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The Executive Briefing - Tuesday, October 12th

Will we need to track booster doses?

COVID Recap:

  • More than 26% of new COVID cases in PA, where case counts are rising, are vaccinated. (AP)
  • Former FDA chief Scott Gottlieb thinks we should all be stocking rapid antigen tests in our homes for this winter.  (The Hill)
  • Health authorities in the UK have shared additional guidance for the vaccinated: isolate if you have symptoms, even if you test negative with a PCR test. They reiterate that a rapid positive should be considered a true positive.  (The Guardian)
  • Meanwhile in the UK, unvaccinated pregnant women make up one out of every five critically ill COVID patients. (Washington Post)
  • Merck has applied for an EUA for it’s oral antiviral pill to help treat COVID. (AP)
  • Patients waiting for an organ transplant who refuse to get vaccinated are getting moved down or even bumped off transplant lists across the country. (NBC)
  • Hospitals are bracing for a “twindemic” of flu and COVID this winter, with some worried that easing restrictions will prompt a major flu rebound. (NPR) 
  • Mixing and matching COVID vaccines may be in our future - the CDC will hear about the results of a trial that mixed various combos of the approved vaccines to see how well they did in conjunction. (STAT)
  • Gov. Abbot issued an executive order effectively barring vaccine mandates in TX. It will almost certainly be challenged in court, where judges have a long history of upholding vaccine mandates. (NY Times)
  • The results are clear: vaccine mandates work. Employer mandates and requirements for indoor activities are convincing even the very hesitant to get the shot. (NPR)

Today’s Health News:

  • A significant outbreak of Salmonella (now linked to fish from a Denver-based supplier) led to over 100 illnesses with about 20% requiring hospitalization.  It’s still considered ongoing. The fish was distributed through many large outlets including Safeway and Albertson’s. (CDC)
  • 45 million health workers wrote a letter to the COP26 climate meeting, calling for urgent action on climate change, which is endangering the world’s health. (MedPage Today)
  • Global rates of depression and anxiety soared during the pandemic, by over 25%. (The Lancet)

Best Questions:

Will we need to track booster doses?  Will someone be considered fully vaccinated or not if they’re eligible for a booster dose but haven’t gotten one? 

The reality right now is that we don’t have a good definition from public health officials and scientists about what exactly “fully protected” means, or what levels of antibodies provide protection. For right now, it looks like the CDC and other agencies mandating vaccination will not be considering booster shots when they determine if someone is fully vaccinated, but that’s subject to change as we learn more about the level of protection over time. It’s normal (and expected) that vaccine-provided protection will wane over time, which is why we get a yearly flu vaccine, for example. In the future, you might need to provide proof of your yearly COVID vaccine to prove that you’re fully protected. Given that this is subject to change, we think it’s a smart idea to start gathering info about which of your employees have a booster dose, in case the definition of “fully protected” changes, which can impact work exclusions after exposure, as well as vaccine mandate compliance.

We’re seeing a lot of breakthrough cases.  Is there something we should be doing differently?

We are also seeing a lot of breakthrough cases - 26% of all reported cases in Pennsylvania currently are among vaccinated individuals.  Relaxed precautions including less social distancing and fewer people wearing masks are leading to this high breakthrough rate - along with the incredible infectiousness of the Delta variant.  Make sure that you’re continuing to follow COVID prevention practices like not working sick (no, it’s probably not “just a cold” right now!), daily wellness checks, social distancing, and masking indoors.  These will help reduce risks for both the unvaccinated and the vaccinated.  And, most importantly, make sure you’re doing everything possible to encourage your unvaccinated employees to go get their shots!

A vaccinated employee is caring for her child who is COVID positive.  Does she need to be excluded?

A fully vaccinated employee who has no symptoms doesn’t need to be excluded when caring for a family member, even a child, with COVID.  This is a great reason to get vaccinated!  Without vaccination, it would be a 20 day exclusion starting from the child’s symptom onset. It is incredibly important that this team member wears a mask when working for a full 14 days after their child meets the criteria for ending self isolation - so they might be wearing a mask for a month or more. While the chances of a breakthrough infection are lower, they’re not zero, and wearing a mask drastically reduces the chances of them passing the virus to others. It’s also key that they monitor for  symptoms, even very mild ones, throughout that time, and that they stay home if they have any symptoms at all.

A team member’s sister tested positive and although our team member hasn’t had contact with her sister, she does care for her baby.  Do we need to exclude her?

If it’s true that the team member has had no close contact with their sister, and the baby doesn’t have any symptoms and hasn’t tested positive, the team member can work, regardless of her vaccination status. If the baby (or anyone else the employee has had close contact with) tests positive or develops symptoms, then the employee will likely need to quarantine for 10 days from the most recent contact if unvaccinated. Until then, she can continue to work as long as she’s had no direct contact with anyone sick. It’s not a bad idea to ask this person to wear a mask when working indoors, if they aren’t already, to reduce the risk of transmission if it turns out the baby or other family members are sick. Whether vaccinated or not, she should not work if she develops any symptoms. 

Federal contractor guidelines don’t include a testing option for unvaccinated employees. What's the likelihood that OSHA’s ETS won’t include employee testing?

While the government has the prior precedent confirming its authority to require vaccination mandates for contractors, the same likely isn’t true for private employers who aren’t government contractors.  This is a question we’ll leave for the lawyers but all indications are that weekly testing will be required for non-vaccinated employees. 

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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.