COVID-19 Briefing - 9/4

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Did you know that ZHH and Zedic are now offering Wellness Checks? Our daily, online employee wellness check program is the only one out there staffed by real medical professionals. Our clinical team clears roughly 40% of employees who fail a daily check to work today or tomorrow after chatting with them getting your employee back to work safely and quickly.

While we know some of you are already using our wellness check service, please share with those you know who might be interested in our services. Thanks!

Today’s Recap:

• There were 45,601 new confirmed cases of COVID yesterday and we’re seeing case counts rising in the midwest.  The hot states include SD, AL, MS, ND, TN, AR, IA, MO and KS.

• It’s not just COVID out there. 1,469 people now sickened by a salmonella strain linked to onions, according to latest reports.
  
  
• Experts now are convinced that herd immunity alone won’t stop COVID-19.  Popular Science does an excellent job of explaining why.

• FDA approved an emergency use authorization for a single test that can differentiate COVID-19 versus one form of the flu.
  
  
• While we’ve been told that antibodies are effective for as little as 90 days, a new study from infected fishing boat crews show it could be as long as six months.
  
  
• Experts continue to debate the accuracy of rapid tests.  A new study evaluated 22 other studies on rapid antigen and molecular‐based tests and found wildly varying rates of accuracy. Rapid antigen test accuracy averaged 56.2%.  They also found lots of holes in every study.

• Experts worry that Labor Day Weekend travel and bar attendance will kick off a surge of cases, like Memorial Day and 4th of July weekend did in the summer. Stay safe out there!

Best Questions:

If someone has second-degree exposure (exposed to someone who was exposed), but chooses to get tested on their own, does that qualify as curiosity testing? Do they need to be excluded from work while they wait for results?

We would consider testing done without direct personal contact as “curiosity testing,” meaning it isn’t necessary to exclude that person while they wait for results. They probably didn’t understand the CDC definitions of close contact (which has changed over time). We would not exclude this person unless they receive positive results.

Any guidance on best ways to handle New Mexico rules?

No question that New Mexico’s rules are challenging.  The most difficult portion is their requirement that you close after an employee tests positive, and that all employees, not just close contacts,  are tested (which they will assist in doing).  But the turnaround time is challenging.

Here’s an example of the guidance provided from the state Emergency Response Team after a positive:

The New Mexico Department of Health and the New Mexico Environment Department is directing your business to comply with cleaning, testing, and safety processes following a recent case of an employee testing positive for COVID-19 at your establishment. Remember, you must immediately cease any operations as directed by NMED staff during the previous phone call. Attached is a checklist for you to complete and sign on behalf of your organization to certify compliance with the requirements discussed in the letter.

We understand you have agreed to clean and disinfect the facility and will continue to provide employees with appropriate face coverings and/or personal protective equipment (PPE) as necessary in accordance with OSHA regulations, CDC guidelines and the State’s COVID Safe Practices (a copy is attached for your reference).

A representative from the New Mexico Department of Health will be in contact with you to coordinate the immediate testing of exposed employees. NMDOH and NMED require that any employee identified as a close contact, 3 minutes of contact within 6 feet regardless of face covering usage, to the positive case must self-quarantine for 14 days. ​

Yes, that says 3 minutes!

Does close contact duration vary based on whether or not the sick person or close contacts were masked or unmasked?

The answer is not really. We posed this question to the CDC and here was their response:

“Data are limited to precisely define the “prolonged exposure” to determine “close contact”, however 15 minutes of close exposure can be used as an operational definition for contact investigation. Factors to consider when defining close contact include proximity, the duration of exposure (e.g., longer exposure time likely increases exposure risk), whether the individual has symptoms (e.g., coughing likely increases exposure risk) and whether either the case patient or contact were wearing an N95 respirator (which can efficiently block respiratory secretions from contaminating others and the environment). At this time, differential determination of close contact for those using fabric face coverings is not recommended.”

Translation: If someone is within 6ft for 15 total minutes or more of a sick person, they should quarantine, regardless of whether or not one or both wore masks.

Why would  an employee be excluded for 24 days?

An employee might be excluded for up to 24 days because of the newest CDC guidance for those who have repeated or continuous exposure to someone with COVID, like family members who can’t self-isolate because they’re taking care of the person who is sick, or are unable to sleep in a different room from them, etc.

In these cases, the 14-day quarantine has to start after the sick person has recovered, which is 10 days after their symptoms started (or 10 days after they tested positive if they never had any symptoms). 10 days for the sick person to stop being infectious, plus 14 days for the exposed person to quarantine in case they have been infected, for a total of 24 days from the sick person’s symptom onset.

Can 24 day exclusions be avoided?

You can absolutely avoid a 24-day exclusion by self-isolating from the household member who is sick.  Ideally, that looks like the sick person isolating in a bedroom and using a separate bathroom. Sleeping in a different room is key, and for those that can’t use a separate bathroom, regular sanitizing of the kitchen and bathroom after every use should be sufficient. In those cases, it would be 14 days from the most recent contact.

Here are some questions that that our clinical team uses  when it looks like someone may be headed toward a 24-day exclusion:

• Is the sick person able to self-isolate in your house, by sleeping in another bedroom and using a seperate bathroom, or thoroughly cleaning a shared bathroom between uses?
• Is there any way that you could sleep in a different room, and use a different bathroom or clean the bathroom while wearing a mask and gloves before you use it?
• If you can’t separate from the sick person in your home, you’ll need to stay out of work for 24 days from their symptom onset (10 days for them to stop being infectious, plus 14 for you to wait and see whether you become sick). That’s a long time. Are you sure there’s no way that you can sleep in another bedroom or stay in another place, which would reduce your work exclusion to 14 days from the most recent close contact you had with them?

Best Read:

Researchers say strong ventilation indoors should join handwashing, masking and social distancing as measures to reduce the risk of spreading the coronavirus. With Labor Day here and summer winding down, this is an important topic.

Key to Preventing Covid-19 Indoors: Ventilation

Best Laugh:

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Have a safe, socially distant and masked Labor Day holiday weekend.

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