Key Points:

• In today’s Recommendations for Industry, we TAG’s weekly Risk Matrix and the significance of indoor activities in relation to COVID risk. Read More Below.
• The FDA has authorized the use of Pfizer’s COVID-19 vaccine for adolescents 12-15 years old.
• The CDC has released good communication information for talking about COVID-19 vaccines with friends and family who may have be expressing hesitancy. As part of having these conversations, it is important to:
  • Listen to their questions with empathy
  • Ask open-ended questions to explore their concerns
  • Ask permission to share information
  • Help them find their own reason to get vaccinated
  • Help make their vaccination happen
• Furthermore, the CDC has released even more information that “wearing masks” DOES NOT CAUSE changes in “oxygen or carbon dioxide levels” when worn “while resting and exercising.” Studies conducted included hospital workers, older adults, and adults with COPD.
• The WHO has named the COVID-variant identified in India (B1617) as a fourth variant of concern, in addition to the B117, B1351, and P1 variants.
• COVID cases across India and Asia are rising steadily. This is cause for concern!
• Brazil’s president will allocated over $1B dollars to produce and distribute COVID-19 vaccines.
• In Canada, the future of AstraZeneca’s COVID-19 vaccine is in question due to blood clots. In fact, the provinces of Alberta & Ontario have stopped distributing AstraZenca’s vaccine.
• Starting next week, the UK’s NHS should have its vaccine passport ready for use and launch.

Activities Have Significant Impact on Indoor COVID Risk

1. Our university will be holding an indoor graduation ceremony for which we expect about 3,500 graduates and guests. We are requiring masks, but would like to have everyone sing a short song at the end of the ceremony. Would that have any effect on COVID risk?
2. TAG has been receiving a number of questions about COVID risks associated with the return to indoor activities, including return to work. While the response to the risks will differ based on the calculation of variables (see below), the impact of the activities that will be happening in the space was clearly illustrated when TAG assisted in the calculations.

       That is, can singing be allowed at the graduation ceremony? In assisting with the calculation of risk for the case in question, TAG found:

• 16 minutes of singing = 11 hours of breathing for the 3500 people in attendance.

The significance of this for businesses is that indoor air spaces need to be considered as you develop return-to-work protocols. As discussed in a previous TAG newsletter, the number of people, length of time in a confined space, and activity being performed have more impact on potential transmission than simply sitting six feet apart.

No matter how far apart people may be in the area, the air will mix and droplets spread over time, and the more active the people in the room, the greater this will be. Thus, businesses need to consider the ventilation rate of a room or area, along with number of people, volume of the space, the activities that take place, whether masks are worn, and various other factors based on the specifics of the area. It can be quite complex, but TAG has been assisting business with such determinations throughout the pandemic. Give us a call if you need assistance with this – or other aspects to be considered in returning your people to work.

 

Risk Matrix

Overall things are looking better in the US – including Michigan which is still higher than other states, but no longer so significantly. No state is above the 10% positive rate, and only four states over a 1.0 transmission rate. However other parts of the world are not doing so well,  including Canada where high COVID numbers are persisting in several provinces and vaccine supplies dwindling in others, and Asia which is seeing increasing case numbers. This does not bode well the opening of international travel, and businesses should continue investigating COVID conditions before traveling outside the US.

Positive trends –

• The Government Stringency Index is 36 this week. This is the same as last week, indicating a stabilizing in government stringencies. Five (5) states’ (Arizona, 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).

Table 1.

Figure 1.

Table 2.

Table 3.

• No states have a TPR ≥ 10% and a case rate ≥ 25/100K people indicating that testing may not be adequate to fully characterize the true severity of the outbreak in the state (Table 4).
• Only Michigan has a TPR < 10% and a case rate≥ 25/100K people, indicating that adequate testing is likely finding most symptomatic cases of illnesses (Table 4).

Table 4.

• In Monday’s Recommendations for Industry, we discussed continuing your public health worker protections for the control of Hepatitis in the wake of the lingering outbreak. Read More Here.

• COVID-19 infections are on the rise in South Asia. In India, and countries surrounding it (including Afghanistan, Bangladesh, Nepal, Pakistan, and Sri Lanka), COVID-19 cases have risen dramatically in the last week.
• The CDC officially declared that the SARS-COV-2 virus “is an airborne threat (NYT)” and highlights that “[the] airborne virus can be inhaled even when one is more than six feet away from an infected individual.” See the official update on the CDC’s site. (It’s in big letters now!)
• Some COVID-19 patients in India are developing mucormycosis, a fungal disease with 50% mortality rate, affecting immunocompromised individuals. There is thought that this disease is being triggered by the use of steroids and other COVID-19 treatments. 
• On Friday, the CDC updated its testing requirements for international air passengers into the U.S. to allow for (and accept) the use and results of at-home test kits, as long as the test is supervised by a telehealth service associated with the testing kit manufacturers.
• In the continued discussion on vaccine equity, there are countries whose people want vaccines, but the countries have none to distribute. This continues to highlight the inequities of vaccine distribution.
• In Friday’s Recommendations for Industry, we discuss new studies on COVID-19 projections for the next few months and how businesses should be preparing. Read more here.
• Both the U.S. and the E.U. have indicated support for waiving COVID vaccine intellectual property rights.
• The Premier of Ontario (Canada) has approached Michigan’s Governor “about the possibility of having essential workers” cross the border from Canada to be vaccinated in Michigan.
• CIDRAP reports that three vaccines (and their boosters) are showing promise against COVID-19 variants.
• The CDC predicts that as we continue vaccinations, it is likely that COVID-19 activity in the U.S. will sharply decline – if most of the country maintains a moderate adherence to non-pharmaceutical interventions (NPIs), including physical distancing. (we also discuss that in Friday’s Recommendations for Industry)!
• A new study from IHME estimates that the global death toll from COVID-19 is probably twice as high as official estimates due to underreporting (of cases and deaths) and insufficient testing. STAT News discusses this further.
• Pfizer/BioNTech announced today that they have submitted an application for full FDA-approval for the COVID-19 vaccine; if this is approved, it will be the first COVID-19 vaccine in the US to receive full FDA approval.