Prepare Your Business for Omicron Variant Reinfections

Key Points:

• In today’s Recommendations for Industry, we discuss COVID-19 variants, BA.4 and BA.5. Read more below.
• Despite what many of us might like to believe, COVID-19 has not gone away. South Africa recently identified two new subvariants of Omicron – designated BA.4 and BA.5. These subvariants have now spread to several other countries, including the United Kingdom and the United States. In the U.S., the CDC has designated BA.4 and BA.5 as variants of concern. Additionally, the new variants can reinfect people who had COVID even just a few months ago. Read more about them here.
• Pfizer reports strong COVID vaccine protection in kids under 5, will file with FDA .There is a strong efficacy for 3 dose vaccines for children between 6 months and 4 years old. Additionally, the FDA is meeting on June 28^th to discuss whether vaccines should be modified to strains, specifically what strain should be selected for fall of 2022.
• CDC now recommends and expands that children 5-11 should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series. Individuals 12 and older who are immunocompromised and those 50 and older should receive a booster dose at least 4 months after their first.
• A large UK study in BMJ suggests that COVID-19 vaccination after infection lowers the odds of persistent symptoms, with a 12.8% initial decline after the first dose and an 8.8% drop after the second—although the long-term effects are unclear. Vaccination after infection may cut risk of long COVID-19.

Influenza:

• The CDC reports that the seasonal influenza viruses continue to circulate, and activity is increasing in parts of the country. This week, 7 jurisdictions experienced moderate activity and 3 jurisdictions experienced high or very high activity. 7.5% of deaths attributed to pneumonia, influenza, or COVID-19 this week (above threshold).
• There is continuing incidence of hepatitis of unknown origin. Currently, there is no evidence of human-to-human transmission. There is question whether this is an infectious disease since reports are sporadic. As of May 18, there have been 575 related cases in at least 25 countries around the world. Most cases have been reported in the US and the UK likely because of strong surveillance systems in these countries. A recent Lancet study suggests that children may have had very mild and undetectable COVID illness that left lingering particles of the coronavirus in the gastrointestinal tract in these children. These could then be priming the immune system to over-react to adenovirus-41F with high amounts of inflammatory proteins that ultimately damage the liver.  
• Monkeypox cases increase across Europe, North America, currently there are about 200 confirmed and suspected cases. A common symptom to be aware of is a genital rash.

Public Health & Food Safety:

• As climate change continues to alter weather patterns around the planet including the Midwest, researchers at Michigan State University are modeling the impact on crops such as corn. The researcher’s near-term climate model scenarios found that between 2031-2040, aflatoxin is going to become more of a problem in the U.S. Corn Belt in the Midwest. Fungi Aspergillus flavus and Aspergillus parasiticus produce aflatoxin which can be found in peanuts, tree nuts and corn. Aflatoxin degrades corn quality and causes health problems for consumers. Aflatoxin contamination typically occurs in warmer and dryer climates.
• Danone is sending more infant formula from Europe to the United States to address the shortage.
• The J. M. Smucker Co. Issues Voluntary Recall of Select Jif® Products Sold in the U.S. for Potential Salmonella Contamination. Products with lot numbers 1274425-2140425- across US and Canada. See all of the potentially contaminated peanut butter products here.
• Vertical farming is being affected by zoning in large cities. Rethinking urban zoning laws to accommodate large-scale indoor agriculture, such as vertical farming, will require the many urban jurisdictions in the US to undertake significant hard work that is preceded by consensus building and thoughtful analysis. Healthy Food Policy Project is geared toward small projects such as community gardens and greenhouses. They are permitting on-site sale of produce.

Recommendations for Industry

Prepare Your Business for Omicron Variant Reinfections

With CDC’s community level maps showing a gradual spread of high and medium COVID levels, particularly across the Northeast and Upper Midwest, recent studies of neutralizing antibodies (NAbs) (including medrxiv.org and biorxiv.org) are showing that mutations in the Omicron subvariants (BA.2.12.1, BA.4, and BA.5) allow them to easily evade vaccine and previous infection immunity.

Many in the US who were infected this winter were likely infected with the BA.1 subvariant. While this initially provided protection against re-infection, after about four or five months, previous infection is providing little protection against reinfection with BA.4 or BA.5 and the development of symptomatic illness.

The CDC Variant Tracker provides a good illustration of where the predominant variants are occurring regionally in the US.  BA2.12.1 is most predominant on the East Coast and moving Westward. However, we will need to watch and see if BA.4 and BA.5 become the predominant circulating strains in the coming months, as they have already been detected in wastewater samples in Minnesota. 

Whichever variant(s) become dominant, it is evident that all regions need to be prepared for increased illness/absenteeism as the coming months may see (re)infection in both those who were infected this winter with BA.1 and those who were not. Keeping your wellness checks going and ensuring that those who are sick stay home are key to protection against spread. TAG is continuing to work with businesses on protections against COVID and other workplace infectious diseases. Give us a call if you need assistance.

