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Zero Hour Health + Zedic Newsletter - Friday, July 9th

The Delta variant transmits in seconds - do we need to change the definition of close contact?

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  • The Delta variant is officially the dominant strain in the U.S., making up more than half of all cases right now. (CNN)
  • And the Delta variant doesn’t just spread more easily - it actually grows more quickly inside of you. Infected people had about 1000x more copies of the virus in their respiratory tracts than those with the original version. (NPR)
  • Pfizer says it’s time for a booster shot, but the CDC and FDA say it’s not needed yet - and that it’s not up to the companies alone to decide when those are needed. Ongoing studies, including many that aren’t run by the drug companies, are looking at whether protection is waning, and when a booster might be necessary. (CNN)
  • The Minneapolis Federal Reserve announced it was ending remote work and mandating vaccinations for all employees in order to return to the office.  Their letter explaining it to employees is getting a lot of attention. (Minn Fed)
  • The Olympics won’t have spectators this year, as Japan announced a state of emergency this week due to rising COVID cases. (CNN)
  • Arkansas, Missouri, Wyoming and other places where vaccination rates are low could be the breeding grounds for the next COVID variants after Delta. (CNN)
  • Studies show that patients want COVID shots from their primary care doctors, who are trusted sources. (MedPage Today)
  • Sydney, Australia is warning that an extended lockdown may be coming to control a new surge of the Delta variant there. (Reuters)
  • A new report estimates that vaccinations in the U.S. saved at least 279,000 lives from COVID, and over 1.25 million Americans from hospitalization. (Commonwealth Fund)

Today’s Health News

  • Experts continue to warn that this year’s flu season could be huge. If you haven’t read our blog post about it, check it out here. (CNBC)
  • Moderna started a clinical trial of an mRNA flu vaccine, the first step towards using the super effective mRNA method for a better flu shot. (The Verge)
  • HIV prevention clinics will struggle after drugmaker Gilead announced it will end its free antiretroviral program for uninsured people. (NBC)
  • Dollar General may be getting into the healthcare game - they hired a Chief Medical Officer. (CNBC)
  • The Tyson's pre-cooked chicken recall has expanded and now includes things like chicken salads at Circle K stores and pizza toppings from Jet’s Pizza, Little Caesars just to name a few.  (CDC)

Best Questions:

I’ve heard the Delta variant can spread in just 5 minutes. Should we change the definition of “close contact” exposures?

There is some very scary news coming out of Australia this week about how easily transmissible the Delta variant is. We already knew that it infects more people, on average, than the original coronavirus strain, but these new reports show that even fleeting encounters can lead to transmission. One particular case shows that someone was infected during her time at a quarantine hotel - where she was specifically confined to her room and only opened the door to the hallway to receive food. They believe the transmission was due to a sick person opening their door to the same hallway - but never touching or even being within 6ft of anyone else. And there’s another scary case from Australia where CCTV showed two people walking past each other in a train station. Experts believe the incredibly brief passing encounter shows when the virus was passed from one to the other. According to an interview with the Guardian, Queensland’s chief health officer, Dr. Jeannette Young, said that she thinks the transmission window for the Delta variant is shorter even than five minutes -  just five or ten seconds.

The CDC hasn’t yet updated its guidelines for defining close contact. So much of this is hard to measure, in part because tracking down the genetic trail of the virus is challenging and time consuming, and in part because there are so many places a person can be exposed. These examples are just a few, but they’re notable because they’re easy to pinpoint that the transmission happened in such quick encounters.  All in all, we think it’s safe to keep using 15 minutes as a good measure for now, but we’ll be keeping a close eye on it as we get more data about the spread of the Delta variant.

If an employee has been exposed at work, can we take their word for it that they've been vaccinated if they haven't shown us their card?

This might be one to confirm with your legal team, but we don’t recommend it. If they aren’t willing to show a photo of their vaccination card to avoid a 10-day quarantine, we’re concerned that they might not be vaccinated in the first place. Ultimately, this is a policy decision for your team that will require HR and legal counsel, but our gut says that truly vaccinated people will be willing to prove it if they were exposed to someone COVID+ at work (or anywhere else, for that matter).

If someone tells us they tested positive but can't produce the result, do we need to do a contact investigation and exclude coworkers?

This was more common at the beginning of COVID, when results were often relayed by phone and written results took a few more days. But it’s much, much less common now that pharmacies, doctors’ offices, and hospitals have had a year and a half to streamline their processes. We would recommend that the person’s manager ask them where and when they got tested, and then coach the employee through calling that site to get a copy of the results. To really put the pressure on, the manager can even call the clinic and ask how they share positive COVID results. If they say that they share them via email or online, you’ll know that the employee may not be telling the full truth. While the clinic won’t share another person’s results with anyone but them, most will confirm the method by which they share results in general.

Who should know an employee’s vaccination status?

Employers should tread carefully with employee vaccination status, as the EEOC has said that it’s considered confidential medical information and therefore should only be shared if there’s a specific need to know. But the CDC’s mask guidance has different guidelines for vaccinated and unvaccinated people, so there’s a reasonable need for supervisors to know their employees’ vaccination status in order to enforce mask rules, or to determine if employees need to stay out of work if they were exposed to COVID. Employees shouldn’t be asked why they aren’t vaccinated, because you don’t want to get into tricky legal situations around disability status.

Some employers are considering badges or bracelets to indicate vaccination status, but the Society for HR Management (SHRM) recommends that you avoid directly identifying who is vaccinated and who isn’t in a public way for other employees to see. Instead, one Cincinnati lawyer they spoke with, Patricia Pryor,  suggested that companies could use badges to indicate who may go mask-free, which would include fully vaccinated employees and also anyone who has been provided a reasonable accommodation allowing that, for example. Most are going for a more measured approach, setting clear company policies around masks and vaccination status and requiring employees to sign that they agree to those rules and risk consequences up to and including termination if they break them.

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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.