COVID becoming an endemic virus

Key Points:

• In today’s Recommendation for Industry, we discuss COVID becoming an endemic virus. Read more below.
• COVID hot spots shift; studies add evidence for Wuhan market origin. In its weekly update, the WHO said about 6.6 million new cases were reported last week, about the same as the previous week. However, cases rose in three WHO regions: the Western Pacific, the Eastern Mediterranean, and Southeast Asia. BA.4 and BA.5 continue to be the dominant variant among individuals currently. Two studies, one performed at University of Arizona and the other at University of California, San Diego, both point to the Huanan market as the epicenter for the emergence of SARS-CoV-2. The two groups said SARS-CoV-2 was very likely present in live animals such as red foxes, hog badgers, and raccoon dogs sold in late 2019 at the market, where it likely spilled over to people working and shopping there in two separate virus introductions.
• Persistent brain fog, hair loss highlighted in long-COVID studies. Two new studies describe long-COVID symptoms, with one finding that 53% of hospitalized COVID-19 patients still had cognitive impairment (“brain fog”) 13 months after infection, and another adding conditions such as hair loss and sexual dysfunction to the list of persistent symptoms among outpatients. Among COVID-19 survivors, the risk factors for long COVID included female sex, younger age, non-White ethnicity, socioeconomic deprivation, smoking, obesity, and a wide range of underlying illnesses. Sixty-two symptoms were significantly linked to long COVID, with the largest adjusted hazard ratios (aHRs) for loss of smell (aHR, 6.49), hair loss (3.99), sneezing (2.77), ejaculation difficulty (2.63), and reduced libido (2.36).
• Few Parents Intend to Have Very Young Children Vaccinated Against COVID. In a new survey, 43 percent of parents of children ages 6 months through 4 years said they would refuse the shots for their kids. An additional 27 percent were uncertain. A majority of parents polled said they considered the vaccine a greater risk to their children than the coronavirus itself. The parents’ chief concerns were about potential side effects of the vaccine, its relative newness and what they felt was a lack of sufficient research. How a child will fare if COVID is contracted is unpredictable, which emphasizes experts’ opinions in why they believe the best option is to receive the vaccine.
• COVID in China: Million in lockdown in Wuhan after four cases– China follows a “zero COVID” strategy, including mass testing, strict isolation rules and local lockdowns. Travel decisions, sport choices, the timing of a day’s activities and, in some cases, even the ability to find work are all dependent on COVID.

Public Health & Food Safety:

