Testing Before Return from Isolation

Key Points:

• In today’s Recommendations for Industry, we discuss testing symptomatic employees prior to their return to work. Read more below.
• South Africa has declared that they’ve moved through the peak of their fourth COVID-19 wave that has been driven by the Omicron variant. Additionally, it has removed its curfew.
• The U.S. has topped 2 million cases in a week; this is a first during the pandemic for the U.S. (USA Today).  
• As discussed, the WHO is finding more evidence that the Omicron variant is milder (Aljazeera).
• In Vaccine News:
  • The FDA has authorized the Pfizer booster doses in 12 – 17-year-old individuals. Additionally, the FDA is also encouraging booster shots for immunocompromised children ages 5 – 11 years old.
  • Two recent MMWRs on Pfizer’s COVID-19 vaccine, the vaccine has been shown to be safe and effective in 5 – 11-year-olds. Additionally, the studies have found that the vaccines are 92% effective against infection in 12 – 17-year-olds (CIDRAP).

Influenza:

• In the U.S., the seasonal flu is back. Severe cases could further strain the healthcare system; in fact, we are seeing increased flu hospitalizations and deaths starting to become reported. Most influenza cases detected in the US are Influenza A (H3N2). Twelve jurisdictions in the US are experiencing moderate activity while 19 are experiencing high or very high activity.
• Globally, the WHO has also seen an increase of influenza activity (although globally levels are relatively low). The WHO states, “with the increasing detections of influenza during COVID-19 pandemic, countries are encouraged to enhance integrated surveillance to monitor influenza and SARS-CoV-2 at the same time, and step-up their influenza vaccination campaign to prevent severe disease and hospitalizations in high-risk groups of influenza.”

Recommendations for Industry

Testing Before Return from Isolation

Based on a number of current media reports on statements from Dr. Anthony Fauci, the CDC is considering updating its guidance that shortened the isolation period for those with COVID-19 to include testing on Day 5, with a negative result prior to returning to work.

TAG agrees with testing being added to the guidance. However, with the continued shortage of tests, day 5 may not be the optimal time to test as some of our clients are finding that 80% of those who were symptomatic continue to test positive on day 5. Thus, if testing is limited in your area, TAG would recommend you ask employees to stay out and test on day 7. If that test is negative, they can then return to work with continued masking.

If your area has sufficient availability, you could continue to request the employee use a rapid antigen test on day 5 if symptoms have significantly improved; if it results in a positive, they can then test again on day 7 with an antigen test. If either comes back negative, they can then return to work, continuing to mask.

In either case, allowing a person who had COVID to return on day 5 without a test could risk transmission from the highly contagious Omicron variant in the workplace and result in additional time out for employees. 

In case you missed it

• In last Thursday’s Recommendations for Industry, we discussed increased absenteeism in the new year and looked at the weekly Risk Matrix. Read more here.
• OSHA Withdrew its COVID-19 Healthcare ETS a week after it had reached its six-month expiration date, with the exception of the recordkeeping requirements, which remain in place under a separate provision of OSH Act. OSHA is continuing to work on a permanent version of the rule. The decision does not affect OSHA’s COVID-19 vaccination and testing ETS that applies to American businesses with 100 or more employees. Enforcement of that measure is slated to begin on Jan. 10, three days after the U.S. Supreme Court hears arguments on whether to block it and a health-care worker vaccination mandate.
• Moderna and J&J Boosters Said to Protect against Omicron.
• Moderna announced that its COVID-19 vaccine booster significantly increased antibodies against Omicron, saying data show that it can boost neutralizing antibody levels 37-fold higher than pre-boost levels. A double-dose booster, equivalent to that used in the main shots, given primarily to immunocompromised people, raised antibody levels by 83 times.
• A Johnson & Johnson study showed that two shots of the vaccine reduced the risk of hospitalization from Omicron by 85 percent. Although CDC is recommending a preference for the other boosters, the results are particularly important for vaccination efforts in Africa, where J&J is a mainstay of COVID public health efforts. 
• Two new over-the-counter, at-home COVID-19 tests have been brought to U.S. market. The tests, one manufactured by SD Biosensor and distributed by Roche and the other manufactured by Siemens, have received FDA emergency use authorization (EUA) after being evaluated through the Administration’s new accelerated pathway to support FDA review of tests with potential for large-scale manufacturing.
• A rising number of pediatric cases have convinced officials in some states to order a return to remote learning after the winter break. Around 300 schools in Maryland, New Jersey, New Mexico and New York will remain closed. With cases surging in Northeast Ohio, the  Cleveland Metropolitan School District also announced that all schools in the district will conduct classes through remote learning through at least the first week of January. Some provinces of Canada also have returned to remote learning.
• Researchers found SARS-CoV-2 in 36% of white-tailed deer in Ohio, with evidence of deer-to-deer spread, according to a study late last week in Nature. The evidence “leads toward the idea that we might actually have established a new maintenance host outside humans,” said the senior author, an Ohio State University Professor. A previous study found about the same level of COVID-19 infection in Iowa deer, and Canada reported SARS-CoV-2 in deer earlier this month.

Food Fraud:

• A Dubai Restaurant is using Technology Against Seafood Fraud. Diners ordering fish receive a QR code with their order which links to a web page that shows when and where their fish was caught, how it was transported, and provides certifications that it was sustainably sourced. The traceability is provided by Seafood Souq, an e-commerce marketplace that tracks every point on the supply chain.