COVID-19 Briefing - Friday, 11/13

Today's Recap:

• Facing a shortage of healthcare professionals, North Dakota will allow nurses actively infected with Coronavirus to keep working if they're asymptomatic.
• Hospitalizations are surging in OR, IL, MO, and TX, among others.
• OR, CA, and WA issued travel advisories asking visitors to quarantine for 14 days upon entering the state.
• NY announced new restrictions on restaurants and bars, along with CT and NJ. San Francisco banned indoor dining entirely. And New Mexico just banned indoor AND outdoor dining.
• COVID patients with developmental disabilities were 3x more likely to die than others who were infected, an analysis showed.
• Close to home for those of us at the ZHH/Zedic headquarters- a CT doctor charged insurance companies thousands of dollars for “super COVID tests” and even charged separately for giving them their results!
• Dr. Mike Osterholm spoke at Restaurant Finance Week and his message was bleak.  He called Pfizer’s news about vaccine efficacy “misleading” because they still haven’t shared any data about how they define efficacy, how long protection lasts, and how many doses are needed, among many other unanswered questions.
• Osterholm expects we won’t see “normal” in 2021 and it will take until 2023 to vaccinate the world - and until the world is vaccinated, no one country is beyond COVID.
• This NYT article does a good job of explaining how complex vaccine distribution will be.
• And some participants in Pfizer’s trial said the vaccination side effects felt like a “severe hangover” with headaches, body aches, and fever. This has tough implications for getting good compliance with second doses - it’s hard to convince someone to go back for round 2 if they felt crummy after the first shot.
• Ticketmaster will require negative COVID tests to attend concerts.
• A meat manufacturer sued NM after their plant was ordered to close due to COVID.
• A new report shows COVID spread among Marine recruits even with stringent quarantines in place.
• Measles deaths soared last year as people delayed vaccination due to the pandemic, hitting their worst rates in 23 years.

Best Questions:

Do I need to exclude an employee that was excluded from school?

Yes, if the school excluded the employee for close contact with a confirmed COVID+ person, then we would recommend excluding from work as well. Even when there’s unclear information, we generally think it’s best to honor a school’s quarantine. Nobody wants to hear that the cashier checking them out can’t be at school due to exposure....

A team member who previously tested positive in the past few weeks is worried about returning because family members have tested positive more recently. What do you say to them?

If someone tested positive for COVID in the past 90 days and is now recovered, the CDC does not recommend excluding them even if they are exposed to someone COVID positive again. This is because your body develops a certain level of protection against the virus when you’ve recovered from it, and reinfection is rare in those 90 days after you are first infected. So, even if you’re exposed and others in your house have COVID, if you’re still in the 90 day window you’re not likely to be sick or be able to spread infection to others. You should still handwash regularly and wear a mask, though.

How do we allay fears of team members who are worried about working with someone returning after COVID?  

The CDC clearly states that you’re no longer infectious after 10 days from onset or positive test (even though they may test positive for a longer time than that).  If the employee feels well enough to work and doesn’t have any fever, respiratory, or GI symptoms, then they are clear to work because their viral load is small enough that they will not infect others.

Communication is key. Make sure that your team knows that you are consistent and conservative in following return to work recommendations of the CDC, local health department and your clinical advisors (us).

Should we be recommending employees get tested?

Our recommendation is still to be cautious before recommending or requiring as an employer that someone gets tested. It can be complicated, and should probably be run by your legal counsel. Generally, we tell individual employees who ask our clinical team if they need to be tested that testing is an individual decision, and to consult their doctor and CDC guidelines. CDC does recommend that people with COVID symptoms get tested. It's important to note that a negative test usually doesn’t allow someone to return to work sooner, because there is still a high false negative rate for COVID-19 tests.

Is there any end in sight to this surge?

Not really, unless jurisdictions take drastic measures to curb the spread, like city or state-wide shelter-in-place orders. We know that Thanksgiving is coming up and that people will still travel and/or combine households during that time, which we expect will lead to another spike in case counts. We are seeing more cities and states enact the kind of measures that will stop the spread, like NY’s 10pm bar and restaurant curfew, Ohio’s mask mandate, San Francisco’s ban on indoor dining, and others. But the responses are piecemeal, and holiday travel means that people will bring the virus to and from hotspots.

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Best Listen:

We've mentioned Mike Osterholm a lot today, and for good reason. We're listening to his takes on vaccination and what it will look like moving forward this week, plus more info on mutated virus in minks and our overwhelmed healthcare systems.

Osterholm Update: COVID-19 Episode 31: Pay to Prevail

Best Laugh:

Happy Friday the 13th, everyone!

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