• Push to rename monkeypox to fight growing stigma. NYC Health is asking the World Health Organization if monkeypox can be renamed as soon as possible. NYC Health informed WHO that they had concern around the name of the virus due to its stigma and painful and racist history within which terminology like this comes from communities of color. To expand, experts noted that the virus does not originate from monkeys and was only named as such because of an infection seen in research primates. WHO had been discussing the change of the virus name, but recently dropped the topic until NYC Health sent them a letter expressing their concerns. The total case count globally sits at 18,000 cases in 78 countries, 70% of which are within Europe. The US currently has more monkeypox cases than any other non-endemic country. The case count is currently at 3,487 with more than 500 new cases being reported on July 25^th.
• CDC says 17-state Jif peanut butter Salmonella outbreak is over. The whole Jif peanut butter outbreak consisted of 21 individuals being infected throughout 17 states, four of which required hospitalizations. Additionally, no deaths were reported from any of the illnesses. J.M. Smucker Company voluntarily recalled certain Jif brand peanut butter and many other companies that used the peanut butter as an ingredient in their products also issued recalls. For consumers the FDA continues to urge them to check to see if they have the recalled peanut butter on hand or if they have used the recalled Jif brand peanut butter that have lot code numbers 1274425 through 2140425 and the first seven digits end with 425.
• Dole recalls Simply Nature and Marketside salad mixes over toxic nightshade. Dole Fresh Vegetables Inc is recalling Simply Nature Organic Spring Mix 16 oz., and Walmart’s Marketside Spring Mix 11 oz. and 5 oz. because of its potential to contain hairy nightshade. According to Colorado State University’s “Guide to Poisonous Plants,” nightshades may contain steroidal alkaloids such as solanine and have atropine-like effects on the nervous system inhibiting the enzyme acetylcholinesterase. Some nightshades also contain irritants such as saponins that cause salivation and diarrhea. Nightshades may also accumulate toxic levels of nitrate. Recalled products are located in Ohio, Illinois, Indiana, and Tennessee.
• Some city water utilities have bad news for customers because of ‘forever chemicals’. City water utilities across the country are scrambling to explain they are still selling a safe product to consumers. This is a result of the advisory basis from the US Environmental Protection Agency (EPA) for acceptable levels of PFAS in drinking water. One type of PFAS reduced to just .004 parts per trillion, down from 70 ppt. Another compound is cut to .02 ppt, down from 2.0 ppt. EPA will release the National Primary Drinking Water Regulation in the fall of 2022. An example of what is being said to consumers in areas in which PFAS levels may be in tight levels is the following: Neither EPA nor Colorado’s Department of Public Health and Environment recommends Thorton water users switch over to bottled water. Still, they suggest it may be the right time to invest in an in-home treatment and filtering system.
• Canada sets regulations for some romaine grown in certain parts of California. The Canadian Food Inspection Agency (CFIA) has announced the fall 2022 import requirements for U.S. romaine lettuce with special requirements for certain lettuce produced in California’s Salinas Valley. Whole-head romaine lettuce and products containing romaine lettuce such as bagged salads that were produced in the four Salinas Valley counties of Santa Cruz, Santa Clara, San Benito, and Monterey must “submit an attestation form and Certificates of Analysis for each shipment to demonstrate that the romaine lettuce does not contain detectable levels of E. coli O157:H7,” according to the Canadian Food Inspection Agency (CFIA). The requirements are the same as 2021, but the enforcement timeframe is shifted. The dates for the requirement this year are from September 28- December 22.

Recommendations for Industry

COVID Now Reflective of an Endemic Virus

As depicted by TAG’s weekly COVID Risk Matrix, we are beginning to see indications of what will likely be a gradual decline in COVID cases over the next few weeks. While there is still a great of fluctuation among states, the transmission rates are starting to trend downward. Hospitalization rates appear to remain high in states which have been continually showing higher rates, while other state hospitalization rates are more closely corresponding with their lowered case rates.

Overall, we seem to be in a bit of a holding pattern with no dramatic changes, but optimistic indicators for upcoming weeks. From this, TAG is seeing the current trend as being reflective of an endemic virus. Although the current variant, BA.5, does have high transmissibility, severity is low in most cases and there are now options for treatment. Thus, while there is still debate as to whether the current environment fits the textbook definition of endemic, we see that as how we need to be dealing with COVID and its variants at this point.

Risk Matrix:

In case you missed it:

• In Tuesday’s Recommendation for Industry, we discussed the continuing evolution of COVID vaccines. Read more here.
• Feds look ahead to next-generation COVID vaccines. Federal officials have signaled that second boosters for those under 50 are on hold to speed production of new bivalent shots. The new bivalent booster shots will include the original SARS-CoV-2 strain and Omicron. Health officials are waiting to see if vaccine makers can more quickly deliver the updated boosters, by the middle of September, unnamed sources told the Washington Post. At the global level, researchers are working on a roadmap for developing a new coronavirus vaccine to broadly protect against the most dangerous ones.
• In COVID-19 Omicron patients, high blood pressure doubles risk of hospitalization. People who have high blood pressure and Omicron-variant COVID-19 are at more than double the risk for hospitalization—even if they received three mRNA vaccine doses, according to a single-center study published yesterday in Hypertension. Some risk factors for hospitalization were identified as hypertension, older age, chronic kidney disease, and heart attack. Other previously identified risk factors for severe COVID-19, such as obesity and diabetes, weren’t as strongly linked to hospitalization and Omicron. The main take away from this study is that individuals, no matter how many vaccine doses you have acquired, everyone should do their best at avoiding infection.
• China approves Genuine Biotech’s HIV drug for COVID patients. The Azvudine tablet, which China approved in July last year to treat certain HIV-1 virus infections, has been given a conditional green light to treat adult patients with “normal type” COVID. In a late-stage clinical trial, 40.4% of patients taking Azvudine showed improvement in symptoms seven days after first taking the drug.
• Canada Resuming Random Testing of International Air Passengers. Random testing was paused on June 11 as a part of broader strategy to test travelers outside of the airports, but testing resumed on July 19^th at Canada’s four major airports. Air travelers who are selected for mandatory random testing will receive an email notification within 15 minutes of completing their customs declaration. The reasoning behind resuming the testing is so that Canada can track the importation of COVID and the news variants of concern. Canada requires travelers arriving from other countries to be fully vaccinated, which means they received a primary series of COVID-19 shots at least 14 days before arriving. Travelers who aren’t vaccinated because they are exempt must test for COVID-19 for 10 days after arriving. Any travelers who test positive or develop symptoms are required to isolate for 10 days.

