Zero Hour Health + Zedic Newsletter - Friday, April 23rd

Breaking News

JUST IN: The CDC vaccine advisory committee voted just a few minutes ago to lift the pause on the J&J vaccine. This clears the path for administering more than 9 million doses already distributed to states.

• They’re recommending its use for anyone 18+ under the FDA Emergency Use Authorization, which will include a fact sheet stating that in rare cases it has caused blood clots in women under 50. 
• After a 10-day pause, the number of total cases of these rare blood clots was raised to 15 (still about 2 in a million). 
• The decision amounts to a choice for women under 50: get the J&J if they choose to and understand the risks, or choose another vaccine option. 
• The CDC stressed that the J&J vaccine was still very safe, that the system for reporting side effects worked, and that the risks of getting COVID are still much greater than the risk of these rare blood clots, even for women under 50.
  

Today's Recap

• There’s a newly discovered COVID variant that’s been identified in Texas, BV-1. It’s especially worrisome because it shows signs of antibody resistance. (CNBC)
• But current vaccines appear to be effective at neutralizing the NY variant. (New York Times)
• Small businesses that provide PTO for vaccination will get a tax credit. If you’re a small business wondering about tracking vaccination, we might be able to help. (SHRM)
• Nine out of 10 Americans surveyed said the pause on the Johnson & Johnson vaccine was the right call, and the pause hasn't increased vaccine hesitancy. (Axios)
• Despite questions over its link to rare blood clots overseas, AstraZeneca says it will still apply for emergency use authorization in the U.S. (Fierce Pharma)
• One of every 850 doses of a COVID vaccine has to be thrown out because it was "unused, spoiled, expired, or wasted”. Even though some of that is expected, these figures are likely an underestimate of actual COVID vaccine waste. (CNN)
• Another good reason to get the vaccine: a new study found that people with mild COVID (who weren’t sick enough to go to the hospital) were 60% more likely to die in the next six months than those who didn’t have COVID. (NYT)
• And another: Data shows that, worldwide, pregnant women with COVID-19 and their babies face a higher complication and mortality risk. (JAMA Pediatrics)
• The LA Dodgers are offering a “fully vaccinated” section in their stadium, where masks will still be required but social distancing isn’t. (LA Times)
• Toronto will order workplace shut downs for 10 days if they have more than 5 COVID cases in a two-week period. (Bloomberg)
• A bird flu has jumped to humans for the first time. Many scientists aren’t worried just yet, but it’s a scary reminder that animal viruses can make the leap to humans easily, and COVID likely isn’t the last we’ll see in our lifetimes. (NYT) 
• If you get COVID between shots, you're good to get your second dose once you're recovered and no longer contagious, said Dr. Fauci. (CNBC)
• The NYC DOH issued a Hep A alert - in large part focused on the larger homeless population. NY had been somewhat oddly isolated from the nationwide outbreak until recently. (NY DOH)
  
  

Best Questions

Do we need to wear masks outdoors? 

Most COVID transmission happens indoors. Less than 10% happens outdoors and generally after prolonged close contact, like a personal conversation or two people jogging together. You may have read about a Slate op-ed published this week advocating for dropping masks when outdoors, but, especially in the context of your business, we think that’s still risky as a blanket rule. Instead, we advise that you generally follow the advice of Dr. Linsey Marr, a leading expert on viral transmission, who talks about the 2-out-of-3 rule: outdoors, distanced, or masked.  Outdoors but not distanced? Wear masks. Outdoors but not masked? Stay six feet apart. Indoors, you should always be both distanced and masked. 

For business operators, you’ll need to check in with your legal team before you decide to make masks optional for employees when outdoors. Because the CDC is still recommending masks, some interpret that to mean failure to enforce mask usage could be considered a violation of the General Duty Clause in the case of an OSHA inspection.

What can we do to reduce risk when returning to full capacity? 

As many jurisdictions relax COVID restrictions and your businesses return to full capacity, it’s important to keep in mind that we are still seeing 50,000 new cases per day with new variants spreading, and now is not the time to let your guard down. 

First and foremost, ensuring that your employees keep wearing masks is key, and we strongly recommend it. Wearing a mask reduces your individual risk by about 65% - multiply that by every employee in your business, and you can prevent a COVID+ guest or employee from turning into a full-fledged outbreak.  

Focus on ventilation, too - it’s your next best defense for indoor areas if people will be removing their masks (to eat, for example). Getting a good cross-breeze, opening doors and windows and replacing as much air as possible is key. Adding physical barriers between any seats you add back in can also help.

We’re seeing a significant drop off in employees getting newly vaccinated. What’s up with that?

The seven day average of daily vaccinations dropped by 11 percent compared to the previous week. We have our work cut out for us. Some of this is likely due to increased concern after the Johnson & Johnson pause. More so, we believe it’s a sign that we’ve started to hit the wall where most of the people who were excited to get vaccinated have done so, and the rest are those who are on the fence or never going to get vaccinated. Young people aren’t getting vaccinated at the rate we’d hoped, but new evidence showing higher hospitalization rates, deaths and serious complications after mild COVID cases might continue to sway them. Perks that come with proof of vaccination (like sitting with friends at the baseball game) could help, as well. This is where your business, as a trusted source of information, could make a big difference through good communication and reliable info about the vaccines for those “persuadables” among your workforce.

Should we be worried about the high case counts in India? 

Yes. We’ll still have to worry about COVID for a long time - even after most of the US is vaccinated - because so much of the rest of the world is not yet vaccinated. The US, UK, Canada and other rich countries are refusing to waive the rights to the COVID vaccines, blocking production in more than 100 poorer countries - including in India, where case counts are astronomically high right now. The real concern is that the rampant spread of COVID worldwide will make our vaccines useless in the face of dozens of new variants. If we don’t get global COVID under control, we can definitely expect more booster doses of vaccines, more public health measures to control the spread and a long road ahead of us.

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