The Executive Briefing - Friday, August 27th

What does a good testing program look like? Listen to our latest podcast to hear all about it.

August 27, 2021

New Podcast Episode: Testing & the Path Forward

This week’s guest is Mara Aspinall. Mara is a faculty member at Arizona State University and an industry leader in health information technology, diagnostics, and testing. Leading large organizations in the private sector, to serving on the Health and Human Services Secretary’s Advisory Council on Genetics, Health & Society (SACGHS) in the Obama and Bush administrations, Mara has a truly unique perspective on the path forward in the ongoing pandemic. This conversation was fascinating and will surely change how you think about how your org should be handling COVID. Enjoy!

Listen here!

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COVID Recap

Johnson & Johnson says a second dose of its vaccine increased antibodies significantly, meaning booster doses for J&J may be on the horizon. (CNN)
Moderna has also applied for full FDA approval, which could come in the next few weeks. (Reuters)
Pfizer submitted an application for supplemental FDA approval of a booster dose for all adults 16+. (Pfizer)
The CDC issued an emergency health alert about the rise in prescriptions and severe illness caused by ivermectin, a parasite medication approved for use in humans but most often associated with horses. It doesn’t work against COVID and it can be incredibly dangerous when used for off-label purposes. (CDC)
A doctor in Tallahassee had his hospital privileges suspended for selling mask exemptions for $50 to students required to mask at school. (MedPage Today)
The Ohio state legislature is considering a bill that would essentially ban employer vaccine mandates. (AP)
And a new Montana law says you can’t treat people differently based on vaccination status - but schools and businesses are still grappling with what that means for things like quarantine after exposure. (Kaiser Health News)
Delta Airlines is charging a $200/mo fee to unvaccinated employees to help cover the costs of hospitalizations for sick workers. They’re also ending pay protection for unvaccinated employees who get COVID. (NPR)
About half of COVID patients in a new study had at least one long COVID symptom a year after they got sick. (MedPage Today)
A contamination probe is ongoing after possible issues in a Spanish plant which sent Moderna vaccine to Japan. EU regulators say after assessing risk they can continue production in the meantime. (Reuters)
As COVID cases continue to overwhelm pediatric ICUs, older teenagers - who may work in your business - make up the largest group of kids with COVID. (CNN)

Today’s Health News

There’s a Salmonella outbreak linked to Fratelli Beretta brand prepackaged uncured antipasto trays. There are at least 36 cases and 12 people in the hospital.. (CDC)
One Michigan restaurant had a Salmonella outbreak for ten years. Even extensive cleaning and renovations didn’t work to kill the bug, and eventually it closed permanently. Asymptomatic food workers were part of the protracted spread. (MMWR)
Costa Ricans live longer than those in the U.S. A focus on public health might be the reason. (New Yorker)
Vaccines and seasonal treatment have led to huge wins in fighting the global health issue of malaria in kids. (NEJM)
The next big epidemic could be measles, mumps, meningitis, or other vaccine-preventable diseases because so many kids who have missed their routine vaccinations are headed back to school. (NPR)
Contact with flood water after extreme weather in many parts of the U.S. (including Tennessee) brings health risks like tetanus and Hep A. (News 5)

Best Questions

How often should we be testing employees returning to the office or other work settings?

Our latest podcast out today features Mara Aspinall, one of the leading experts on employee testing. Mara’s basic guidance was that all employees, whether vaccinated or not, should be tested weekly if possible. And if you are allowing unvaccinated employees to return to work, she believes they should be tested twice a week. Listen to today’s podcast to hear her (rather unexpected) endorsement of antigen testing as a workplace and school-based solution.

Should we be discouraging employees from carpooling to prevent the spread of COVID?

At this point in the pandemic, carpooling with someone you don’t already live with has significant risks. These risks can’t be eliminated but can be reduced with masking and open windows, though they remain relatively high. Anyone unvaccinated is at particular risk, especially because the Delta variant is so infectious. If someone in the vehicle ends up testing COVID+, everyone else unvaccinated will need to quarantine for 10 days, and anyone fully vaccinated will need to mask for 14 days and monitor closely for symptoms. If there’s an easy alternative (and we recognize that there might not be for many people whose transportations options are limited) it’s a good idea to limit all close-quarters contact in enclosed spaces, cars included. If it’s not possible, reiterate to your employees the importance of wearing masks and keeping the windows open; it really does make a difference.

How do we respond to employees who think that sharing their vaccine status post-exposure is a violation of HIPAA?

This is a legal question and we suggest you consult your counsel. But here is how one of our team responded to an employee with HIPAA concerns: “HIPAA is designed to prevent healthcare providers from giving out patient information that they are not authorized to share. You voluntarily sharing your own information is not a violation of HIPAA because it is your information to do what you would like with. If you would like to continue sharing information to get a more accurate return date, we're here. But if you would not like to share additional information, we understand.” You should treat anyone who refuses to share vaccination information as unvaccinated for the purposes of work exclusions, mask requirements, and other safety precautions.

A fully vaccinated employee reports that her dorm waste water tested high for COVID, so they want everyone to get tested. Does that sound legitimate and can she work?

Yes - we are excited to see more pooled testing and testing of wastewater, which increases testing capacity enormously. When a sample shows higher levels of COVID than previously, everyone in a dorm or building can be tested. We’d expected to see more of it by now. We’re based in Connecticut and several cities in our state are doing city-wide wastewater testing to monitor for rising levels.

Since there are presumably hundreds of students in that dorm, unless the employee is symptomatic, there is no reason to exclude her just because she is being tested as part of a large group. As usual, we’d recommend that she monitors herself closely for symptoms and stays home if she feels sick or tests positive.