The Executive Briefing - Tuesday, August 10th

Updated Exclusion Chart

• We’ve updated the ZHH + Zedic Exclusion Chart to reflect the most common Delta variant symptoms and the rising case counts nationwide.
• Read about our changes and see the updated chart here.
  

COVID Recap

• Some children are getting severely ill from COVID, especially in Florida and Texas, where one baby in the Houston area had to be airlifted due to a shortage of pediatric beds. (ABC News)
• And kids are getting seriously sick with long COVID, suffering from a huge variety of symptoms lasting months or longer. (New York Times)
• Fake vaccination cards are proving to be an issue for the colleges that are mandating vaccinations. (AP)
• Some employers are tacking on a $20-$50 surcharge to their unvaccinated employees to incentivize vaccination, similar to smoking surcharges. (Forbes)
• Dr. Larry Brilliant, who was part of the WHO team that eradicated smallpox, believes the pandemic may be closer to the beginning than the end. (CNBC)
• A small study shows that a single dose of Pfizer vaccine may be all that’s needed for someone who previously had COVID to have similar antibody levels to those who didn’t have COVID and received two shots.  (MedPage Today)
• The U.S. military and United Airlines are two of the latest organizations to require employees to be vaccinated. (AP, NPR)
• Most unvaccinated adults see the vaccine as a greater health risk than COVID-19 itself, according to a new study. In reality, COVID is much, much riskier. (Kaiser Family Foundation)
• CNN fired three workers for coming to work unvaccinated, a violation of their company policy. (NPR)
• Travelers using Abbott’s Binax IDNow at-home COVID tests (which are conducted via Zoom) are facing long wait times. (Points Guys)
  

Today’s Health News

• Experts are investigating a deadly outbreak of Melioidosis, usually found in tropical climates. 2 people have died, with 4 patients in GA, TX, KS, and MN. A source is not yet known. (US News)
• The pandemic has set off a deadly rise in speeding that hasn’t stopped - leading to more highway deaths despite much less traffic. (NBC)
• West Africa’s first confirmed case of Marburg virus disease was identified this week. It’s a highly infectious disease in the same family as Ebola and with similar symptoms. There are no vaccines or antiviral treatments. (WHO)
• West Nile Virus is back with the first cases of the year detected in L.A. and Orange Counties in California. (LA Times)

Best Questions

Do vaccinated people need to be excluded if they have symptoms?

This question continues to come up a lot recently. Anyone with new COVID symptoms should be excluded, even if they are fully vaccinated. Even mild symptoms are important to monitor, since vaccinated people tend to have more mild symptoms if they do get a breakthrough infection.

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We want to require either vaccination or regular testing at our offices. What testing works best?

Many of our clients are asking the same question and many are now mandating vaccination for return to the office or larger work settings. We strongly support that. There are employees who are not able to be vaccinated (for medical or religious reasons) and they will require reasonable accommodation. For those employees, weekly PCR testing seems to be the norm at the employee's expense (most testing is covered by insurance and free testing remains widely available).  You will need a system for keeping track of test results which can be challenging.  To date, none of our clients are allowing the testing option for employees who simply opt not to receive the vaccine.  They are not being permitted to return to the office.  While you should review whatever policy you settle on with your counsel, the EEOC has clearly supported vaccine mandates.

If you need help with on site testing (or self-collected PCR testing), email Julianne at jfonto@zerohourhealth.com.

We’re dealing with a lot of employee anxiety about allowing vaccinated employees back to work who have been exposed to COVID, especially with so many breakthrough cases. What is the science we can share with them?

We’ve gone from employees being furious that they’re excluded from work while fully vaccinated with symptoms, to employees being bewildered and concerned that they’re NOT excluded from work after exposure. Certainly, there’s some whiplash here, and the anxiety isn’t entirely unfounded. There are breakthrough cases happening regularly, though the good news is that when they do happen, people aren’t getting very sick.

According to a recent study of the 25 states reporting on breakthrough cases, less than 1% of all fully vaccinated people have experienced a breakthrough case. About 98.4% of all COVID cases are in people who are unvaccinated. So, there is still some risk to letting fully vaccinated people work after exposure, but it’s a relatively low risk - made even lower if they wear a mask and monitor for symptoms for a full 14 days.

Sharing that data with your employees, and encouraging them to wear masks and monitor for symptoms, is one of the most effective ways to help combat that anxiety. You can also consider encouraging testing at day 3 or 5 after exposure, which is recommended by the CDC. We still don’t recommend allowing employees to remove their masks if they test negative since enforcing a strict 14 day mask requirement for those exposed seems like the best and most logistically realistic path. And realistically, as we learn more about the prevalence of breakthrough cases and the evolution of new variants, this might continue to change.

An employee refuses to wear a mask because they already had COVID.  This is in a county with high transmission where we’re requiring masks for all employees.  How should we address this situation?

Unfortunately, a study published in Science magazine provided significant data demonstrating that someone who had COVID but is unvaccinated may be twice as likely to contract COVID again as someone who is vaccinated.  So, it simply isn’t correct that someone who had COVID doesn’t need to wear a mask  - to protect themselves or others (as they could be reinfected and asymptomatic spreading the virus).  Mask mandates apply to everyone.

The CDC’s latest guidance says vaccinated people must wear a mask for 14 days unless they test negative 3-5 days after exposure.  Are other companies allowing fully vaccinated employees to provide negative tests to discontinue wearing a mask after exposure?

The latest CDC guidance states that unvaccinated people who are exposed must quarantine, while fully vaccinated people should get tested 3-5 days after exposure, and wear a mask for 14 days or until they receive a negative test result. Most of our client companies are having a difficult time managing this masking exemption through testing and are not including testing instructions in their employee communication after an exposure.

Those who are allowing employees to test out of the mask requirements are finding few employees availing themselves of the options (but many have employees testing on days 3-5 because they’ve developed symptoms).  We do expect that there may be additional changes to the guidance as we learn more about the vaccines, variants, and breakthrough cases.  

Best Read:

We were excited to be featured in this article from the Wall Street Journal about in-person meetings and office re-openings:

Companies Thought They Had Plans for Fall. Now They Are Scrapping Them.

Best Laugh:

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