Updated Exclusion Chart:

• We have updated our ZHH + Zedic Exclusion Chart to reflect the current lower COVID case rates and higher chances of other illnesses, including flu, RSV, strep, and more.
• Here's the updated chart: ZHH + Zedic Exclusion Chart
• The primary changes include:

            - Shortness of breath no longer leads to a 5-day if it's the only symptom

            - Added Flu, RSV, and Strep Throat positive test results

            - No more exposure exclusions in any state!

            - More relaxed wording around masking after exclusion

            - Clarifying language around runny nose to help reduce exclusions for cold or weather

• We will continue to monitor the situation and update our exclusion chart as needed. Please always refer to the latest CDC and local guidelines.

COVID News:

• There won’t be a combo COVID and flu shot in time for this fall, but we still expect this in the future. (CBS)
• With the latest Omicron variants and multiple layers of immunity, we don’t actually have a good sense of how much asymptomatic transmission is happening. (The Atlantic)
• Global COVID cases and deaths continue to drop. (CIDRAP)
• COVID vaccines will hit the commercial market with the next virus strain when they’re tweaked to match the new strain. (SF Chronicle)
• 35 years of US investment in research is what allowed the development of mRNA COVID vaccines. (CIDRAP)
• Long COVID is associated with lower brain oxygen levels, worse performance on cognitive tests, and increased psychiatric symptoms. (SF Chronicle)

Public Health News:

• Nearly 20,000 people may have been exposed to measles at the Asbury University religious revival in Kentucky. (CBS News)
• A new Hep A outbreak with 9 cases is being investigated by the FDA. The source is unknown. (FDA)
• Stomach bug cases caused by both norovirus and Shigella are being reported in Florida and throughout the country. (WMFE)
• Walmart will add 28 health centers and expand into AZ and MO in 2024. (Modern Healthcare)
• 51% of people alive in 2035 will be obese or overweight, and could cost over $4.3 trillion annually. (STAT)
• China has reported a new H5N1 flu case in a 53-year-old woman who had contact with poultry. (CIDRAP)
• Oysters from Cedar Key, FL have been recalled after 8 Salmonella cases across 3 southeastern states. (Florida DOH)
• Multidrug-resistant E.coli has been found in Japanese wastewater. (CIDRAP)
• The CDC is calling for parents to properly sterilize breast pumps and store powdered formula after a baby died from a Cronobacter sakazakii bacterial infection from a contaminated pump. (MMWR)

Mental Health News:

• The Federal Trade Commission ordered BetterHelp to pay users $7.8 million over claims they shared users’ private health data with advertisers, including Facebook. (FTC)
• Mental health first aid helps friends and coworkers act as first responders in a mental health crisis, and it’s helping teens (and adults) help each other. (Washington Post)

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

Best Questions:

Why did you update the exclusion chart now?

We regularly update our employee work exclusion chart based on the latest clinical data and client needs. We’ve made some minor updates to reflect the latest clinical data. For example, shortness of breath is not a common Omicron symptom on its own, so we downgraded it. We’ve added some other respiratory illnesses to the chart since we’re seeing more positive tests for non-COVID illnesses. And we’ve made a number of modifications aimed at getting people back to work as soon as it's safe for them to do so. Our goal is to help relieve stress on your businesses while still maintaining excellent employee health standards, and regularly updating our chart is part of how we make sure we’re changing with the pandemic landscape.

We have an employee who went to the Asbury University revival in Kentucky where measles may have spread. What should we do?

Around 20,000 people attended the massive religious gathering in Kentucky at the same time as a resident who was infected with measles last month, which means they may be exposed. Measles is one of the most contagious diseases – up to 90% of close contacts who aren’t immune will get it. It’s spread through the air and surfaces, and a revival with close quarters and lots of singing has superspreader potential. Most of us think of a rash when we think of measles, but the rash isn’t actually the first symptom. Initial symptoms are similar to flu or COVID, with high fever, cough, runny nose, and red, watery eyes. 2-3 days after symptoms start, tiny white spots may appear inside the mouth and after 3-5 days the telltale rash breaks out. The good news is that most employees will have been vaccinated against measles as part of their standard childhood vaccination schedule. If the employee attended the revival and is unvaccinated, the CDC is urging them to go get vaccinated (or get immunoglobulin) to help prevent infection. They should also be on the lookout for any of the symptoms and stay home if they feel sick or develop a rash.

Is there a clinical reason the COVID state of emergency ends in May?

Not exactly, though it’s likely timed to coincide with the end of flu season. Ending the emergency after we’ve gotten through the winter, when respiratory viruses spread more easily, is a smart move. That said, we’ve seen COVID spikes in the spring, summer, and fall over the past three years, so there’s nothing that prevents that from happening, just makes it slightly less likely.

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If someone doesn’t know if they got the Hep A vaccine, can they get another one?

Yes, there’s no limit to how many doses you can have. If you’re not sure if you have had the Hep A vaccine, you can get another dose to be confident that you’re protected. You could theoretically do antibody testing to see if you’re protected, but the process is complicated and usually not necessary. Most people who aren’t sure opt to get a new dose.

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Best Read:

People aren’t getting the COVID booster. Employers can change that. - SF Chronicle | Opinion