• In today’s Recommendations for Industry, we discuss considerations and recommendations for moving into the next phase of the pandemic, including demasking, infectious disease cautions, and avoiding fraud. Read more below.
• The CDC has provided updated guidance on mask usage for unvaccinated individuals. This guidance includes NOT wearing masks that (a) have exhalation valves or vents; or (b) are single layer or made of thin fabrics that don’t block light. Additionally, the CDC recommends that unvaccinated individuals continue to wear masks anytime they are indoors or outdoors around people that don’t live with them.
• The CDC has also released updated information and guidance for vaccinating migrant/migratory and seasonal food and agriculture workers as these populations are “at higher risk of being exposed to COVID-19 [and have had] disproportionate illness and mortality.” The CDC has even created a “Guide to Vaccinating Workers” to “help jurisdictions identify and quantify sub-populations of workers and then create a specific vaccination plan.”
• The WHO has announced “simple, easy-to-say labels for SARS-CoV-2 Variants of interest and concern.” This effort is also intended to decrease the stigmatization of countries that are linked specifically to certain variants. See table below:

• China’s Sinovac vaccine has received WHO urgence approval.
• A recent study in the Brazilian town of Serrana found that a 95% drop in COVID-19 deaths, 86% drop in hospitalizations, and 80% symptomatic drop of COVID-19 cases after 75% of individuals were fully vaccinated. This study further highlights the benefits of having more 70% fully vaccinated.
• Canada has joined countries like the UK & Spain to recommend “mixing and matching AstraZeneca, Pfizer, and Moderna COVID-19 vaccines.”
• Vietnam has detected a new highly contagious COVID-19 variant that seems to contain/express traits from both COVID Variant Alpha (B117 variant) and COVID Variant Delta (B1617.2 variant).
• The UK is thought to be in the early stages of its third wave.
• An increasing number of fungal infections have arisen in India resulting from the use of immune-suppressant drugs and an overburdened healthcare system. Not only was there the black fungus, now there is also concern of a white fungus caused by Candidas auris (C. auris) that has a 70% mortality rate (much higher than the black fungus).
• The FDA is recommending that testers stop using the Lepu Medical Technology SARS-CoV-2 Antigen and Leccurate antibody tests. Not only is there a high risk of false results, BUT this test is not authorized, cleared, or approved by the FDA for usage!
• OSHA has updated and solidified its vaccination information for employers (on what can be asked and incentivized). This includes:
  • Federal EEO laws do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19, so long as employers comply with the reasonable accommodation provisions of the ADA and Title VII of the Civil Rights Act of 1964 and other EEO considerations. Other laws, not in EEOC’s jurisdiction, may place additional restrictions on employers. From an EEO perspective, employers should keep in mind that because some individuals or demographic groups may face greater barriers to receiving a COVID-19 vaccination than others, some employees may be more likely to be negatively impacted by a vaccination requirement.
  • Federal EEO laws do not prevent or limit employers from offering incentives to employees to voluntarily provide documentation or other confirmation of vaccination obtained from a third party (not the employer) in the community, such as a pharmacy, personal health care provider, or public clinic. If employers choose to obtain vaccination information from their employees, employers must keep vaccination information confidential pursuant to the ADA.
  • Employers that are administering vaccines to their employees may offer incentives for employees to be vaccinated, as long as the incentives are not coercive. Because vaccinations require employees to answer pre-vaccination disability-related screening questions, a very large incentive could make employees feel pressured to disclose protected medical information.
  • Employers may provide employees and their family members with information to educate them about COVID-19 vaccines and raise awareness about the benefits of vaccination. The technical assistance highlights federal government resources available to those seeking more information about how to get vaccinated.
• In December 2020, Barcelona held an indoor concert; however, findings were that this well-controlled indoor concert did not lead to any additional COVID-19 cases as the concert-organizers employed “rapid COVID-19 lateral-flow screening, N95 respirators, and a well-ventilated venue.” Read more here.
• Although COVID-19 vaccinations continue to increase in the US, with 62% of adults now saying they’ve received at least one shot (up from 56% in April), vaccinations across the country vary by region with Southern states lagging behind (especially in Mississippi & Alabama which have the lowest vaccination rates in the U.S.).

Moving into the Next Phase of the Pandemic

As TAG’s weekly risk matrices continue to show improving trends across the U.S. and more people become vaccinated each day, businesses are making critical decisions about reopenings and bringing people back into offices. As you make these decisions, it is important to remember that while COVID-19 is on the decline … it is not gone. So there many considerations of which to be aware as we all move forward.

