Cliché but True: Keep Calm and Carry On

Key Points:

• In today’s Recommendations for Industry, we discuss the current progression of COVID and the flu and why keeping calm is the phrase of the day. Read more below.
• Happy Lunar New Year to all our readers!
• The U.S. FDA has given full approval to Moderna’s COVID-19 vaccine, henceforth known as Spikevax (VOA News, CIDRAP).
• Further information on COVID vaccines finds that the vaccines can markedly cut household transmission (especially if there are two vaccinated parents), with a study in Science finding an “estimated 89.4% lower risk of infection” (CIDRAP). Additionally, a third COVID vaccine boost does provide increased effectiveness against hospitalizations (CIDRAP 2).
• While less severe in terms of hospitalizations when compared to the Delta variant, Omicron is causing more reinfections in those who had been previously infected and/or are vaccinated (CIDRAP). Cases in many parts of the U.S. have peaked and are coming down, there are still some high hospitalization rates (Montana) and increased cases (Colorado, Florida, Louisiana) (NYT). Due to how things are going across the world, the U.S. has increased the number of countries and territories on its “Level 4: Very High” risk travel list to include Mexico, Brazil, and Singapore (Reuters). There are now 130 countries on this list.
• New studies on the Omicron subvariant, BA.2, have found that it is more transmissible than the original Omicron strain (CNBC; CIDRAP).
• The origin of Omicron is now under a three-theory discussion. This article in Nature tracks the evolution from the original strain to now. 

Influenza:

• In the U.S., influenza activity remains stable with a slight decrease. “The vast majority of flu viruses remain influenza A strains (97.2%), with the H3N2 strain accounting for 100% of subtyped samples at public health labs. The CDC says most of H3N2 viruses identified so far this season are genetically closely related to the vaccine virus, but some antigenic differences have been observed as the viruses continue to evolve.” (CIDRAP). Cases of flu are rising in some parts of the U.S. (including South Dakota) while falling in others (Louisiana).
• Denmark has reported its first case of variant swine flu discovered in a slaughterhouse worker (CIDRAP).

Public Health:

• In the DRC, Nigeria, and Ukraine, there are an increasing number of vaccine-derived poliovirus type 2 cases (CIDRAP).
• The first E. coli O103 outbreak has been found in raw celery (Food Safety News).

Recommendations for Industry

Cliché but True: Keep Calm and Carry On

While both COVID and flu transmission is continuing, there is no need for panic.

• For COVID: You have likely been seeing more about a “new” subvariant of Omicron, as this has been of increasing focus in the news. But the science has shown that the subvariant (BA.2) likely is not new but emerged at the same time and place as BA.1. From its emergence, the two strains then became dominant in different geographic locations, with BA.1 becoming dominant in the U.S. Although BA.2 appears to be at least marginally more transmissible, it is no more serious than BA.1, and it is likely that having had either one will protect a person from the other. Overall, COVID appears to be following the anticipated progression, with cases still ebbing in a westward flow.
• For Flu: Despite early thoughts of a potentially high season of influenza, we are not seeing a heavy flu year. Cases rose a bit, then stabilized, and this year’s strain has not shown to have a super high infectivity. It is higher than that of 2021, which is to be expected since more COVID protections were in place, which helped to mitigate flu transmission, but it is no greater than what had previously been the norm.
• For COVID-Flu Combo: While co-infection of COVID and the flu can happen, it is not a significant issue in otherwise healthy people.

So, while it has become cliché to say it: Keep calm and carry on. We are not seeing anything new of concern, and continue to hold out guarded optimism for both COVID and the flu.

In case you missed it

• In Thursday’s Recommendations for Industry, we discussed our guarded optimism for the ebbing of Omicron. Read more here.
• OSHA Withdraws Its Workplace Vaccine Rule. On Tuesday, OSHA announced its withdrawal of the November 5, 2021, ETS issued to “protect unvaccinated employees of large employers (100 or more employees) from the risk of contracting COVID–19 by strongly encouraging vaccination.” The withdrawal followed the January 13, U.S. Supreme Court stay of the ETS, finding that challengers were likely to prevail on their claims. In the withdrawal, OSHA stated, “Notwithstanding the withdrawal of the Vaccination and Testing ETS, OSHA continues to strongly encourage the vaccination of workers against the continuing dangers posed by COVID-19 in the workplace.” The 6-to-3 Supreme Court’s decision said that OSHA did not have the authority to require workers to be vaccinated against the coronavirus or tested weekly, describing the agency’s approach as “a blunt instrument.”
• CDC confirms Omicron less severe than other variants. 31 states, Washington DC and Puerto Rico are reporting decreasing or plateauing new COVID-19 case averages, signaling that the massive surge caused by Omicron may be receding. New data published in Morbidity and Mortality Weekly Report show that illnesses caused by Omicron are less severe than previous variants, with the ratio of peak emergency department visits, hospital admissions, and deaths to cases all lower than in other variants. But deaths continue to increase, with more being announced each day than at any time since last winter and hospitalizations appear to be reaching a national peak.
• Pfizer, BioNTech launch trial of Omicron-specific COVID-19 vaccine. Pfizer and BioNTech have initiated a clinical study to assess the safety and efficacy of a vaccine for ages 18 to 55 years that targets Omicron.
• Two countries that experienced early Omicron surges in Europe—Denmark and the Netherlands—are stepping down their restrictions. Denmark’s epidemic committee recommended lifting all COVID-19 restrictions by the end of the month, and that, as of Feb 5, COVID-19 should no longer be categorized as a “socially critical” disease. However, variant surges are accelerating in countries such as Japan and South Korea, triggering tightened measures. South Korea reported a new daily record high for COVID cases, with Omicron now dominant; Japan’s daily total rose above 60,000 for the first time, and officials placed 18 more prefectures under a quasi-state of emergency, which now covers about 70% of the country.
• The WHO weekly update showed a slow of the steady global rise in COVID-19 cases last week, with cases up 5% compared with the previous week, however Eastern Mediterranean region reported the biggest rise last week and five countries added the most cases to the global total: the United States, France, India, Italy, and Brazil. More than 21 million new cases were reported, marking the highest weekly total since the pandemic began, and deaths remained similar to the previous week, with nearly 50,000 fatalities last week.
• 75% of COVID ICU survivors have physical symptoms 1 year on. One year after 246 COVID-19 survivors were treated in intensive care units (ICUs) in the Netherlands, nearly 75% reported lingering physical symptoms, more than 26% said they had mental symptoms, and upwards of 16% still had cognitive symptoms, according to a study in JAMA.

Public Health:

• Antibiotic-resistant infections killed more than 1.2 million people in 2019. According to a new estimate published in The Lancet, antibiotic-resistant infections, on the rise globally, killed more than 1.2 million people in 2019. Additionally, researchers estimated that a total of 4.95 million deaths in 2019 were “associated” with bacterial antimicrobial resistance (AMR).