Today's Recap:

• COVID is spreading out of control across the US and the world.
• In LA, one person is dying every 8 minutes from COVID, and the county has a 21% positivity rate right now. Their ambulance crews are being asked not to bring patients to the hospital if they can’t resuscitate them in the field.
• There are two new, more infectious variants floating around - the one first found in the UK and separate one found in South Africa. The initial theory is that they lead to a higher viral load which is what makes them so much more infectious.
• Tonight, just before we hit send, the FDA issued a warning that the variants may lead to more false negative test results for certain types of COVID tests. Read more in the Best Questions section below.
• In San Jose, CA someone wearing an inflatable holiday costume led to a hospital-wide COVID outbreak.
• China has locked down Hebei province as a new COVID outbreak has been detected there.
• Meanwhile, a second Chinese vaccine was approved in Brazil this week, as China continues its vaccination campaign at home and in developing countries.
• Only 21 people have had anaphylactic reactions out of more than 1.8 million who received the Pfizer vaccine in the US.  That’s .0001%.
• Various proposals for mixing vaccine brands or altering timing have little or no data supporting outcome. Although manufacturers and the FDA are advising to administer the same brand of vaccine for Doses 1 and 2, Britain is considering the option of giving whatever’s available.
• After sheltering in place with nearly 400 lawmakers due to the unrest at the Capitol, a US Congressperson tested positive for COVID just a few hours later, leading to concerns about COVID spread in Congress.
• Mexico is reportedly offering to vaccinate undocumented folks living in the US.
• And in some good news, Nancy Messonnier said in a recent interview with STAT that vaccine distribution should speed up “pretty massively” in the coming weeks.
• One hospital is offering a $500 incentive to get vaccinated and the business community is watching this closely.
• As expected, the CDC changed it’s tone a bit about visiting restaurants and bars in an update to their website earlier this week, hidden in the page called “Personal and Social Activities | COVID-19”  They now specifically say visiting bars and restaurants can increase your risk of getting and spreading COVID-19 and reference the same highly criticized earlier study.
• Traditional flu has all but disappeared, according to last week’s stats from CDC testing.  Less than 1% of samples submitted for flu testing were positive.  A similar phenomenon had been noted in Australia during their flu season (our summer).
• The CDC is also reporting a dramatic increase in pediatric COVID positives, according to Dr. Messonnier on yesterday’s Flu Summit call.

Best Questions:

Does current lab testing detect the recently identified COVID variants?

Just a few minutes before we hit send on this, the FDA issued a warning stating that there may be false negatives due to the new variant. This is bad news.

They identified three specific COVID tests that are impacted because they test the specific part of the virus that has mutated. For the new strains from the UK and South Africa, there are 3 tests that are particularly affected by the mutations in those variants. (For those wondering, they are Accula SARS-Cov-2 Test, TaqPath COVID-19 Combo Kit, and Linea COVID-19 Assay Kit.

More info is sure to come out around this shortly, as this was just posted Friday night, but the FDA commissioner did mention that at this time, vaccines are still expected to be effective against these new variants.

We have some employees who are being vaccinated at their healthcare jobs. Their second doses are coming up. Should we plan for them to be out sick?

Many people will not experience any side effects. Others will need to take 1 or 2 days off. It’s a good idea to avoid scheduling them the day of or day after if it’s an easy scheduling switch, but again, many people will be ready to work with no side effects at all.

We are just slammed with COVID cases and close contact exclusions. Are you seeing this everywhere? Is there anything we can do?

Yes. We keep breaking our own records for the number of cases each week, and it’s more and more cut and dry positive cases or exposures. Here’s what you can do: get serious about ensuring that every single employee is filling out a survey at least 2 hours before work, every single shift they work. Keep track and hold managers accountable for ensuring  employees can’t work without passing their wellness checks. Send sick employees home immediately. If you do all of those things, it will help to break the cycles of illness and reduce the overall exclusions, even if it will be painful in the short term.

We’re still wrestling with: Do we need to exclude an employee if a family member was vaccinated and having side effects?

Vaccine side effects don’t include respiratory symptoms and generally occur on day 1 or 2 after vaccination.  They include low grade fever, headaches, chills or body aches.  The employee does not need to be excluded.  However, any respiratory symptoms or “side effects” beginning or worsening on day 3 or beyond should be considered possible COVID, and the employee should be excluded.  We’ve been speaking with the CDC and various medical advisors looking for a definitive definition of post-vaccination low grade fever (for example, below 100.4°?) and don’t have an answer in writing.  However, Dr. Nancy Messonnier of the CDC (referenced earlier) states that would be a good benchmark and that most fevers during the vaccines’ clinical trials were below 100.4°F.  This same exclusion guidance generally holds for vaccinated employees.

Local health departments are giving varying guidance.  Some are insisting on 14 days in states that have adopted 10 days for exposure, others are  insisting on closures for positives. Any advice on this?  It’s so frustrating.  

We hear you and agree, it is incredibly challenging and impossible to track.   Many of you have asked if there is a central repository for this kind of information and, unfortunately, there doesn’t appear to be one down to the local level. We had Suffolk County, NY insisting on 14 days when NYS adopted ten days weeks ago. Worcester, MA insisted that MA has a 2-day automatic closure when it’s been 1 day all along.  A county in IN required negative tests to return to work (with no testing capacity in the area).  A health department in VT suggested we needed to test all employees (and the nearest testing only available to symptomatic individuals with doctors orders was an hour away). We will always tell you that the local health department is in charge and your fate is in their hands. So be respectful, don’t be argumentative, give them the information they ask for in a timely manner, and understand that they, too, are extremely stressed and overworked now.  Wish we had a better answer.

If an employee is excluded for symptoms of COVID and then a family member tests positive, should we extend their exclusion?

This has been the question of the week.  The CDC says symptoms rule over exposure.  This situation has more clarity if the employee tested positive.  However, that is often not the case.  We would not extend this employee’s exclusion.  Also according to Dr. Messonnier, we’ve greatly mitigated the risk with the exclusion and we can’t mitigate all risk.

Best Read:  

Early vaccination has been challenging, but it was supposed to be the easy part. Dr. Fauci and others sound optimistic, but it will require a lot of coordination to ramp up for the next phase.

The Next Phase of Vaccination Will Be Even Harder

Best Laugh:

This is not an ad for this orthodontics company, we promise, but we saw this online and it actually made us laugh out loud.

‍