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The Executive Briefing - Tuesday, November 29th

Will there be a post-Thanksgiving surge? It’s a waiting game


  • COVID is no longer mainly a pandemic of the unvaccinated, with 58% of those who died in August at least initially vaccinated. As protection wanes over time, this is expected to rise. Experts urge updated boosters. (Washington Post)
  • 9 out of 10 US COVID deaths are in those 65 and older. (Washington Post)
  • Omicron started surging one year ago at this time, and its sub-variants have continued to reign supreme among mutated versions of the virus. (NY Times)
  • Only about 1 in 20 people have managed to dodge COVID entirely, at least so far. (Mercury News)
  • BQ.1 and BQ1.1 now make up nearly 60% of new infections nationwide and are more likely to resist antibody treatments used by immunocompromised people. (CNBC)
  • Those with severe long COVID have turned to unproven treatments in an effort to find any relief. (Washington Post)

Public Health & MPX News:

  • RSV cases are at a critical point, and experts hope they’ve peaked, but won’t know until a bit more time has passed since last week’s holiday. (Axios)
  • Flu hospitalizations are up 30% from last week. (CNBC)
  • Nearly 40 million children are dangerously susceptible to the growing measles threat after vaccinations have declined sharply and cases are rising. (CDC)
  • Scientists are working on a universal mRNA flu vaccine that would work against all known strains. (Science)
  • The FDA warned against serving or eating raw oysters from Dai One foods which may be contaminated with sapovirus. Symptoms are similar to those of norovirus. (FDA)
  • Houston has lifted the boil water notice that it issued over the weekend after a power outage affected water pressure. (Houston Chronicle)
  • Polio is back in Indonesia and a nationwide vaccination campaign is up and running. (AP)
  • The WHO will phase in the name Mpox (we’ve used MPX and Mpox here at ZHH for a few months now) to reduce stigma. (STAT)

Mental Health News:

  • Poor countries are developing a new paradigm for mental health care through community-based care, and the US is taking notes. (Vox)
  • Amid an ongoing Adderall shortage, people with ADHD may face withdrawal. (NY Times)

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:

Are there at-home flu tests?

Believe it or not, they’re not available in the US, even though the technology for a rapid antigen test exists, and they’re just like at-home COVID tests. At-home COVID tests were authorized for emergency use because of the pandemic, but traditionally the FDA has been very slow to approve at-home tests of any kind, for fear that people will inaccurately administer or interpret the results, according to reporting by Brittany Trang of STAT. But COVID tests have changed a lot of that with scanned barcodes, digital results, and telehealth proctored tests. Still, insurance only covers at-home COVID tests because there’s a public health emergency underway, and when that ends, they won’t be covered, which is how it works for flu tests right now. So, in order to get useful at-home flu tests - which would help with diagnosis and correctly prescribing life-saving antivirals - we’ll need some policy changes both in how the FDA approves tests and how insurance covers them.

Can you get RSV twice?

You can certainly get RSV more than once, and in fact, many people will get it repeatedly throughout their lifetime. It’s even possible to get RSV more than once per season, though most will have a period of protection right after being sick. There are two different main strains of RSV in circulation (just like the flu), which increases the chances of reinfection with whichever strain they didn’t have. As early as next year, an mRNA RSV vaccine may be available which should help reduce the circulation of the virus, but until then, taking the same precautions as you would for COVID and washing your hands well can help reduce your risk.

I have rebound COVID. Do I need to isolate again?

Unfortunately, yes. If you have COVID rebound, you may be infectious and should restart your five-day isolation again. You should wait until your symptoms are improving or until Day 5 (again) before you end your isolation to ensure you’re not spreading the virus to others.

What can we do to minimize the risk of a Listeria outbreak?

With at least two Listeria outbreaks recently that were linked to deli meats, deli cheese, and soft cheeses, businesses can take some extra precautions to reduce the risk of a Listeria outbreak. First, make sure fridges are at the correct cold-holding temp and properly cleaned without spills. Separate raw and prepared foods, and be sure to store raw foods properly according to the food code. Fix any cracked tools, tiles, or areas with standing water. If you have deli slicers, be sure they’re regularly cleaned and in good repair, as they’re often involved in Listeria outbreaks. Be sure you have clear, approved sources for any food suppliers and sources. And, of course, a solid sick call program can quickly identify possible foodborne illness outbreaks before they’re out of control.

Best Read:

Will America continue to turn away from vaccines?

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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.