Some of those of greatest concern at this point are:

• Demasking considerations. The pandemic has had as much psychological impact on many people as it has physical impacts, and much of that remains in their feelings on masks and the protections provided. Businesses need to be fully aware of this as they make demasking decisions – particularly those that are public facing. A customer doesn’t know if your maskless employees are vaccinated, so may not feel comfortable interacting with them. Employees themselves may not yet feel comfortable around others who are unmasked – which was evidenced recently by workers who quit because their employer allowed vaccinated individuals to unmask.

While some may scoff saying “it’s all in their head,” not only must employees’ feelings be considered, there also is continuing physical rationale for masks even for the vaccinated. While the rate is low, there have been breakthrough cases of fully vaccinated persons.

• Staying out when ill. With the symptoms of many infectious diseases being similar in nature, it can be difficult to determine if a worker has a cold, the flu or COVID. But all are contagious and can be transmitted among your workers. So it is essential that management teams remind workers that, if they have infectious symptoms, they should stay home until they can be assess – even if fully vaccinated.
• COVID fraud. Unfortunately COVID has brought out the shams, with a number of fraudulent COVID-related offerings being discovered. From K95 masks to unauthorized tests, fraudulent vaccines, and fake vaccine certificates. While some can be difficult to tell the real from the fake, wherever possible, ensure that you are sourcing items from an authentic/authorized source, and be wary of deals that seem to be too good – they probably are.

As we have since the start of the pandemic, TAG will continue providing recommendations and advise as we move forward into the next, hopefully declining, phase – and carry forward lessons learned to help reduce the business impacts of other infectious diseases.

Risk Matrix

TAG’s weekly risk matrices continue with downward trends of COVID-19 cases in the U.S. TAG recommends that you continue to strive for balance between the risks and benefits of reducing/maintaining your current protections. TAG has also released a Dial-Back Planning Toolkit that allows you to better characterize the risks in your facility, including accounting for vaccinated individuals, mask-wearing, etc.

Positive trends –

• The Government Stringency Index is 37 this week. This is down from 43 last week, indicating a reduction in government stringencies. Four (4) states’ (California, Colorado, New Mexico, and Oregon) businesses continue to be in mixed opening stages.
• In Figure 1, this week, we compare the case rate/100K (Table 1) in the population to the percentage of a state’s population that has been fully vaccinated (Table 2). Table 3 compares the previous week’s percentage of states’ populations that have become fully vaccinated full dose (and the rate of change between the last week and this week).
• As with last week, no states have a TPR ≥ 10% or TPR <10% and a case rate ≥25/100K people! This is positive news and incredibly promising!

Table 1.

Figure 1.

Table 2.

Table 3.

• In last Friday’s Recommendations for Industry, we discussed how and why businesses should be using the expected “quiet” of summer to develop plans to reduce the impacts of fall respiratory illnesses. Read more here.
• The HHS has begun a “We Can Do This: COVID-19 Public Education Campaign” to increase confidence in COVID-19 vaccines while reinforcing basic preventive measures (like wearing masks and social distancing). The idea is to drive communication science and provide tailored info for at-risk groups. Please check this out for further messaging for your communities!
• As cases in Delhi (and across India) slowly decrease, Delhi and other areas are easing lock-down measures to allow operations and construction activities to continue.
• Like Ohio (which has incentivized vaccinations), California will give away $116.5M to vaccinated residents!
• In its testing phases, Moderna has announced that its COVID-19 vaccine appears to be safe and effective in adolescents (12 – 17 years).
• Researchers are designing a new way to deliver vaccines using inhaled nanobodies. So far, the research in hamsters is showing promise!
• In last Wednesday’s Recommendations for Industry, we discussed this week’s COVID-19 Risk Matrix as well as a perspective on CDC’s travel recommendations. Read more here.
• The CDC has provided new recommendations for domestic travel for vaccinated and unvaccinated individuals in the U.S. including recommending that unvaccinated individuals should not travel until they are fully vaccinated. However, if unvaccinated individuals do want to travel, they should follow CDC’s recommendations for unvaccinated people.
• NPR reports that in 25 states, more than 50% of all adults are fully vaccinated! The majority are in the Northeastern states of Maine, Vermont, Massachusetts, Rhode Island, and Connecticut.
• In South Africa, testing of wastewater is helping to identify the spread of COVID-19.
• Moderna is applying for FDA approval of its COVID-19 vaccine for 12-17 year olds.