COVID Cases Rise Again – but Don’t Overreact

Key Points:

• In today’s Recommendation for Industry, we discuss how COVID cases are rising. Read more below.
• CDC panel recommends Novavax vaccine as BA.5 gains more ground. On July 19, CDC vaccine advisers unanimously approved recommended the use of the Novavax COVID-19 vaccine for the primary series for people 18 years and older. The CDC director has accepted ACIP’s recommendation to utilize Novavax for individuals 18 years of age and older. Currently, experts want to target the primary Novavax vaccine to the 10% to 13% of the US population that is currently unvaccinated. The Biden administration has bought 3.5 million doses of the vaccine, which is administered in a two-dose series given 3 to 8 weeks apart. Those with moderate or severe immune compromise should receive the doses 3 weeks apart. CDC officials said on July 19, if orthopox vaccine is given first, healthcare providers should consider waiting 4 weeks before administering COVID-19 vaccine. And if Novavax or another COVID-19 vaccine is given first, orthopox vaccination should not be delayed.
• Global COVID-19 cases plateau, but deaths rise. After 5 weeks of increasing cases, the pace of new infections plateaued last week, the WHO said. It received reports of nearly 6.3 million new cases. The five countries with the most cases were the United States, France, Italy, Germany, and Japan. The WHO received reports of 11,000 deaths last week, with the global rise fueled by increases in three regions: Southeast Asia, the Eastern Mediterranean, and the Americas. Global COVID-19 activity stayed high and largely even last week, as deaths rose, the World Health Organization (WHO) said today in its latest weekly update on the pandemic.

• The C.D.C. shuts down its public Covid dashboard for cruise ships. The Centers for Disease Control and Prevention has ended its Covid-19 mitigation program for cruise ships in U.S. waters, the public health agency announced on its website. Cruise lines participating in the voluntary program, which ended Monday, had followed the agency’s policies for coronavirus testing and reporting the vaccination status of passengers and crew, as well as providing regular updates about coronavirus case counts.
• CDC Community Level Map:

Public Health & Food Safety:

• WHO: 14,000 monkeypox cases worldwide, 5 deaths. The WHO reported on July 20, monkeypox cases have nearly reached 14,000, including 5 deaths in African nations. On July 21, the International Health Regulations Emergency Committee will review the latest data and consider whether the outbreak of monkeypox constitutes a public health emergency of international concern. Earlier this week, the WHO updated its guidance for men who have sex with men (MSM), the group most at risk for infection. The agency urged MSM to be aware that symptoms can develop within 21 days of contact with an infected person and said MSM should self-isolate while waiting for test results. The UK has a national total of 2,137 monkeypox cases currently recorded. The United States has 45 jurisdictions with cases, totaling the whole country with 2,108 cases.
• IAFP going to an open-access journal. The Journal of Food Protection beginning in January 2023 will be published as a fully open access publication, the International Association for Food Protection (IAFP) announced Wednesday. Its products include journals such as The Lancet, Cell, the ScienceDirect collection of electronic journals, Trends, the Current Opinion series, the online citation database Scopus, the SciVal tool for measuring research performance, the ClinicalKey search engine for clinicians, and the ClinicalPath evidence-based cancer care service.
• FDA Issues Country-Wide Import Alert for Enoki Mushrooms from the Republic of Korea. This alert was issued to protect public health and to prevent the importation of enoki mushrooms that could be linked to human infections; Import Divisions may detain without physical examination importations of enoki mushrooms from the ROK. During 2021, FDA testing revealed that 43% of enoki mushrooms sampled from the ROK were contaminated with Listeria monocytogenes. The sampling performed from March 2020 through May 2022, was due to a multistate outbreak that spanned from 2016-2020 linking these mushrooms to the Republic of Korea.

Recommendations for Industry

COVID Cases Rise Again – but Don’t Overreact

TAG’s weekly COVID matrix is showing that transmission rates and cases are, once again, rising across the country with BA.5 continuing to be the dominant strain, 39 states having a TPR greater than 10%, and case rates greater than 25 cases per 100,000. While hospitalizations are also up, this could be slightly skewed as patients who are hospitalized for other reasons, but also test positive for COVID, are often reported as being hospitalized for COVID. Additionally, even with the increased transmission and case rates, BA.5 is much less severe for most than were previous variants.

Our analyses have long shown the TPR to be a strong predictor for what will continue to occur; however, we are seeing this as potentially reflecting one of two things – that cases may continue to increase in the upcoming weeks, or it may be that we have reached an ultimate high and cases will start back down. One area that, at least anecdotally, appears to be true is that those who have not be previously infected with COVID, whether vaccinated or not, are the most likely to be infected now.

So, we are not yet out of the woods, and the excessive heat driving people indoors, macroeconomic situation, and other stressors of today are also wearing down peoples’ systems. While these are certainly not causing COVID, they can make people more susceptible to infection.

Given all this, TAG’s recommendation is that businesses remain aware of what is happening in your community and your business. Be aware of employee stress and overall health and remind employees that they should stay home if they’re experiencing Covid-like symptoms and get tested.  Often people may have to test multiple times with an antigen test after symptom onset before they test positive.  While less effective than staying away from work, masking remains an effective mitigation tool for those that are symptomatic and must come to work.

