Health News:

• While no changes have yet been made, sources in the CDC say they plan to drop the current five-day COVID isolation guidelines in the future, opting instead for looser guidance similar to California and Oregon. (Washington Post)
• An elderly Alaska man is the first known death from Alaskapox. The virus related to smallpox and mpox was first found in 2015 and there have only been 6 confirmed cases in humans. (Alaska Dept. of Health)
• The Listeria recall list has expanded to include more salad dressings, salads, and taco kits. (FDA)
• A stronger species of bedbugs is heading north of the equator and may make the growing bedbug problems in the US even worse. (Atlantic)
• Even mild flu doubles the risk of heart attack and stroke in older patients. (CIDRAP)
• CDC is tracking a new variant, BA.2.87 from South Africa that has over 30 mutations on the spike protein, but only 9 cases so far. (CDC)
• The Minnesota Dept. of Health confirmed a measles case in the Twin Cities metro area. (CBS)
• The Grand Rapids, MN municipal water supply is the source of an ongoing Legionnaires’ disease outbreak, with 14 cases since last April. (CBS)
• Oregon has its first human plague case in 8 years, likely from a pet cat. (NBC)
• The fourth bird flu case in Cambodia this year was diagnosed in the brother of a 9-year-old who died of the virus last week. (AP)
• The Ebola vaccine can reduce risk of death even in people who are already infected, a new study shows. (STAT)

Mental Health & Substance Use News:

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• More than half of mental health appointments are virtual, even after the pandemic. (Washington Post)
• Harvard public health researchers are working with social media influencers to help them present better information to their audiences. (NPR)
• The cost of mental health care is increasingly out of reach for many. (Colorado Sun)

If you or someone you know may be considering suicide or need help, call 988 or message the Crisis Text Line by texting HOME to 741741. 

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Best Questions:

What’s happening with the CDC’s COVID isolation guidance?

It’s not yet official, but internal discussions at the CDC indicate that new guidance in the next few months will replace the current 5-day recommendation for those with COVID symptoms or a positive test. The new guidance will recommend that people who test positive use a symptoms-based approach to ending isolation. Once someone is fever-free without fever-reducing medications for 24 hours and their symptoms are “mild and improving,” they can return to work or school. This brings COVID guidance more in line with current symptoms-based recommendations for flu and RSV. Based on some internal memos, these may be announced by or before April. There are already strong reactions from some in the public health field that may influence the final recommendations, and we expect more information about OSHA implications before these go into effect, so changes aren’t imminent.  

Source: Washington Post

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Why is the CDC considering these changes now? Has anything changed about the virus? 

Nothing has changed about the virus that causes COVID or how it’s transmitted. COVID is still dangerous and more deadly than the flu. 2300 Americans per week are still dying from it. What has changed is that vaccines and treatments are available (though uptake is still low), and hospitalizations are down from the peak of COVID (though 20,000 people per week are still hospitalized). CDC is making these changes in part to try to create guidelines that people will actually follow and to relieve some of the burden for workers without sick leave or child care for sick kids. This is more about human behaviors than about any changes to viral transmission.

Sources: Washington Post, CDC

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If we were to use California or the CDC’s upcoming new guidelines, how would we determine when someone can come back to work? 

Under these new guidelines, a positive COVID test wouldn’t necessarily exclude someone for a specific number of days. Instead, they would stay out until their symptoms were “mild and improving,” a subjective measure that will be hard for employers and workers to identify. Certainly, they’re out for at least two days if they have a fever since they must be a full 24-hours fever-free without fever-reducing meds, but beyond that, the new guidance is hard for employers to enforce. We expect that there will be more short work exclusions for two or three days and lots of extensions. The plus side is that more employees, especially asymptomatic positive ones or those with very mild symptoms, will miss fewer work days. The downside is that it will be harder for managers to predict how long an employee will be out to cover their scheduled shifts, there’s a higher risk for workplace outbreaks, and there are concerns around how colleagues and customers may feel if they find out an employee is working with COVID. 

Sources: ZHH, Washington Post, CDC

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Won’t people working while COVID+ create workplace outbreaks?

COVID is still very infectious, and allowing people to work while COVID positive will almost certainly lead to additional viral transmission, though just how much is unknown. Oregon, which enacted similar rules in May, says it hasn’t seen significant increases in transmission. Those in favor of these relaxed rules point out that COVID transmission is already happening, and the goal is to create rules that people will actually follow. OSHA workplace transmission guidance may be subject to change since it refers back to the CDC’s COVID isolation recommendations, though how and when remain unclear. 

Sources: ZHH, Washington Post, CDC

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Best Read:

People are confused about when to take sick days, especially now that many are back to the office but worried about layoffs:

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Sick days ushered into confusing new era - Axios

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