Health News:

• COVID wastewater levels are very high across the US and higher than they were this time last year. (CNN)
• Flu is high, as well, with a 16% increase in the positive test rate this week. (CDC)
• More patients are losing their primary care doctors and trust in the healthcare system. (NPR)
• Norovirus continues to spread across Utah, continuing to concern local and state public health officials. (KSL)
• One person has died in a Scottish E. coli outbreak with 30 cases. (Guardian)
• Extremely drug-resistant Shigella sonnei infections in men who have sex with men are rising in the UK. (Gov.UK)
• Shigella cases are rising again in Old Town Portland, OR. (KOIN)
• Chronic wasting disease (CWD), also known as “zombie deer disease,” is surging in the US, and scientists are concerned about possible spread to humans. (Independent)
• Drugmakers are set to increase the price of over 500 drugs in January. (Reuters)
• Glaxo is discontinuing the common inhaler Flovent at the height of respiratory illness season. Many patients will need new prescriptions for the generic. (NPR)
• The Dept. of Transportation published 2024 random drug and alcohol testing rates, all unchanged across their four agencies. (Transportation.gov)
• H5N1 avian flu has been detected in a polar bear and a squirrel, raising concerns about its ability to infect omnivores. (CIDRAP)
• A new law requires bars that serve food to follow food safety guidelines in North Carolina for the first time. (Axios)
• Less than 5% of preschoolers hospitalized for COVID were fully vaccinated. (CIDRAP)
• California has become the first state to offer health insurance to all undocumented immigrants through Medi-Cal. (ABC)

Mental Health & Substance Use News:

• A controversial Canadian law set to start in March will allow doctors to help patients with mental illness end their lives. (NY Times)
• Americans on Medicare now get better access to mental health care. (NPR)
• Some nightclub security guards have been confiscating naloxone from guests, which is at odds with policies aimed at having the life-saving drug readily available in bars and clubs. (NY Times)

If you or someone you know may be considering suicide or need help, call 988 or message the Crisis Text Line by texting HOME to 741741.

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Best Questions:

My employee has tested negative for COVID, flu, rsv, and strep but is still actively sneezing, blowing their nose, and coughing for nearly two weeks. Can they come back to work?

Unfortunately, viruses don’t always work on schedules that are convenient for us. The reality is that people with a cold can still be infectious for the duration of time that they have symptoms, even up to two weeks. That means if someone is still coughing, sneezing, and blowing their nose, they may still be spreading the virus that caused it to others. At some point, if their symptoms begin to improve or if they share a doctor’s note clearing them to work, they can return. But there’s also the perception of other staff and guests to consider - nobody wants to be served by someone coughing up a lung or sneezing uncontrollably.
Source: NHS

Should we be stockpiling PPE for the next pandemic?

We’d love to say that the world learned its lesson and governments have made changes to be better prepared for the next pandemic, but we can’t. The reality is that what NPR called the “boom-and-bust cycle of funding” for and interest in public health means that there’s a huge gap between what we actually need for the next pandemic and what we have. There are half-built rubber glove factories throughout the US whose pandemic funding dried up part way through development. Unless the government and states make some bigger plans soon for stockpiling PPE, we think there’s a chance that we’ll be left in the lurch for the next big pandemic. But there are challenges, too. The next pandemic may not be spread through aerosol particles, for example, so we may be stockpiling things we don’t need. PPE expires, so it’s a real investment to keep it up to date. Barring any new information about future threats, we think it’s a good idea to have enough gloves and masks at all to get through a 2-week COVID-style lockdown.
Source: NPR

How does wastewater monitoring work?

Sewage in cities can be tested to detect viral particles circulating in a community. The thing that makes it special is that it can tell us how much viral activity there is, even if people don’t have symptoms. Because it doesn’t require people to choose to go in and be tested, it’s an earlier warning system to show infection levels. It tends to be more accurate in predicting surges than cases and test positivity rates. And it’s not just COVID - wastewater testing works for many viruses and is already being used for flu, RSV, polio, and mpox here in the US.
Sources: CDC, NPR

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Best Read:

As more people are getting sick during the respiratory virus season, we can’t help but notice their lingering coughs…

The Cough that Doesn't End - The Cut