COVID-19 Briefing - 8/7

Updated travel advisories, asymptomatic spreaders and more

August 10, 2020

Today’s Recap:

Several of you have had very unpleasant visits from health departments threatening that the police would close your location if you did not voluntarily close. And in another instance (this happened one last month), the health department was accompanied by police.
Case counts may jump dramatically next week when states begin counting Antigen positive cases that weren’t previously being reported to them.
Yesterday, the CDC issued updated travel advisories for many countries. We’re not sure exactly why, as US positive rates are much higher than many of these countries.
Scientists are expressing concern re: the pending emergency FDA approval of plasma treatment for COVID, stating it will complicate on-going clinical trials. Early studies are showing plasma’s effectiveness in reducing mortality while there are also on-going studies for the use of plasma from recovered COVID patients for prophylaxis (post-exposure) or early intervention.

While COVID case counts grow, contract tracing is still falling short. A study this week by Johns Hopkins shows there’s been hardly any growth in the US Contract Tracing workforce since mid-June.

And this week’s JAMA reports that asymptomatic COVID+ people may be as infectious or have similar viral loads to those who are symptomatic and those who are asymptomatic may actually shed the live virus for longer than those who are symptomatic.

Best Questions:

When an employee is tested through employer-coordinated testing, who informs the person if they’re positive?

Good question and one which you should absolutely clarify prior to initiating any testing. It is usually the health care facility who notifies the patient. However, in group testing settings, they do sometimes rely on the testing organizer (clinic, lab, or insurer) or ordering physicians to notify the patient. How it is handled is critically important. The patient should be notified before anyone else (and before contact tracing begins).

If an employee tested positive and was excluded for ten days and later a household member tests positive, does the employee need to be excluded again (for close contact)?

At this time, we are not excluding someone who tested positive and is later exposed. As we learn more about how long antibodies last (or don’t…), that may change. It is important that the employee who was sick was tested and tested positive. If they were not tested, and only a presumed positive or just symptoms, then they would be excluded for the later exposure out of an abundance of caution.

An employee visited their doctor and the doctor decided to COVID test the employee. Should we exclude the employee until those results come back?

We would recommend that. Although we don’t know all of the details of that visit, it is unlikely the doctor would order a COVID test unless there were some symptoms reported that the doctor thought might possibly be consistent with COVID.

How soon after exposure should you get tested?

While there is no definitive answer to that, many people are getting tested too soon (like immediately after someone they know develops symptoms or tests positive). Best guidance is to be tested on day 4 or 5 after exposure.

Should we be excluding employees returning from Mexico for 14 days?‍

Travel exclusion decisions are up to each employer and many vary by travel destination, travel modality, and other risks. There are employees who commute between Mexico and the US every day, and excluding them is not realistic. Yesterday’s CDC travel updates did specifically raise the risk level for Mexico to a level 3, or the highest level. The ZHH/Zedic Wellness Check no longer includes the international travel question because there continues to be very little international travel. But we are seeing more travel to Mexico than previously. There is no specific CDC guidance re: 14 day quarantine from Mexico, but specific state quarantines should be checked (and change frequently).

Best Read:

While COVID-19 is new, coronaviruses are not (example: the common cold is one). And we’re learning the prior exposure to coronaviruses may play some role in who gets sick or how sick and who doesn’t.