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The Executive Briefing - Tuesday, December 14th

Omicron 'explosion' is coming 📈

December 14, 2021

COVID Recap:

  • The US passed 50 million COVID cases this past weekend, and today we hit a tragic milestone of 800,000 deaths. (Reuters)
  • NY and CA both instated mask mandates for unvaccinated people indoors in public ahead of the holidays. (NY Times)
  • The Biden administration is warning of an explosion of cases as Omicron spreads amid holiday gatherings. (Axios)
  • “We’re heartbroken. We’re overwhelmed.” A full-page ad in most major MN newspapers across Minnesota pleaded with residents to get vaccinated, wear masks, and stay home sick, signed by CEOs and doctors from major healthcare orgs. (Washington Post)
  • Only half of nursing home residents have had booster doses. Pair that with the fact that the majority of deaths happen in those 65 and older, plus reduced vaccine effectiveness with Omicron, and the risk is very real. (CNN)
  • The definition of “fully vaccinated” isn’t changing to include boosters in the near future, according to Dr. Fauci this weekend. (CNBC)
  • Some hospitals are dropping staff vaccine mandates amid a labor crunch as the federal mandate for healthcare workers has been temporarily suspended in court. (WSJ)
  • Missouri is dropping many COVID-19 measures after a court ruled that public health departments in the state lack the authority to implement mask mandates or isolation orders. (Gizmodo)
  • The Supreme Court declined to block New York’s vaccine mandate for healthcare workers. (Axios)
  • Some companies are canceling holiday parties and coming up with creative substitutes, like giving everyone $100 to get supplies for a virtual one. (Axios)
  • Massachusetts will distribute over 2 million at-home COVID tests to communities with high levels of poverty who are particularly at high risk. (Washington Post)
  • Pfizer’s oral antiviral pill reduced risk of hospitalization or death by about 88% when taken within the first 3-5 days. (Pfizer)

Today’s Health News:

  • A school in Pittsburgh is closed due to a suspected noro outbreak. (CBS)
  • A new report shows the impressive investigative detective work that epidemiologists did to identify the Walmart room spray that was the source of a deadly infection. (CIDRAP)
  • In an unexpected reversal, the DOT announced that labs and employers can continue to use older drug screen chain of custody forms. Supply chain issues have prevented distribution of new multi-part forms that had been set to replace the old ones this month.  (DOT)
  • Multiple new polio cases across the world are worrying health experts. (CIDRAP)
  • Coca-cola, Sprite, and Minute Maid were recalled in eight states for having metal pieces inside. (WXIN)


Best Questions:


Should we accept home tests?

We do recommend accepting home test results for positive tests and for routine testing. At-home rapid tests have a very high accuracy rate for positives, though less so for negative tests. At-home tests are usually unobserved and therefore could be anyone’s result, which is a risk….however, the risk of not accepting an at-home positive is much, much higher.  Assume any positive result is a true positive, especially given that PCR tests might take a few days to return.


What else is needed after someone tests positive on a home test?

Most of our clients will accept the at-home test result, exclude the employee from work for 10 days from the onset of symptoms (or the date of the test, if asymptomatic), and do contact tracing based on that positive result. We’ve heard of some clients asking the employee to include a photo of the result with a date/time stamp and their ID next to it to verify that it’s theirs.

We don’t  require a laboratory PCR test for confirmation of an at-home positive result, because nearly all rapid tests are over 99% accurate for positives. The patient’s doctor may decide a PCR test is needed to prescribe monoclonal antibodies for someone at high risk for severe illness, or who is particularly sick. Later, when oral antiviral medications for COVID treatment are available, PCR lab confirmation may be required to prescribe those meds, as well. But for public health purposes in most states, there is no requirement for lab confirmation.  Your own company may have different policies for sick leave, so you should check those, as well.


If you have no reaction to a booster shot, does that mean it didn’t work?

The booster dose is working, even if you don’t have a strong reaction to it! Some people experience fever, fatigue, swollen lymph nodes, sore arms, and other symptoms in the day or two after their shots, but others have nothing at all. Either way, there’s good evidence that boosters are working well to help build your immune response to the coronavirus, so rest assured!

How much are you seeing long COVID? What does it look like?

Unfortunately, our clients are seeing lots and lots of long COVID. Generally, it starts with a person who is excluded from work for 10 days due to a positive COVID test, who then isn’t ready to return for a long time. They’re suffering from a wide range of issues, from brain fog and severe fatigue, to shortness of breath, cough, pain, dizziness, heart palpitations, fever, and so much more. We’ve seen people with vastly different symptoms and experiences, but all triggered by a bout with COVID. Our clients’ HR departments have been working with long haulers on medical leaves of absence, with many still suffering from severe illness even a year beyond their initial infection.



Best Read:

Opinion: We Can Live Better Lives While Being Smart About COVID



Best Laugh:

The reason they skipped Nu in the Greek alphabet...