Public Health & Food Safety:

• WHO director declares monkeypox a public health emergency. Over the weekend, Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus, PhD,  decided that the ongoing international monkeypox outbreak was a public health emergency of international concern (PHEIC) after a meeting of advisors failed to reach a consensus on the matter. The United States has added 298 cases since last week’s total, raising the number to 2,891. The number of affected jurisdictions remains at 46. The CDC reported late last week that the US has two confirmed cases of monkeypox in children. There are eight cases among women. The US has not yet declared monkeypox a public health emergency, but it is being discussed within the White House. Recommendations are issued for 4 groups of countries:
  • Those that have not yet reported a case of monkeypox or have not reported a case for more than 21 days.
  • Those with recently imported cases of monkeypox and that are experiencing human-to-human transmission.
  • Those with transmission of monkeypox between animals and humans.
  • Those with manufacturing capacity for diagnostics, vaccines, and therapeutics.
• Largest monkeypox study to date highlights new symptoms. Many of the people infected in an international monkeypox outbreak experienced a single lesion or sore in their mouth or on their genitals, a departure from typical symptoms of the virus that could lead to clinicians to misdiagnose monkeypox as another sexually transmitted infection (STI). The new international study included clinical observations from 528 confirmed infections. Among those individuals observed, 13% were hospitalized for their infection. One in 10 people had only a single skin lesion in the genital area, and 15% had anal and/or rectal pain, a symptom not typically seen in other monkeypox outbreaks. In a second study, 91.7% of patients were men who have sex with men (MSM), and detailed sexual history showed that those who reported having anal-receptive intercourse had longer incubation periods (8 vs 6 days) and higher rate of systemic symptoms before the rash (62.0% vs 27.6%) and presented more frequently with proctitis (32.9% vs 6.9%) than MSM who did not engage in this type of sexual practice.
• Consumer Reports warns that tara flour isn’t safe and should be avoided. Daily Harvest CEO Rachel Drori admits that her company has identified tara flour as the cause of more than 470 reported illnesses. Last month, Daily Harvest and the FDA announced a recall of the product “Fresh Lentil and Leek Crumbles,” after multiple reports of consumers becoming ill after eating it. Tara flour is an additive that Daily Harvest identified as the culprit of the recent outbreak that was contained within their recalled product. “Because the reported symptoms have been so severe and so little is known, we’re advising people to avoid tara flour until we understand what is causing the illnesses, and until consumers can be assured that any products containing tara flour in the wider market are safe,” says James E. Rogers, Ph.D., director of food safety and testing at Consumer Reports.
• FDA Works to Enhance the Safety of Berries. Currently the FDA is developing a food safety prevention strategy to enhance the safety of fresh and frozen berries. The strategy is being developed due to a history of hepatitis A (HAV) and norovirus (NoV) outbreaks that were linked to both fresh and frozen berries. To date, the FDA has collected and tested more than 1,100 samples under this assignment and plans to collect and test about 427 more to meet the assignment’s public health goals. The FDA plans to work collaboratively with industry, academia, and regulatory partners in the development of the food safety prevention strategy to identify measures that can be taken to limit or prevent contamination from occurring throughout the berry supply chain, approaches to re-enforce control measures and their application, and areas where additional research is needed.