The Executive Briefing - Friday, July 30th

CDC Update: Flash Briefing

• Listen now to our Flash Briefing on the new CDC updates. Roslyn and Jenn from the ZHH team decode this week’s new CDC guidelines in under 15 minutes on our podcast. Listen when it works for you!
• Or if reading is more your style...check out our blog post on the CDC updates here. 

Today’s Recap

• The CDC released data that shows that the Delta variant can be spread by someone who is fully vaccinated and has an infection rate similar to Chicken Pox, one of the most contagious diseases.  (Washington Post)
• Nearly 67% of US counties fall under the CDC’s  high or substantial risk categories for masking. (NPR)
• COVID cases in Tokyo are soaring, concerning officials as the Olympics continue. (AP)
• Mandated vaccinations (or weekly tests and strict COVID protocols) are becoming more mainstream this week, from the Federal government, NYC, CA, 
• A new internal study by Pfizer shows its vaccine efficacy begins to drop at 6 months. This will continue to be reviewed and peer edited, but is the first step toward evidence that boosters will be necessary. (StatNews)
• Meanwhile, Israel approved a third booster dose of Pfizer for those over 60. (CNN)
• A new model, widely referenced by public health officials, shows that U.S. COVID cases are likely being undercounted by 60%. (MedScape)
• Companies scrambled this week to update their return-to-office plans based on thisDelta surge. Some are mandating vaccination for office use, others delayed reopening or requiring masks indoors regardless of vaccination status. (New York Times)
• COVID is not just affecting those who choose not to be vaccinated - kids under 12 still can’t get the shot, but they’re feeling the effects. Pediatric COVID cases are up 64% in the last week. (MedScape)
• Although you’re much less likely to be hospitalized or die from COVID if vaccinated, some breakthrough cases report feeling very sick. (Boston Globe)
• In an about-face, Broadway shows will begin re-opening, but now require both vaccinations and masks. (NYT)
  
  

Today’s Health News

• While COVID and mask and vaccine mandates have dominated the news, there’s been a giant recall of cake mix for e.Coli.  Best not to eat raw cake batter right now.  (CDC)
• While dogs may be considered man’s best friend, cats may actually help us figure out genetic puzzles. (Phys)
• The feds are requiring that the HIV prevention pill PrEP be covered by all insurance providers at no cost, along with any associated care, a big step forward in preventing HIV - but advocates say it still leaves the uninsured without care. (NPR)
• Johnson & Johnson specifically marketed talcum powder to Black women despite cancer concerns. They claim there’s no clear evidence of a link to cancer, but they’ll stop selling talc-based baby powder in North America. (USA Today)

Best Questions

If someone is fully vaccinated and gets sick, can they return to work sooner with a negative test since it might be a cold, for example?

Right now for our wellness checks, we allow people to return sooner than 10 days with a negative COVID test and a doctor’s note clearing them to work, as long as they are symptom free. That’s regardless of vaccination status, and it’s aimed at people who see a doctor and get diagnosed with some other illness, like flu or strep.

For vaccinated people, it’s not out of the question to replace that doctor’s note with proof of vaccination and say vaccinated people with a negative test and symptom-free can return. A major concern around implementing this right now is that the rate of breakthrough cases is unknown, but there are some alarming trends. Nearly 20% of LA County’s cases in June were breakthrough cases in fully vaccinated people. Our concern around letting someone back without seeing a doctor is that everyone thinks it won’t happen to them – but it does. Our team isn’t changing our process at this time, and would still require a doctor’s note along with that negative test and confirmation that the person is symptom-free. 

 Any fully vaccinated people actively having symptoms should stay home from work, regardless of whether they have a negative test.

What does it mean if a COVID test is inconclusive?

An inconclusive test means that something went wrong with the test itself and the result can’t be determined. It’s effectively the same as if someone was not tested at all. You should treat it as such, and we recommend getting re-tested for a conclusive result - and of course staying home and isolating if you have symptoms.

Do test kits expire?

Yes. Don’t use an expired test kit if you have one. It’s important to check the date and to replace your test kits if they’re past their expiry date. If you have a test result from an expired kit, you should get re-tested - but if it’s a positive test result, you should assume it’s a true positive and take the necessary precautions until you get another test. It’s always best to be safe rather than sorry.  

Do we count a positive on a rapid test as a legitimate positive?

Yes! All tests, both rapid and PCR, have extremely accurate results for true positives - most are 99% accurate or more when they show a positive result. It’s the negative test results that are less reliable - since rapid tests produce some false negative results, especially in those who are asymptomatic. 

Should breakthrough cases be handled the same way as a new COVID+ case?

Yes, absolutely. The newest CDC studies (which prompted their updated guidance) show that while those who are fully vaccinated get sick less often and have milder symptoms, they’re actually still transmitting the virus, potentially at the same levels as those who are unvaccinated. So it’s extremely important that breakthrough cases in fully vaccinated people are treated the same way as regular COVID+ cases - with full contact tracing, self-isolation, and if necessary, and heightened cleaning and ventilation. 

