Where is COVID-19 Heading Now?

• In today’s Recommendations for Industry, we discuss the risk matrix and the current decline of COVID-19 coinciding with the OSHA vaccination/testing standards. Read more below.
• The BBC reports that a recent study has found that lateral flow tests “are very good at detecting people most likely to spread COVID-19 and positive results should be trusted.”
• Pfizer will be seeking Health Canada’s approval for its vaccine for children between 5-12 years old in the next few days.
• Recent preliminary data has found that “[p]eople who received a Johnson & Johnson coronavirus vaccine may be better off with a booster shot from Moderna or Pfizer-BioNTech.”

Public Health & Food Safety

• The most recent IFT podcast discusses the current state of African Swine Fever which has been “spreading across the globe, killing millions of pigs.” It is considered a viable threat to the pork industry. This podcast discusses what the U.S. can do to protect its “hog population and how the COVID-19 pandemic has compounded the problem.”
• A recent assessment and study of ochratoxin A in coffee has found that there is “no evidence […] identified from historical data to suggest OTA is acutely toxic in humans from coffee consumption or other exposure sources. Therefore, findings from this assessment indicate that no PC [preventive control] is warranted for US coffee manufactures, based on the low severity and likelihood of risk according to margin-of-exposure estimates and historical data.” Read the assessment and study here.

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Where is COVID-19 Heading Now?

In analyzing TAG’s ongoing COVID-19 matrix assessments along with other sites that have been tracking the trajectory of case counts (including Covid Act Now and Worldometers), it appears that, if we continue at the current rate of decline, the U.S. will be down to pre-Delta peak levels in about six weeks – the end of November.

The most recent TAG matrix indicates overall falling numbers with some major exceptions in a few states where the case counts remain high, including Minnesota, Michigan, and Montana (along with Pennsylvania and Vermont according to Johns Hopkins data). But there does not appear to be any emerging new variants of concern in other parts of the world that would signal that a new wave of COVID-19 will hit the US in the near future.

Thus, the release of the OSHA standards for compliance with the vaccine/testing mandate for businesses (with more than 100 employees), which is expected to publish soon, is likely to coincide with very low cases of COVID-19 in the US. Even without decreasing numbers, compliance is likely to lead to disruption and economic consequences; but with the decrease, is it now becoming more of an exercise in regulatory compliance than public health?

On the plus side, we do see definite tangential benefits and value in the increased access to rapid tests, particularly with the current labor shortages with which businesses are contending. A rapid test providing a negative COVID result can enable employees to return to work much more quickly and continue working with general protections if symptoms turn out to be cold, sinus, etc.  And even with positive tests, we are seeing some significant promise in new and effective therapies such as monoclonal antibody or antiviral drugs.

This analysis and discussion also bring up a point that TAG has previously raised, that – following this fourth wave of COVID-19 in the US – we’re likely entering the endemic-phase of the pandemic and consider managing it that way – like influenza. That is, can we manage it through the combination of vaccinations for those that want it, avoidance of spread to the greatest extent possible through personal and workplace protections, and the use of antiviral drugs as needed.

COVID-19 management continues to be a challenge for businesses, but you don’t have to go it alone. Give TAG a call for assistance.

Risk Matrix:

Overall, things are looking up. Between last week and this week, 45 states have seen a decrease in cases while 5 states (Montana, Colorado, Minnesota, Michigan, and Pennsylvania) have seen an increase in cases.

Table 1.

Figure 1.

Table 2.

Table 3.

• In Tuesday’s Recommendations for Industry, we discussed how to prepare for the OSHA vaccine and testing standards. Read more here.
• If you’re interested in how the WHO estimates excess COVID-19 deaths, the WHO has published its methodology here.
• CNBC discusses that if one is fired for refusing a COVID-19 vaccine, depending on a state’s regulations, there is a likelihood that the ex-employee may not be able to receive unemployment benefits.
• As we’ve discussed before, the rise of the Delta variant has slowed the economy as employers continue to struggle finding workers. September’s Labor Department report found that unemployment rates sank to 4.8% from 5.2%.
• Pfizer will be conducting a full city-wide study in Toledo, Brazil of its COVID-19 vaccine by fully vaccinating everyone in the city over the age of 12 years old to better study the safety and efficacy of its vaccine.
• AstraZencea’s experimental antibody cocktail is successful in late-stage study applying it to treating COVID-19.
• While authorities believe it’s too soon to “declare victory against COVID-19 ahead of the holidays,” Fauci has said that outdoor trick-or-treating, especially for fully vaccinated kids, should be fine and safe.
• Merck has petitioned and submitted an EUA application for its pill (the drug, molnupiravir) to treat COVID-19.
• COVID-19 vaccinations for adolescents are quickly lagging. In fact, only “47% of the nation’s 12- to 17-year-olds are vaccinated against COVID-19, and in nine states, less than a third of eligible teens are vaccinated.” The vaccination gaps in the country can be seen in: “Alabama, Georgia, Louisiana, Mississippi, South Carolina, and Tennessee.” In fact, in addition to the South, North Dakota, West Virginia, and Wyoming have “less than 30% of adolescents vaccinated.”
• COVID is shown to affect all ages in the family equally; however, “families with one immune member had a 45% to 61% lower chance of infection than those with no immune member.”
• The National Restaurant Association reports that customer demand for outdoor dining has risen due to the Delta variant; in fact, “71% of operators that offer[ed] outdoor dining say[s] the delta variant led to an increase in customer demand for outdoor seating in recent weeks.”
• Although the rate of COVID-19 cases has dropped in 45 states, in 5 states (Montana, Colorado, Minnesota, Michigan, and Pennsylvania) have had at least 10% more cases.
• The WHO is recommending the COVID-19 booster shot for immunocompromised. “The World Health Organization is recommending that people with weakened immune systems be given a booster shot of the COVID-19 vaccine. A panel of WHO vaccine advisers said the additional dose would help immunocompromised people because that population is less likely to respond to a standard vaccination, and they are at high risk of severe COVID-19 disease. The panel, called the Strategic Advisory Group of Experts on Immunization (SAGE), also recommended booster shots for people over age 60 who have received inoculations made by Chinese vaccine makers Sinopharm and Sinovac. It cited evidence in studies in Latin America that those vaccines do not perform as well over time. The panel did not recommend an additional booster dose for the population at large and said it would review the issue of widespread booster use on November 11.”
• Texas governor, Greg Abbott, will ban COVID-19 vaccine mandates, including for private employers. Read more in the Texas Tribune.

Flu Status

• CDC: 1.9% of patient visits reported through ILINet were due to influenza. The percentage of patient visits for ILI remains below the baseline of 2.6% nationally. All ten regions are below their region-specific baselines.
• WHO: “Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year. Worldwide, influenza A and B viruses were detected in similar proportions.”