Positive COVID Trends Enable Focus on other Emerging Disease

Key Points:

• In today’s Recommendation for Industry, we discuss the positive COVID trends we are seeing. Read more below.
• Study: Pfizer COVID vaccine efficacy wanes 27 days after dose 2 in teens. A new study finds waning Pfizer/BioNTech COVID-19 vaccine protection against symptomatic infection in Brazilian and Scottish teens starting 27 days after the second dose amid the Delta and Omicron variant waves, but protection against severe illness was still strong at 98 days in Brazil. During Omicron, 27 days after the second vaccine dose, VE against symptomatic infection began to fall, plummeting to 5.9% (95% CI, 2.2% to 9.4%) in Brazil and 50.6% (95% CI, 42.7% to 57.4%) in Scotland at 98 days or more. Over the same period after dose two in Brazil, VE against severe infection stayed above 80% at 28 days and was 82.7% (95% CI, 68.8% to 90.4%) at 98 days or more. The researchers noted that two doses of vaccination with BNT162b2 [Pfizer] among adolescents are insufficient to sustain protection against symptomatic disease; however, they do offer substantial protection against serious COVID-19 outcomes for at least 3 months.
• Omicron subvariants gain more ground, including BA.4.6 in the Midwest. Though the 7-day average for new daily COVID-19 cases is slowly declining, the more transmissible and immune-evasive Omicron subvariants became even more dominant last week, with an offshoot called BA.4.6 gaining traction in some Midwestern states. In its weekly variant proportion updates today, the Centers for Disease Control and Prevention (CDC) said the proportion of BA.5 viruses in sequenced samples last week rose from 84.5% to 87.1%, while BA.4 declined slightly, from 8.2% to 6.6%. However, the proportion of BA.4.6 viruses rose from 4.2% last week to 4.8% this week. Midwestern states—Iowa, Kansas, Missouri, and Nebraska—are seeing the highest BA.4.6 proportions, where it makes up 13.2% of sequenced specimens.
• Global COVID cases level, deaths decline. After a period of declining cases, global COVID-19 cases have begun to stabilize. There are still cases increasing in Japan and South Korea. Deaths declined 9% last week compared to the previous week, with about 14,000 fatalities reported, the WHO said. In the United States, the 7-day average for new daily cases is 108,820, according to a Washington Post analysis. The 7-day average daily death count isn’t declining as the case rate is within the US, these numbers sit at 499.

Public Health & Food Safety:

• Monkeypox:
  • US to begin intradermal injections of Jynneos, stretching the supply. Stretching the supply of Jynneos will allow clinicians to use one-fifth the amount of vaccine per patient to expand the limited supply within the United States. The United States had made 1.1 million doses of Jynneos available and about 600,000 doses have already been distributed. The remaining doses, under the new intradermal rule, will turn into just under 2 million doses. The CDC’s current recommendation is to vaccinate close contacts and those at risk for contracting the virus, including those who have had multiple sexual partners in the last 14 days in an area with high monkeypox transmission. Evidence that the technique is effective is limited to one study conducted in 2015, in which two intradermal doses produced similar results to subcutaneous injections. Those who may have already received their first dose as subcutaneous can receive their second dose as intradermally. The nation’s total has raised to 8,934 cases. As Montana just discovered its first case, Wyoming is now the only state without a recorded case. Global counts sit at 31,000 cases in 93 countries.
• Following the discovery of type 2 vaccine-derived poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to all children between the ages of 1 and 9 in all London boroughs.
• USDA gets employee safety training and OSHA gets access to food facilities under new MOU. FSIS and OSHA will coordinate FSIS efforts with workplace hazards and conditions training. The training must be completed within 120 days, with annual refresher training. At FSIS-regulated establishments, OSHA-provided posters will be made available on how to report injuries to OSHA. The agencies have cooperated for almost 30 years to protect workers, signing their first Memorandum of Understanding (MOU) for employee safety on Feb. 4, 1994.
• Cyclospora patient count grows in outbreak of unknown origin. The Food and Drug Administration says there are now 77 confirmed patients compared with 60 a week ago. The agency has not yet determined what food is the source of the parasite. There is a steady increase in individuals obtaining this illness. The FDA also reports that it has begun traceback efforts in relation to a separate outbreak of Cyclospora infections, but the agency has not revealed what food or foods are being traced.

