COVID-19 Briefing - Friday 12/4

Today's Recap:

• This is clearly getting much worse. Yesterday, there were 222,729 new cases and 2,554 recorded deaths.
• We updated our COVID Exclusion Chart (found here) to reflect this week’s CDC options for reducing close contact quarantine.  Last night, we started telling employees who were on 14-day exclusions that they could return to work after 10 days if they were symptom free and had not tested positive. No surprise, but a large number either have symptoms or have tested positive.
• We’re working closely with the National Restaurant Association to get a better sense for which states will formally adopt CDC guidance for reduced quarantine for close contact (and when).  The NRA believes Maine may adopt other guidelines.  NY generally follows CDC guidance.  MN has limited testing capacity so any changes will need to address that.
• California will impose the strictest stay-at-home orders yet, in response to severely limited ICU bed availability as case counts skyrocket.
• The CDC is asking Americans to stay home for the holidays. Meanwhile Italy is implementing a travel ban even between towns over Christmas.
• Vaccination cards will be distributed with each vaccine, according to reps from Operation Warp Speed. These will look a lot like CDC yellow cards, and the hope is to collect cell phone info as well to remind people about their second dose.  But like yellow cards, they get lost, are illegible and generally less than overall helpful.
• Congressman John Delaney proposes incentivizing vaccination with 2nd round stimulus checks - a suggestion which drew both praise for its boldness and harsh criticism.
• Former Presidents Obama, Bush, and Clinton offered to take the vaccine on camera in hopes of allaying public fears, according to Reuters.
• “There will absolutely be a black market” for vaccines, according to this excellent article from STAT.
• And if this wasn’t all enough, now there’s a listeria outbreak in deli meats.
  
  

Best Questions:

Can we return employees to work now who are on days 11-14 of quarantine for close contact?

Yes, as long as they are symptom free and have not tested positive.  It is important to remember that the CDC is still saying a 14 day quarantine is recommended.  And when your employees are contacted by contact tracers, many are still telling them 14 days, as well.  And states are expected to begin issuing their own guidance soon which may impact this.  But at this point, most of our clients have reduced their employee work exclusions or quarantines for close contact to 10 days from 14 (returning to work on Day 11).

If the exclusion is reduced to 10 days from 14 for close contact, does that mean that someone who is a caregiver and cannot isolate from their sick family member can now be excluded for 20 days instead of 24 days?

The short answer: generally yes. The idea behind a 24-day exclusion was that someone who is continuously exposed to a COVID+ person stays quarantined for the full time that sick person is infectious (10 days) plus the full quarantine period, which is now being reduced to 10 days in many cases. So we think that reducing an in-home, continuous exposure exclusion to 20 days is reasonable given that the CDC has said a 10-day quarantine period is acceptable. Of course, there may be local jurisdictions that require longer quarantines and we recommend deferring to those when specifically instructed.

We’ve noticed you’re not talking much about the portion of the CDC recommendations allowing use of testing to bring employees back earlier than ten days.  Can you discuss that?

We don’t recommend allowing any employees to return sooner than 10 days for COVID exposure. Most of our clients have decided to not pursue testing as an earlier return to work option at this time, other than in some very limited and specific circumstances.  Here’s why:

Testing is still a mess. Some clients, who have very defined business needs (such as no manager available or they’ll need to close the location unless they can get a few employees back) will consider using testing to bring those key people back earlier.  However, the lack of available testing, slower turnaround times, and long lines for testing make it a difficult option to make actionable.

Plus, most state health departments told us they were surprised when the CDC recommendations for early return with testing included antigen testing (rapid tests). Many told us they will not adopt that portion of the CDC recommendations when they do release their own state guidance. The idea of being tested on day 5 or 6 to return after day 7 doesn’t match the most recent NIH study showing an average symptom onset of over 8 days! So someone might test negative on day 5 and be shedding virus and infectious by day 8 when they return to work.

We will continue to monitor this and expect there will be a great deal more discussion surrounding it in the coming weeks.

I noticed the symptom survey you use still asks employees about contact and testing “in the past 14 days.” Why isn’t that updated to 10 days now?

Even though the quarantine time is reduced to 10 days, CDC still recommends monitoring for symptoms for 14 days because the incubation period for Coronavirus is still 2-14 days. Even though people may return on Day 11 if they don’t have any symptoms and haven’t tested positive, they still need to monitor for symptoms for a full two weeks, and it’s important to know if they had exposure or symptoms at any point during that time.  

Best Read:

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How COVID-19 Highlights the Uncertainty of Medical Testing
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Best Laugh:

Missed our webinar this week?‍

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You can view the recording by clicking here!
Use the passcode: NL56Qj7?

Many thanks to Michelle Harden, from Messner Reeves, LLP, for joining us to answer all of your questions on the legal and clinical issues related to COVID!

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Have a great (and safe) weekend out there!