Risk Matrix

In case you missed it:

• In Tuesday’s Recommendation for Industry, we discussed BA.5’s continued transmission and low severity. Read more here.
• FDA green-lights Novavax vaccine as COVID-19 levels rise: While the FDA has approved emergency use authorization for Novavax vaccine, the CDC must recommend it before it can be administered. The CDC Advisory Committee on Immunization Practices (ACIP) will be meeting on July 19 to discuss the Novavax vaccine. The vaccine is composed of the SARS-CoV-2 spike protein produced in insect calls and contains the Matrix-M adjuvant as an immune booster. Other parts of the world such as the European Union, United Kingdom, South Korea, and Australia already use Novavax.
• COVID-19 boosters offer good protection against early Omicron subvariants. A study of adults in 10 US states was published that determined the first and second COVID-19 vaccine booster doses conferred substantial protection against emergency department/urgent care visits and hospitalizations cause by Omicron subvariants BA.1, BA.2, and BA.2.12.1. During BA.1, 41.6% of all patients hospitalized for COVID-like illness were unvaccinated, 28.5% had received two vaccine doses, and 29.9% had received three. Amid BA.2/BA.2.12.1, 28.6% of patients were unvaccinated, 23.4% had received two doses, 42.9% had received three doses, and 5.1% had received four.
• As U.S. Covid hospitalizations climb, a chronic nursing shortage is worsening. Hospitalizations have risen steadily in recent weeks due to BA.5 infections. Some states are struggling to retain nursing staff such as New York, Massachusetts, and North Carolina, along with many others. The shortage has even caused a temporary shutdown at a hospital in North Carolina. New York’s Mount Sinai’s hospital network alone had 771 unfilled registered nurse and nurse practitioner positions. Demand for nurses is projected to keep growing significantly in the United States. The McKinsey consulting firm projected in a report in May that the nation could face a shortage of up to 450,000 nurses by 2025.

Influenza:

• Reported by WHO, global influenza activity has remained stable, following a decrease from the peak in March 2022. Most commonly in countries throughout the world, influenza A (H3N2) has been the dominant virus subtype.

Public Health & Food Safety:

• Monkeypox viral DNA detected in saliva, semen. From a study of monkeypox infected patients, DNA of the poxvirus was found in semen, saliva, urine, and feces. In the study, indications of high viral loads were detected in all 12 saliva samples and in skin lesions of all 12 patients. Detectable DNA was collected from 11 of 12 rectal swabs, 10 of 12 from nasopharyngeal swabs, 7 of 9 from semen, 9 of 12 from urine, and 8 of 12 from feces. All samples were collected at the time of diagnosis. No deaths from monkeypox have been reported from the European region, but three people have required intensive care unit admission. Globally, 11,208 cases have been confirmed, mainly in non-endemic countries.
• CDC director: Expect more monkeypox cases in coming weeks. As more tests are becoming available, there is expected to be a rise in case numbers across the country. Among the US, the government has distributed approximately 160,000 vaccine doses. An additional 131,000 doses are being made available starting this week. The United States currently has 1,470 cases from 44 jurisdictions, an increase of 417 from last Thursday.
• Adenovirus common in kids with unexplained acute hepatitis, studies show. In two new studies, researchers isolated human adenovirus from the vast majority of children diagnosed as having acute hepatitis but couldn’t determine whether the ubiquitous virus typically associated with transient respiratory, gastrointestinal, and conjunctival illnesses was the cause. Eight of the nine children (89%) with unexplained hepatitis tested positive for human adenovirus. In the other study, twenty-seven of the 30 patients (90%) who underwent molecular testing were positive for human adenovirus. Six patients (14%) developed liver failure and received a liver transplant. From Oct 1, 2021, to Jul 13, 2022, 338 children with unexplained acute hepatitis were reported to the US Centers for Disease Control and Prevention (CDC) from 42 US states and territories, according to an update yesterday. The data reflect 6 new cases.
• FDA proposes another delay for pre-harvest agricultural water requirements. The 2021 agricultural water proposed rule, if finalized, will require farms to conduct annual systems-based agricultural water assessments to determine and guide appropriate measures to minimize potential risks associated with pre-harvest agricultural water. The supplemental rulemaking proposes to establish the following compliance dates for the pre-harvest agricultural water requirements for covered produce other than sprouts: 2 years and 9 months after the effective date of a final rule for very small businesses; 1 year and 9 months after the effective date of a final rule for small businesses; and 9 months after the effective date of a final rule for all other businesses. There will be continued enforcement discretion for the harvest and post-harvest agricultural water requirements of the Produce Safety Rule until the following dates: Jan. 26, 2025, for very small businesses; Jan. 26, 2024, for small businesses; and Jan. 26, 2023, for all others. Companies impacted by this should ensure that development of their agricultural water assessments is underway.
• Blueberries recalled nationwide over high levels of lead. BrandStorm Inc. is recalling certain Natierra Organic Freeze-Dried Blueberry pouches because of the presence or potential presence of lead above the FDA’s recommended limits. After further investigation, it was found that the products’ country of origin is Lithuania and aggressive monitoring of heavy metals may be deemed necessary. The recall is limited to two batches of Natierra Freeze-Dried Blueberries with the following codes Best By Date 12/2024 & 01/2025.
  • Lot 2021363-1, Best By Date: 12/2024
  • 1 serving, 1.2oz (34g), UPC 812907011160
  • Lot 2022026-1, Best By Date: 01/2025
  • 1 serving, 1.2oz (34g), UPC 812907011160
• FDA Issues RFI on Fluorinated Polyethylene Food Contact Containers– The FDA is seeking scientific data and information on the current food contact uses of fluorinated polyethylene, consumer dietary exposure that may result from those uses, and safety information on substances that may migrate from fluorinated polyethylene food containers. Fluorination of polyethylene may result in the formation of per- and polyfluoroalkyl substances (PFAS) and this request is part of our continued work to ensure that authorized food contact uses are safe.