Recommendations for Industry

Positive COVID Trends Enable Focus on other Emerging Disease

As can be seen in this week’s COVID matrix, and other tracking news and sites, we continue to be optimistic about declining rates of COVID across the U.S. Although we are still seeing some states with case and hospitalization rates that are a bit high, overall the test positive rates and transmission rates are showing a consistent decline. There are no states with transmission rates in the “red zone,” with all flattening or declining.

Overall, TAG sees COVID rates trending in a positive direction, with no warning signs of further issues on the horizon.

With that said, the going-on-three years that TAG has spent educating ourselves and our clients on COVID has gained our team incredible public health expertise in managing workplace infectious diseases. As such, we will be making some significant updates to our risk matrices in the upcoming weeks, adding data and assessment on Monkeypox and including other emerging diseases as applicable. Keep an eye out for these upcoming newsletters – and give TAG a call if you would like assistance with your infectious disease prevention and management practices and program.

Risk Matrix:

In case you missed it:

• In Tuesday’s Recommendation for Industry, we discussed the ongoing monkeypox headlines. Read more here.
• US COVID cases show hints of decline. The 7-day average for new daily cases has dipped slightly to the 120,000 range over the past 3 days, according to an analysis by the Washington Post. Meanwhile, the 7-day average for new daily deaths has risen some, reaching 496. According to the Centers for Disease Control and Prevention (CDC), 41.7% of US counties have high COVID community levels, and 38.9% are at the medium level.

• Study: In-class college COVID spread rare amid public health mandates. At Boston University (BU), which mandated COVID-19 vaccination and face coverings for students, faculty, and staff in fall 2021, only nine cases of SARS-CoV-2 transmission were identified among more than 140,000 full-occupancy, in-person class meetings, accounting for 0.0045% of all class sessions. The findings were published late last week in JAMA Network Open. Possible in-class viral transmission was considered after two or more positive polymerase chain reaction (PCR) COVID-19 tests from students or faculty in the same class who did not identify each other as close contacts outside the classroom. BU was fully open and required completion of a COVID-19 vaccination regimen, isolation of infected students, enhanced air filtration, and use of face coverings indoors—but not physical distancing—during that time. Vaccination rates for faculty, staff, and students were 98.5%, 93.5%, and 98.7%, respectively. Average class size was 31 students.
• Ontario’s 7th wave of COVID-19 has peaked, says top doctor. Public Health Ontario says COVID-19 case rates decreased in 22 of Ontario’s 34 health units for the week ending July 30, with percent positivity down slightly week over week, and hospital admissions decreasing to 306 compared to 463 the previous week. Based on the newest data released by the province Thursday, however, there were 80 deaths linked to COVID-19 over the week, making it the second deadliest of the seventh wave so far. Ontarians aged 18 and older have been eligible for a fourth dose of a COVID-19 vaccine for three weeks — previously it was only available to people 60 and older, as well as immunocompromised or Indigenous adults. Just under 16 percent of Ontario adults have received four doses. In the particularly vulnerable population of people aged 80 and older, about 61 percent have received a fourth dose.

