The Executive Briefing - Tuesday, August 3rd

COVID Recap

• It’s official - we are back to some of the highest case counts we’ve seen throughout the pandemic. Florida and Louisiana are seeing the worst rates ever. (Reuters)
• The White House is frustrated over “irresponsible” media coverage of breakthrough cases (which are still rare and almost always mild), concerned that they’ll fuel vaccine hesitancy. (CNN)
• To be clear, 99.99% of vaccinated people have NOT had a COVID breakthrough case severe enough to need hospitalization or to die.  (CNN)
• Sen. Lindsey Graham says he is “very glad I was vaccinated” after testing positive for COVID with mild symptoms, saying his “symptoms would be far worse” without the vaccine. (CBS) 
• The eviction moratorium ended this past weekend, with more than 6.5 million households behind on rent. Amid this surge in COVID cases, public health experts worry that evictions will fuel outbreaks. (Reuters)
• Public health workers in Missouri set up a mobile vaccination clinic at a county fair. Not a single person showed up to be vaccinated. (NBC)
• People seeking unauthorized booster doses in the U.S. are creating headaches for the healthcare system. Germany, Israel, and the U.K. have approved additional shots but the U.S. has not. (STAT)
• As we predicted last week, Gov. DeSantis of FL is out of the gate early with a ban on mask mandates for schools - this on the same weekend that FL broke its single day records for both new cases and hospitalizations. (Reuters)
• Meanwhile, NYC will require proof of vaccination for indoor dining, gyms, and entertainment venues, set to begin in mid-September. It appears this will extend to workers at those businesses, as well.  (New York Times)
• A new Gallup poll shows how quickly Americans’ perception of the pandemic changed in the past few weeks: just last month, most thought it would last a few weeks or months. Now, nearly 80% believe it will last through 2021 or beyond. (Gallup)

Today’s Health News

• There’s a Hep A outbreak in Canada linked to frozen mangoes. It’s not yet clear if any were distributed in the U.S. (Toronto City News)
• A norovirus vaccine may be on the way! A new study has isolated norovirus antibodies that may be the first step toward a vaccine against the highly contagious stomach bug. (Nature)
• Contact tracing really works! The CDC hasn’t found any new cases of monkeypox in the U.S. after monitoring hundreds of people connected to a positive case in Texas. (STAT)

Best Questions

How much of the U.S. falls into the “high or substantial” transmission category where fully vaccinated people should wear masks indoors?

As of Tuesday, 80.87% of U.S. counties fall into the high or substantial transmission categories. The number of counties falling under the highest transmission status increased by ~16% over the last week, so unless something drastic changes you can expect it will likely continue to rise next week. 

You can see the current percentages up to date on the CDC website here:  https://covid.cdc.gov/covid-data-tracker/#county-view. Scroll down that page to see the table called "Level of Community Transmission", which you can see here with this today's data:

If 80% of the US is “substantial or high” transmission levels, should we just mandate masks universally?

Clinically and operationally, we do think this is the right move. Whether the other social and political implications make sense for your company is another story. Over 78% of US counties last week fell into the category where fully vaccinated people should wear masks indoors. Population-wise, it’s likely an even higher percentage of the total US population. Tracking week-by-week, county-by-county transmission data is going to be a challenge. Plus there’s the issue of what to do when someone works in one county and lives in another if they’re at different transmission levels. It’s all very complicated. Our honest opinion is that it’s safest to require masks for everyone indoors at work right now for the next few weeks to see how this plays out and to get us through this surge. 

Are other ZHH clients who planned to return to the office after Labor Day delaying? 

In the past few weeks, we’ve learned a lot more about how infectious the Delta variant is and about the rate of breakthrough cases in fully vaccinated people. As we do, it’s becoming more and more clear that vaccinated people can transmit the virus if they get infected, even if their symptoms are mild, which means that we can expect prolonged time indoors to lead to outbreaks even if most of the people inside are vaccinated. Given that risk, and how quickly all of this has changed in the past four weeks, many of our clients - along with large companies like Google, Facebook, Apple, Goldman Sachs, and more  - are making major changes to their reopening plans. Many are delaying from September to October, with a few even skipping straight to January 2022 planned reopening. Others are moving to requiring proof of vaccination for those who are in-person at the office. It’s important to remember that most public health experts are concerned about what will happen in the fall 

How can we reduce risks as we return to the office?

This is a hot topic right now. Many of our clients are choosing to require vaccination for everyone who works indoors, either without exception or with masks and weekly testing required for anyone who isn’t fully vaccinated. Others are delaying their return to the office until case rates and transmission calm down in their area. Things are changing quickly, so whatever you choose, keep in mind that we’re still learning new things about how the Delta variant works and how vaccines protect against it, so we will need to be flexible and continue to make changes over the next few weeks and months. 

If we are requiring vaccination or weekly testing, do we have to arrange and pay for the weekly testing?

This is a legal question more than a clinical one, but many of our clients are having employees make their own testing arrangements and email a copy of results. According to a recent New York Times article on the subject, it’s really up to employers whether to cover the bill. For their part, the federal government will be footing the bill for weekly testing for their own unvaccinated federal workers. Meanwhile, neither NY nor CA has confirmed who will pay for their workers after announcing similar weekly testing requirements for unvaccinated state employees. MGM Resorts will charge their employees a $15 copay for testing. As always, be sure to check with your legal counsel before finalizing any vaccination or testing policy. 

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