Best Read

Will the coronavirus get worse than the delta variant? No one knows.

Best Laugh

COVID Recap

• The CDC released data that shows that the Delta variant can be spread by someone who is fully vaccinated and has an infection rate similar to Chicken Pox, one of the most contagious diseases.  (Washington Post)
• Nearly 67% of US counties fall under the CDC’s  high or substantial risk categories for masking. (NPR)
• COVID cases in Tokyo are soaring, concerning officials as the Olympics continue. (AP)
• Mandated vaccinations (or weekly tests and strict COVID protocols) are becoming more mainstream this week, from the Federal government, NYC, CA, 
• A new internal study by Pfizer shows its vaccine efficacy begins to drop at 6 months. This will continue to be reviewed and peer edited, but is the first step toward evidence that boosters will be necessary. (StatNews)
• Meanwhile, Israel approved a third booster dose of Pfizer for those over 60. (CNN)
• A new model, widely referenced by public health officials, shows that U.S. COVID cases are likely being undercounted by 60%. (MedScape)
• Companies scrambled this week to update their return-to-office plans based on thisDelta surge. Some are mandating vaccination for office use, others delayed reopening or requiring masks indoors regardless of vaccination status. (New York Times)
• COVID is not just affecting those who choose not to be vaccinated - kids under 12 still can’t get the shot, but they’re feeling the effects. Pediatric COVID cases are up 64% in the last week. (MedScape)
• Although you’re much less likely to be hospitalized or die from COVID if vaccinated, some breakthrough cases report feeling very sick. (Boston Globe)
• In an about-face, Broadway shows will begin re-opening, but now require both vaccinations and masks. (NYT)
  
  

Today’s Health News

• While COVID and mask and vaccine mandates have dominated the news, there’s been a giant recall of cake mix for e.Coli.  Best not to eat raw cake batter right now.  (CDC)
• While dogs may be considered man’s best friend, cats may actually help us figure out genetic puzzles. (Phys)
• The feds are requiring that the HIV prevention pill PrEP be covered by all insurance providers at no cost, along with any associated care, a big step forward in preventing HIV - but advocates say it still leaves the uninsured without care. (NPR)
• Johnson & Johnson specifically marketed talcum powder to Black women despite cancer concerns. They claim there’s no clear evidence of a link to cancer, but they’ll stop selling talc-based baby powder in North America. (USA Today)

Best Questions

If someone is fully vaccinated and gets sick, can they return to work sooner with a negative test since it might be a cold, for example?

Right now for our wellness checks, we allow people to return sooner than 10 days with a negative COVID test and a doctor’s note clearing them to work, as long as they are symptom free. That’s regardless of vaccination status, and it’s aimed at people who see a doctor and get diagnosed with some other illness, like flu or strep.

For vaccinated people, it’s not out of the question to replace that doctor’s note with proof of vaccination and say vaccinated people with a negative test and symptom-free can return. A major concern around implementing this right now is that the rate of breakthrough cases is higher than we’d known before. Nearly 20% of LA County’s cases in June were breakthrough cases in fully vaccinated people. And there is a Cape Cod cluster where a shocking 73% report being vaccinated. Our concern around letting someone back without seeing a doctor is that everyone thinks it won’t happen to them – but it does. Our team isn’t changing our process at this time, and would still require a doctor’s note along with that negative test and confirmation that the person is symptom-free. 

Anyone who is fully vaccinated and actively having symptoms should stay home from work, regardless of whether they have a negative test.

What does it mean if a COVID test is inconclusive?

An inconclusive test means that something went wrong with the test itself and the result can’t be determined. It’s effectively the same as if someone was not tested at all. You should treat it as such, and we recommend getting re-tested for a conclusive result - and of course staying home and isolating if you have symptoms.

Do test kits expire?

Yes. Don’t use an expired test kit if you have one. It’s important to check the date and to replace your test kits if they’re past their expiry date. If you have a test result from an expired kit, you should get re-tested - but if it’s a positive test result, you should assume it’s a true positive and take the necessary precautions until you get another test. It’s always best to be safe rather than sorry.  

Do we count a positive on a rapid test as a legitimate positive?

Yes! All tests, both rapid and PCR, have extremely accurate results for true positives - most are 99% accurate or more when they show a positive result. It’s the negative test results that are less reliable - since rapid tests produce some false negative results, especially in those who are asymptomatic. 

Should breakthrough cases be handled the same way as a new COVID+ case?

Yes, absolutely. The newest CDC studies (which prompted their updated guidance) show that while those who are fully vaccinated get sick less often and have milder symptoms, they’re actually still transmitting the virus, potentially at the same levels as those who are unvaccinated. So it’s extremely important that breakthrough cases in fully vaccinated people are treated the same way as regular COVID+ cases - with full contact tracing, self-isolation, and if necessary, and heightened cleaning and ventilation. 

Best Read

Will the coronavirus get worse than the delta variant? No one knows.

Best Laugh