Public Health & Food Safety:

• Monkeypox:
  • US declares monkeypox a public health emergency. On August 4^th officials from the Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) declared the ongoing monkeypox outbreak in the United States a public health emergency. HHS has previously said the federal government has ordered 6.9 million doses of Jynneos, but the bulk of the vaccines will not be available until 2023. This led the FDA to consider authorizing fractional dosing of the Jynneos vaccine to stretch the supply. In other news, an editorial in the New England Journal of Medicine today asks officials to consider clinical trials of tecovirimat (Tpoxx)—an antiviral drug approved for treating smallpox—to test for efficacy against monkeypox.
  • Monkeypox reported in Illinois daycare worker, US cases top 7,000. Adding another element to quickly evolving monkeypox developments, Illinois health officials today announced that they are investigating a case in an adult who has links to a daycare. The Food and Drug Administration (FDA) is allowing vaccination for those younger than 18 who may have been exposed to the virus and that anyone with guardian approval will be vaccinated today, according to NBC News. The national case count has reached 7,102 cases with Washington DC having the most cases per capita in the country. Globally, there are more than 26,800 cases from 88 countries. The outbreak is growing most quickly in the United States and Europe, where Spain has the most cases, with 4,942.
• Virginia Tech researchers testing potential vaccine for norovirus. Virginia Tech researchers are testing a potential live oral vaccine for norovirus. The vaccine that the team is testing is in development by Indiana University researchers and uses the Rotarix rotavirus vaccine as a platform. On average in the United States, norovirus causes 900 deaths, 109,000 hospitalizations, 465,000 emergency department visits and 19 to 21 million cases of vomiting and diarrhea illnesses. Yuan, who is the leader of testing the vaccine, and her lab study gnotobiotic pig models of human intestinal virus infection and disease, including how probiotics affect immunity and the evaluation of rotavirus and norovirus vaccines and anti-norovirus biologicals.
• Canadian Blood Services urges donors to keep appointments as blood supplies reach new low. Canadian Blood Services is urging donors to keep their appointments because it predicts it will fall short of supplies of certain types of blood products next week. Currently, spokesmen are encouraging new and returning blood, platelet, and plasma donors to book and keep appointments. Blood donation is crucial for many different scenarios including individuals with cancer, accident/trauma victims, people undergoing surgery and people with blood disorders. There are 57,000 open appointments that must be filled before the end of August for the organization to be able to provide patients across Canada with the essential blood products they need on time. The call for donors to keep appointments comes after the organization suspended its mandatory masks and physical distancing policy in its buildings, vehicles, and donation events on July 25. The organization says masks are still available and welcome.
• USDA wants to reinstate organic welfare standards; could benefit food safety. The United States Department of Agriculture’s Agricultural Marketing Service (AMS) proposes to amend the organic livestock and poultry production requirements by adding new provisions for livestock handling and transport for slaughter and avian living conditions; and expanding and clarifying existing requirements covering livestock care and production practices and mammalian living conditions. This would also include crucial updates that require organic chickens to have adequate space indoors and access to the outdoors, thus eliminating “porches” that have allowed some factory-farm chicken operations to market their poultry and eggs as organic. Improvements in animal welfare have the potential to reduce on-farm risks to food safety, principally through reduced stress-induced immunosuppression, reduced incidence of infectious disease on farms and reduced shedding of human pathogens by farm animals, and through reduced antibiotic use and antibiotic resistance.
• National Chicken Council objects to USDA plan to name Salmonella as adulterant in some chicken products. USDA’s Food Safety and Inspection Service (FSIS) decision to declare Salmonella as an adulterant in breaded and stuffed raw chicken products is not welcomed by the regulated industry. NCC (National Chicken Council) is concerned about the precedent set by this abrupt shift in longstanding policy, made without supporting data, for a product category that has only been associated with one outbreak since 2015. It has the potential to shutter processing plants, cost jobs, and take safe food and convenient products off shelves. The FSIS reported that since 1998, breaded and stuffed raw chicken products have been associated with up to 14 outbreaks and approximately 200 illnesses. The FSIS will be proposing to set the limit at 1 colony forming unit (CFU) of Salmonella per gram for these products, a level that the agency believes will significantly reduce the risk of illness from consuming these products.