COVID-19 Briefing - Friday, June 12

Today’s Recap:

• COVID cases continue to rise nationwide, with deaths up by about 5% and cases up by around 9% since last week.
  

• Fourteen states are still seeing a rise in new cases, led by Arizona. In Arizona, average COVID-19 hospitalizations have risen 49% from May 26 to June 9.
  

• But this isn’t the “second wave” -- it’s still the first. 
  

• Different experts have very different opinions on what’s safe. 133 epidemiologists weighed in on a number of different scenario-based questions in the NY Times this weekend. Their assessment of risk varied, but provided us with some interesting info about how epidemiologists see the next few months playing out. 
  

• Upcoming Hurricane and Flu seasons add complications to some of the world’s major hotspots, including the US and Brazil, though the current flu numbers are lower than is normal for this time of year (which is a good thing!)
  

• Facing pressure and threats,  public health officials are quitting their jobs. Ohio’s state health director, who had armed protesters come to her house, resigned yesterday. The health officer for Orange County, CA quit Monday after criticism and threats over an order requiring face coverings in public. 
  

• Some of you may have seen an article by Bret Thorn in Nation’s Restaurant News where I described contact tracing “like the wild, wild west.” And you’ve experienced it getting even wilder. Some health departments are now saying to exclude for 14 days from a positive test date.  Others are saying ten days from the date of the positive result (which could be a week or more after symptoms started).  Some are following the WHO guidance. Others are following the CDC’s guidance.  They don’t align. And yet others seem to be making up their own rules.  Stay tuned…there’s sure to be lots more on this.
  
  

Best Questions of the Day:

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The single most asked question of the week:

If someone has been excluded for symptoms of or exposure to COVID, and then tests negative, can they come back to work? 

Unfortunately, no.  First, these tests have a very high false negative rate - ranging anywhere from 30% to in some cases, 50%.  But second, and more importantly, the test is only a snapshot in time and you have no way of knowing that the person is incubating COVID and doesn’t yet have a detectable viral load.  The incubation period is 2 to 14 days. 

We have an employee who has been excluded twice now. Can someone get COVID more than once? 

At this point in time, we do not have reason to believe someone can get COVID more than once.  There are some jurisdictions that are excluding people a second time, but not many.  It’s possible that the first exclusion may have preceded the employee’s ability to get tested, get a copy of their results, or get results confirmed.  So the first COVID may have been presumed, but not really COVID.  These really need to be assessed on a case by case basis.  But the short answer is, at this time, we think you can’t get COVID more than once. 

Does someone recovered from confirmed COVID need to be excluded if a family member later gets sick?

Along those same lines as the question above, we’re not excluding again if someone has lab-confirmed COVID, even if their family members later get sick, or if they have close contact with another positive later on. The only time we would exclude is if their COVID was NOT confirmed the first time through a lab test. 

Does someone need to be excluded if they were exposed to someone who was exposed to COVID ( “secondhand exposed”)?

No. They should monitor for symptoms in themself and the person who was exposed to a COVID positive. If either develops any symptoms, the employee should be kept out of work. 

Should we be testing everyone if we have one or two cases in a location?

Testing everyone is a significant operational and legal issue that needs very careful consideration before it’s done.  If you direct an employee to be tested and they test positive, you may own a Workers’ Comp claim. There are times where we do have a need to know how widespread transmission might be.  But those situations are unique and still rare.  Eventually regular, community wide testing will be widely available and this question will be moot. 

Do we need to report our positives to the health department?

Most of the time, no, but you’ll need to know your local requirements. In most cases, the lab that conducts the test, or the ordering physician are usually responsible for reporting a COVID+ to the health department. If you do have multiple confirmed positive cases, chat with us and we can help you think through whether proactive outreach to the local health department might be a good idea.  BUT in Colorado, LA County, San Bernardino County and others there is a requirement to report any known positives to your health department.

Why are some health departments excluding sick employees for 10 days and some excluding for 14 days?

As we noted in the recap, there is wide variability between health departments’ and contact tracing teams’ interpretations of guidance. Plus there is constantly changing guidance, discrepancies between studies, and varying guidance from the WHO and the CDC. At any given time, we recommend sticking with the CDC’s 10-day guidance UNLESS your local health department is requesting something more stringent, like 14 days. If the local health department says 7 days, keep them out 10 just to be safe. If the local health department says 14, go with that. And again, a negative doesn’t mean they can return to work.

Best Read of the Day:

Getting the flu vaccine in the fall will be more important than ever. Convincing people to do that, so that we don’t inundate our healthcare system, may be the real challenge.

The next COVID-19 challenge: Convincing people to get flu shots

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Best Laugh of the Day:

Schools are ending in many areas… not that school ending is that different than … well any other day since we started staying at home and social distancing.  To those of you whose kids are done with school and camps are canceled, this made us laugh and hope you too..