COVID-19 Briefing - 10/2

Today’s Recap:

• There was chaos in Florida after Gov. DeSantis lifted all restrictions, and then certain cities and counties scrambled to add restrictions back on top of the state guidelines, though they had to justify those to the state. 
• A huge contact tracing study in India shows us that children do spread COVID, and that a small number of people (5%) are responsible for most of the spread (80%) while lots of people don't spread it to anyone at all. It’s unclear whether this has to do with viral load or behavior while infectious, or other factors. 
• Companies trying to develop at-home tests have abandoned trying to use saliva due to unreliability. Instead, they’re turning to nasal swabs. A shame, because saliva-based at-home testing would have been the easiest way to get regular, low-cost testing at home. 
• Split pool testing is a viable way to test large groups of people, like schools and offices more efficiently. The idea is that a group of people’s samples are combined and tested together. If it tests negative twice, we can be fairly sure that no one in that group is COVID+. If it’s positive, it’s split in half and then in half again until the specific positive sample(s) are identified. It’s much more efficient than testing individual samples. 
• Fatigue is shaping up to be one of the most common symptoms of COVID, regardless of the severity of illness 
• And 9 in 10 recovered COVID patients face ongoing symptoms.
• Disregard everything you’ve heard about how a mild flu season is expected because it was nearly non-existent in the Southern hemisphere.  “That’s like comparing apples to oranges,” according to Dr. LJ Tan of Immunize.org.  In Australia, 80% of the population gets a flu shot, they were under a “stay-at-home” order during most of the flu season, and also strictly adhere to mask requirements. Those same preventive measures just aren’t happening here. 
• COVID-19 is a cousin to the common cold, also a coronavirus. Researchers looked at 35 years of data on four seasonal coronaviruses and found that generally immunity lasts 12 months or less. 
• And in other news you’ve already heard already today, the President and First Lady have tested positive for COVID, as have various others in the White House and Congress. To quote someone we heard on MSNBC, “if the White House was a restaurant, it would be shut down right now.”

Best Questions:

My managers don’t want to encourage flu shots because they’re worried that side effects could result in more exclusions (and ten day ones!)?  How do we address that?

Flu shots’ side effects are nearly non-existent these days. Only 1-2% of people who get a flu shot get a low grade fever (1-2%) and it's almost always low-grade so usually wouldn’t result in their exclusion. The leading theory is that building the antibodies (the whole point of the flu shot) causes some very low-grade fever or body aches. And believe it or not - in major studies where some participants got real flu shots and others got saltwater shots, the same 1-2% got a fever afterward.

The majority of people have absolutely no side effects.  And for those who do, it’s extremely mild and lasts only hours and relieved by taking 2 Tylenol a single time.   Preventing the flu is far more important this year.  Years and years ago, flu shots were made with live vaccine which did cause a mild case of a flu. That is no longer the case.

If someone has body aches and/or a fever after a flu shot, do we need to exclude them from work for 10 days?  

No, probably not. If someone has these symptoms after a flu shot, we recommend keeping them out for 3 days. That’s enough time for their symptoms to subside if they are just an immune reaction to building antibodies for the flu, or to get sicker if they actually just have another illness. If they develop other symptoms or don’t improve, we’d extend to a 10-day exclusion likely. If they feel better, they can return to work after just 3 days. 

My Ops team is really panicked about flu season and additional 10 and 14 days exclusions for flu symptoms and exposure to those who have flu symptoms.  Any guidance on how to reassure them?

It’s true that flu season will mean that more people are sick, unfortunately. The good news is that flu testing and COVID testing are pretty widely available, so that when someone is sick, we’re able to find out pretty quickly if it’s flu, and then return them earlier than COVID unless they have specific close contact with a COVID positive person, or are in an area with rising COVID case counts. The most important thing here is to remember that keeping folks out until we know they are not infectious, while painful in the short term, is still so much better than the alternative of widespread infection. You don’t want your whole team getting sick at the same time. 

And of course - encourage them to get flu shots! The best way to prevent widespread flu transmission is for most of the team to get a flu shot. 

We’re seeing more health departments following varying guidance when we have a COVID positive.  Some say close for cleaning, close for 14 days, or test everyone.  And NM defines close contact as 3+ minutes.  Can we successfully push back when they are requiring practices that are so different from the CDC recommendations or their own state’s guidance?

The answer is definitely yes.  We’ve worked with many of you to “educate” local health departments, advocate for the best practices you’re already following, and point out that their request differs from their own previous requests or from neighboring counties or their own state DOH. 

Some simple advice:  Be polite. Do good contact tracing and exclusions BEFORE you call them. Make sure you’ve done everything you’ve said you’ve done (cleaning, exclusions, talking points). And if someone has an existing good relationship with them, have that person be your primary communicator.  The local DOH who knows the operator in their small town prefers to talk to them over someone from Corporate 3,000 miles away.  If you’re talking to their epidemiologist, we can help too. 

We’re a restaurant open for indoor dining, but guests don’t always put their masks on when servers come to the table. Can we ask them to?

We can’t give you legal advice and this is a great question for your counsel. But we do know that guests and employees have welcomed direction on this topic. And that employees do truly appreciate when your guests mask up. This might be a good thing for the manager to help with, especially since we know that it can be intimidating for servers, bussers, or hosts to have to confront patrons.

Does the person taking guest temperatures need PPE other than a mask? 

This depends on your local and state guidelines. In New York, a mask is the minimum required PPE for someone screening guests or employers for temperature checks. We also recommend gloves. If you have access to it, a face shield may provide additional protection, but is not required in most areas.  Regardless, they should be equipped with cleaning and sanitizing products to wipe down their screen and thermometer between each new use. 

Best Read:

There are people alive today who lived through the last global pandemic. This fascinating read compares what we’re seeing today to the 1918 Spanish Flu pandemic.

Coronavirus: Medical historian compares today's outbreak to the 1918 flu pandemic

Best Laugh:  

Lots of discussion about what Halloween will look like this year… Many of us went home on Friday, March 13th and still haven’t left… maybe we should have just tried rebooting?

Disclaimer: This Executive Summary 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. 

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