In Case You Missed It:

• In last Thursday’s Recommendations for Industry, we discussed the trends of COVID based on TAG’s weekly matrix and the CDC community levels mapping. Read more here.
• Four global regions around the world had seen a rise in COVID-19 cases, in the last week, including in the Eastern Mediterranean region, Western Pacific, The Americas, and the African region. The WHO is currently monitoring BA.4, BA.5, and BA.2.12.1 Omicron subvariants, “So far, BA.4 has been identified in 20 countries, BA.5 in 19, and BA.2.12.1 in 38.” (CIDRAP).
• The FDA expanded booster dose eligibility for Pfizer’s COVID-19 vaccine to children 5 – 11 years old (FDA).
• Based on current CDC guidance of communitiy risk, one-third of the U.S. should consider masking; most of these medium and high-risk areas are in the Northeast and also Northern Great Lakes states (CNN).

• A recent study has found that “over 75 percent of long covid patients were not hospitalized for initial illness” (NYT).
• With a demographic breakdown quite similar to that in the U.S., Australia’s COVID-19 death rate is 1/10^th that in the U.S. While one can say that this might be due to early lockdowns or Australia’s isolation from the world or even its vaccination scheduling and dispersal, “dozens of interviews, along with survey data and scientific studies from around the world, point to a lifesaving trait that Australians displayed from the top of government to the hospital floor, and that Americans have shown they lack: trust, in science and institutions, but especially in one another.” Indeed, Australians not only overwhelmingly trusted their healthcare system (76% trust), but also agreed that “most people can be trusted” which allowed for ensuring “behavior for [the] common good” for “interpersonal trust – a belief that others would do what was right not just for the individual but for the community.”  Additionally, in Australia, politicians and leaders also “chose to avoid partisanship,” instead “both parties lined up behind a ‘one voice approach,’ with medical officers out front” (NYT).
• Children (under 17 years old) with heart conditions were more likely to develop severe COVID-19 (CIDRAP).
• Recently published studies have found the mRNA vaccines (created by Pfizer and Moderna), “elicited stronger antibody responses against four variants of concern (VOCs) [specifically, Alpha, Beta, Gamma, and Delta] and the original virus compared to viral vector vaccines developed by Johnson & Johnson (J&J) and AstraZeneca.” (CIDRAP).
• A recent study has found that Cornell University’s COVID-19 surveillance and vaccination programs protected vaccinated individuals from the Omicron variant; however, mass testing (and other mitigation measures) were unable to fully prevent “rapid viral transmission.” Most infections were mild with no hospitalizations (CIDRAP).
• Kaiser Health News discusses the importance of increasing ventilation in your home; yes, open those windows.
• The WHO will discuss a Global Pandemic Treaty at the World Health Assembly, next week, May 22 – 28^th.
• In Germany, according to the Schengen Visa Information site, “entry rules for all travellers” will continue to be in place for all; “all persons over the age of 12 are required to present COVID proof – a vaccination, recovery, or test certificate – when reaching Germany, SchengenVisaInfo.com reports.”
• NYT does an expose on “Coping with ‘zero COVID’” in China, exploring what that means and what that means for residents that are currently stuck and under lockdown.

Public Health & Food Safety:

• The monkeypox outbreak is in the U.K., Europe, and also now in the U.S. NPR’s Goat and Soda breaks down what this means. And did you know, monkeypox doesn’t come from monkeys?! (NPR). The first case of monkeypox has been identified in Massachusetts (Reuters).
• 35 states are now affected by the highly pathogenic H5N1 avian flu outbreak (CIDRAP).
• China has confirmed “a fatal H5N6 avian flu case”; since 2015, “China has now reported 78 H5N6 infections, which are often severe or fatal.” (CIDRAP).
• The CDC continues the investigation into the 180 cases of childhood acute hepatitis in the U.S. (CNBC).
• A recent study “found cesarean delivery, either with or without labor, or elective or emergency, compared to vaginal birth does not impact on the likelihood of food allergy at 12 months of age.” This study was conducted on 2,045 infants (EurekAlert).
• A recent systematic review and meta-analysis of community-acquired pneumonia infections in children have found that “an antibiotic treatment duration of 3 to 5 days for CAP in children over 6 months of age was as effective as 7 to 10 days” (CIDRAP).
• Mozambique is reporting its first wild polio case (as an outbreak) in 30 years. The sequenced strain is “linked to a strain of polio spreading in Pakistan in 2019 [and] reported in Malwali earlier this year” (CIDRAP/AP News).
• “Expert warns that the prevalence of ticks in America is growing”; while many are bitten yearly, “contraction of Lyme disease and other infections are rare.” As the weather warms up and we’re outdoors, make sure to do “regular tick checks, [and wear] long sleeves in areas of high exposure and [use] bug spray” (Daily Mail).