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The Executive Briefing - Tuesday, September 28th

Wild west COVID tests, and how to return to work quicker?

COVID Recap:

  • It’s not a surprise but unvaccinated people are less worried about COVID than vaccinated people. (Axios)
  • Dr. Rochelle Walensky, the director of the CDC, made it clear that we will not boost our way out of this disease - but we can vaccinate our way out. (CNN)
  • Increasingly, experts believe kids’ vaccines are key to preventing the next surge and getting back to normal. Pfizer data looks good, and they’ll ask for emergency FDA authorization in the next week or so. (Yahoo News)
  • Harvard moved all first year and some second year MBA students back to remote  learning after seeing a growing case count among students and staff.  They’re also expanding testing from 1x to 3x per week since weekly testing didn’t contain outbreaks for them.  (Bloomberg)
  • One lab is still charging $380 for a COVID test.  The wild west marketplace, complex role of insurers, and overall non-regulation is causing consumer headaches. (Yahoo)
  • Vaccine hesitancy is not set in stone. A little over a third of people who said they wouldn’t get the vaccine in late 2020 got vaccinated in 2021, according to a new study (MedPage Today)
  • The average life expectancy of American men fell by 2 years due to COVID, the biggest drop since WWII. (CBS)
  • NY Gov. Hochul is considering calling in the National Guard to replace unvaccinated healthcare workers after they failed to meet Monday’s deadline for mandatory vaccination. But nearly 92% of health workers are now vaxxed after a big rush to meet the deadline.  (Reuters)
  • Incentives for COVID shots won’t apply for boosters in most places. (New York Times)

Today’s Health News

  • Georgetown University continues to battle a lab-confirmed Norovirus outbreak.  More than 100 students and staff have reported symptoms. (WTOP)
  • There are now 10 cases of Hep A associated with a single ill restaurant employee in Roanoke,VA and the case count continues to rise. The local DOH is recommending vaccination for diners. (WAVY)
  • Valley fever cases continue to rise in the Southwest - a concern for any employer with teams who work outdoors, Valley Fever symptoms can be confusing while COVID continues to circulate. (Newsweek)
  • More than six million diabetes tests (mostly A1C tests) were missed in just six months of 2020 during the pandemic. (MedScape)
  • Melioidosis is a bacterial disease that kills up to 90k people per year worldwide. The CDC found a few US cases over the past few years, and is keeping a close eye on imported aquarium fish and other sources.

Best Questions:

Different clients are requesting different types and frequency of COVID tests for our employees who support them. Are others seeing this and how are they handling it?

Short answer: Yes. All across the board, our clients are having issues tracking the various testing requirements from cities, counties, clients, vendors, and soon federal OSHA. One idea is to appoint regional managers to act as testing coordinators, keeping track of their various testing needs and managing the communications and implementation of those programs. Others are focusing most of their effort on a vaccination push, in an effort to bypass testing requirements altogether.

Why does the ZHH clinical team routinely ask for a negative PCR test and a doctors’ note to return someone to work who was symptomatic?

It’s risky to return someone to work sooner than 10 days if they had COVID-like symptoms that met the criteria for a 10-day work exclusion. You can’t rely on someone's symptoms resolving to return them early, because some people who test positive for COVID and are spreading the virus have mild symptoms that resolve relatively quickly. They might still be infectious with COVID, even though they feel better. You also can’t return someone early based on testing alone, because COVID tests - even the more accurate PCR tests - still have a relatively high rate of false negatives. The rate of false negatives changes based on what day you’re tested, but some studies put it at about 10% overall.

To account for this but still allow for the fact that there will still be cases of strep throat, flu, or other non-COVID illness with similar symptoms, we require both a negative PCR test and a doctor’s note to allow someone to get back to work before their 10 days is up. In all cases, we also require that their symptoms have improved before they can return.

Why do we still keep someone who was exposed  (but not vaccinated) out of work for so long if they don’t have symptoms?  

It can take up to 10 or even 14 days for symptoms to show up with COVID, which means someone could get sick at any point during that time after they’re exposed. They might test negative on Day 4 but could still get sick on Day 7 or 9 for example. To make sure they're not accidentally spreading it to anyone else, they must be excluded from work for the entire 10 days from your last exposure, and monitor for symptoms for a full 14 days.

Are there alternatives to uploading vaccine cards for people who are hesitant to share them?

We’ll need to see the final rules associated with OSHA’s ETS, but several clients are allowing an employee to show their card to a manager who signs an attestation that they personally saw the card and reviewed the information. They then upload the attestation in place of uploading the card.  

Best Read:

Am I Fully Vaccinated If I Don't Get a Booster Shot?

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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.