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Zero Hour Health + Zedic Newsletter - Friday July 23rd

Delta variant, breakthrough infections, and new mask guidance on the way?

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In this episode, we’re joined by Roberta Barbieri of Boudin Bakery! Roberta is the Executive Vice President for Human Resources at Boudin. Many of you are familiar with Boudin's San Francisco Sourdough and bread bowls, which they’re making with the same mother dough since 1849, but you may be less familiar with them as a food service industry employer with a very diversified workforce.

Listen anytime on Spotify, Apple Podcasts, Stitcher, or SoundCloud.


  • The Delta variant is one of the most infectious respiratory diseases known, according to the Director of the CDC. It’s 1,000x more infectious than the original virus.  (CNBC)
  • US case counts have tripled over the last two weeks, and will cause a steep rise in deaths. (Medscape, NPR)
  • Public health officials are urging the CDC to change its mask guidance, saying that while the science made sense, the logistics of enforcing different mask policies for vaccinated and unvaccinated people has deadly consequences. New CDC guidance may be on the way in the next few days. (NPR)
  • President Biden is hoping for full vaccine approval by the Fall. Many unvaccinated say full FDA approval would convince them to get the shot, and it would also pave the way for more vaccination mandates. (New York Times)
  • The largest association of hospitals in the US came out in favor of mandated vaccinations for healthcare workers, adding to a growing consensus in the healthcare industry. (MedPage Today)
  • A new study shows that two doses of Pfizer are 88% effective against Delta. That’s still pretty good, but remember that still leaves nearly 40.5 million fully vaccinated people who might get sick - though less so than their unvaccinated counterparts - if exposed. (New England Journal of Medicine)
  • At least 31 children tested positive for COVID at a summer camp in upstate New York. (New York Times)
  • The ACIP, the CDC’s immunization advisory group, urged quick action on a decision regarding booster doses for the immunocompromised.  (NBC)
  • LA County is reporting that 20% of positive COVID cases in June were among vaccinated people, although hospitalizations were rare. That was up from 11% in May and just 5% in April.  (ABC)
  • Health officials from three Bay Area counties in Northern California want employers to require vaccinations for their employees. (MercuryNews)

Today’s Health News

  • An outbreak of vibriosis from WA oysters is linked to their recent heat wave.  (Eater)
  • More than 200 people are being monitored after possible exposure to Monkeypox after a traveler returned from Nigeria while infectious. (StatNews)
  • There’s a large recall of muffins and mini-muffins widely sold through national outlets like Walmart and 7-11 for possible Listeria. (Newsweek)
  • As extreme heat becomes more common, doctors are coming up with novel ways to handle heatstroke, like filling body bags with ice to cool people down. (Kaiser Health News)
  • The first cases of a dangerous new fungus resistant to all drugs have been found in the US, some of them in healthcare facilities. Drug resistant fungi and bacteria are major causes of concern for the next big public health issue we may face. (STAT)

Best Questions

How can we protect ourselves from the Delta variant surge?

Daily wellness checks and masks are two tools you already have in your toolkit to keep employees and guests safe and prevent closures.  Some have discontinued daily wellness checks, and our recommendation is to reinstate them immediately for every employee (even managers and even at your offices). Everyone should complete one every day two to four hours before they report to work, so there’s time to keep them at home if they do show symptoms.

We’re hearing rumors that the CDC may release new recommendations including indoor masking for everyone, regardless of vaccination status. Wearing a mask cuts your risk of getting sick by more than half, so masks are your best protection against actually contracting the virus.

Should we be testing everyone at in-person company events?

We strongly advise that only vaccinated people attend in-person company events, and that you consider pushing any large in-person meetings until October at the earliest.  The Delta variant is spreading very quickly and although it’s more serious for the unvaccinated, it poses a risk for vaccinated folks, too. With that said, implementing a testing plan for in-person company events is critical to managing your risk. We recommend testing both vaccinated and unvaccinated employees before departure and on arrival.You might also want to consider testing before departing (so they don’t go home infecting fellow passengers, their families and then co-workers back at their home locations).

Do people who have tested COVID+ need to be vaccinated?

YES! This is a common question, and our clinical team knows all too well that the answer is a resounding yes. People who have been infected with COVID do have some natural immunity for a period of time in which it’s very unlikely that they will get COVID again - right now, there’s evidence that it’s at least 90 days for most people. But the issue is that natural immunity from COVID infection is much less consistent and less reliable than immunity from the vaccine, which we know works really really well against the virus, even including the Delta variant. Natural immunity is much more of a gamble and may not provide the same level of protection, plus it may wear off sooner than the vaccine’s protection does. There’s good news here: if someone previously had COVID and they get the vaccine, they are much more protected against the virus. They’re most likely not going to get it again, and even if they were in the very small percentage who did, their symptoms would be much more mild. Long story short: natural immunity is a crapshoot and the vaccine is a sure thing.

Should we mandate vaccination for our employees?

Mandating vaccination is a tricky situation. There are clear pros: it's the safest way to operate your business, you don't need to deal with different mask requirements for different employees, and even if someone were to get sick with a breakthrough infection, their illness will be mild and the chances of an outbreak in the workplace are much smaller. Dr. Fauci and other public health officials have been calling for more local vaccination mandates as vaccination rates stall and the Delta variant surges.

The cons tend to be political and legal. Consider how employees and guests will feel about your mandate. As far as legality, the EEOC says that employers can mandate vaccination. Some states have been trying to block employers' ability to mandate shots, and there's a whole slew of local and state legislation to pick through before making any policy decisions, especially if you're operating across county and state lines. There have been a few big wins for employers and universities mandating vaccination over the past few weeks - Indiana University's mandate was upheld just this week. This is a decision that absolutely has to be made with your legal counsel. Here's a good NPR article about employer mandated vaccination.

In general, most of our clients are not mandating vaccines because of the legal and political hurdles that come with it, and are instead focusing on incentivizing employees. But as the Delta variant reminds us that we are not out of the woods - or even close - we do think it's a good time to be considering this option with your legal team.

Best Read

Burning questions about Delta and the next phase of the Covid pandemic

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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.