is incredibly contagious and is often associated with community outbreaks in nursing homes, schools, cruise ships, and restaurants.

Can Narcan hurt someone if they’re not actually overdosing?

No, naloxone (brand name Narcan) will not harm someone who doesn’t have opioids in their system. In fact, it has no effect on them at all. It works in the brain only, binding to opioid receptors and blocking the effects of opioids. If someone is having some other kind of medical emergency, giving them naloxone won’t hurt them. Narcan usually starts working in 2 to 3 minutes. If someone does have opioids in their system and has been using regularly, they may start having sudden withdrawal symptoms, but that’s a sign that the medicine is working to reverse the effects of the overdose. Be sure to call 911 immediately after administering naloxone.

Should rapid COVID test results still be reported? How?

While there’s no requirement for individuals to report their own rapid test results, there is a way for anyone to report their at-home tests to the National Institutes of Health at https://makemytestcount.org/. The vast majority of COVID tests taken now are at-home rapid tests instead of PCR, which means that most aren’t being reported back to the health authorities. That means that cases are woefully under-counted, which makes understanding what’s going on with the virus harder for public health experts. In a perfect world, we’d love for people to take a few minutes to anonymously report their tests (both positive and negative) to help get better data on what’s really going on out there, but we know that short of some incentive, that’s unlikely to happen in any meaningful numbers. Certainly, if you’re so motivated, we encourage you to report your own test results.

What is TB? What should we do if an employee has it?

Tuberculosis, or TB, is a bacterial infection that primarily affects the lungs. It’s spread from person to person through the air when someone with active TB coughs, sneezes, or talks. TB can be life-threatening if left untreated and symptoms include coughing (including coughing up blood), chest pain, fatigue, and fever. TB can be treated with antibiotics, but treatment can take several months and it’s crucial to stick to the medication schedule to avoid developing drug-resistant TB. It’s important if an employee says they have TB to verify that it’s active. It’s very common to be reactive on a TB skin test, which doesn’t necessarily mean they have active TB, only that they’ve been exposed or had the BCG vaccine in another country as a child (it’s not offered in the US). Be sure to check for a true positive for active TB before taking any action. If it’s confirmed, send the employee home and require a doctor’s note to return once treatment is complete. Sanitize all surfaces and prepare for a health inspection. Depending on your local reporting guidelines, you may need to report, though in most places the lab or doctor’s office that did the test will report it to the health department.

Best Read:

What is Shigella, the increasingly drug-resistant bacteria the CDC is warning about? | 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.