Key Points:

• In today’s Recommendations for Industry, we discuss TAG’s matrix and the current trends of COVID and its variants. Read more below.
• As countries have begun accepting the endemicity of COVID-19 in society and many countries are loosening pandemic protocols, the WHO warns that it is not the time to completely let go of the reins, in fact, it is “premature for any country either to surrender, or to declare victory.” (NYT).
• The FDA is set to meet to discuss Authorization for the Pfizer COVID-19 vaccine for children 6 months-4 years on February 15^th (FDA). The U.S. Surgeon General pledges that the FDA will review the situation rigorously (NYT).
• A recent study published in Radiology has found that those who are fully vaccinated have less severe breakthrough infections than those who are only partially vaccinated or unvaccinated. In fact, in this study, “mechanical ventilation and in-hosptial deaths” only occurred in those who were unvaccinated. Those who were fully vaccinated had a “significantly lower risk of requiring supplemental oxygen and of [intensive care unit] admission than unvaccinated patients” (CIDRAP).
• While COVID-19 cases in the U.S. are dropping, hospitalizations remain high in those that are unvaccinated (CIDRAP).
• The first human challenge study for COVID-19, conducted out of the Imperial College in London, has shed some light into how SARS-COV-2 works, including that “infection [started] in the throat and peak[ed] in the nose.” To that end, “Rapid tests correlated well for swabs, including in asymptomatic people. However, they were less able to flag lower levels of virus at the start and end of infection” which tracks with how TAG has discussed this, also in our COVID-19 toolkit (CIDRAP).

Public Health:

• The CDC has found that the multi-state Listeria outbreak in Dole pre-packaged salad has now been discovered to be associated with harvesting equipment (CIDRAP).
• For the 6^th consecutive year, Tyson Foods has ranked “No. 1 on Fortune magazine’s list of the World’s Most Admired Companies in the Food Production category” (Globe News Wire).
• “The FDA expects to complete the rule in November at which time the food industry would have to maintain records that track certain products as they move along the supply chain from growing to receiving to transforming to creating to shipping” as part of its push towards bringing blockchain-based food tracking into existence.

Recommendations for Industry

TAG COVID Matrix Showing Encouraging Trends

As shown in this week’s matrix, COVID continues to follow TAG’s projected track with case rates gradually dropping across the US, though some northwestern states remain high. Most significant, though, is the downward trend in transmission rates in most states – which is very encouraging. Hospitalizations do remain high, but that is to be expected at this point, especially since studies are showing that it is primarily the unvaccinated who are most severely impacted, requiring hospitalization.

Even with these trends, and many countries beginning to relax COVID protections, the WHO is advising against a loosening of protocols, stating that it is premature to do so. In a similar vein, TAG has been getting questions from clients on the continuation of employee masking, particularly with the new availability of and recommendations for N95s. Because N95s can be uncomfortable and are not always properly worn, TAG recommends considering specific “use-cases” where this level of masking will be most effective. People returning after day 5 of isolation and those opting out of quarantine are good candidates for short term use of an N95 or equivalent mask for source control, as these people are more likely to represent a transmission risk to others. Other situations where N95s are appropriate are densely populated and poorly ventilated indoor spaces or in vehicles while traveling. If employers specifically require the use of an N95 as a respirator (and not as a face covering), OSHA has a number of requirements including education, a medical evaluation, and fit testing.

Risk Matrix:

At this time, Omicron cases are drastically decreasing across the majority of the U.S. While many states still have a Test Positive Rate (TPR) >10% with high case rates (>25 cases/100K people), we are seeing a downturn. In some states like Arkansas, Kentucky, Minnesotta, Montana, Washington, and Wyoming, cases (and TPRs) do continue to rise; however, in the majority of states, cases have dropped down significantly (although many cases are still above 100 case/100K persons). This tracks with our previous discussions of the wave moving from East to West, slowly.

In case you missed it

• In Tuesday’s Recommendations for Industry, we discussed the current progression of COVID and the flu and why keeping calm is the phrase of the day. Read more here.
• Happy Lunar New Year to all our readers!
• The U.S. FDA has given full approval to Moderna’s COVID-19 vaccine, henceforth known as Spikevax (VOA News, CIDRAP).
• Further information on COVID vaccines finds that the vaccines can markedly cut household transmission (especially if there are two vaccinated parents), with a study in Science finding an “estimated 89.4% lower risk of infection” (CIDRAP). Additionally, a third COVID vaccine boost does provide increased effectiveness against hospitalizations (CIDRAP 2).
• While less severe in terms of hospitalizations when compared to the Delta variant, Omicron is causing more reinfections in those who had been previously infected and/or are vaccinated (CIDRAP). Cases in many parts of the U.S. have peaked and are coming down, there are still some high hospitalization rates (Montana) and increased cases (Colorado, Florida, Louisiana) (NYT). Due to how things are going across the world, the U.S. has increased the number of countries and territories on its “Level 4: Very High” risk travel list to include Mexico, Brazil, and Singapore (Reuters). There are now 130 countries on this list.
• New studies on the Omicron subvariant, BA.2, have found that it is more transmissible than the original Omicron strain (CNBC; CIDRAP).
• The origin of Omicron is now under a three-theory discussion. This article in Nature tracks the evolution from the original strain to now. 

Influenza:

• In the U.S., influenza activity remains stable with a slight decrease. “The vast majority of flu viruses remain influenza A strains (97.2%), with the H3N2 strain accounting for 100% of subtyped samples at public health labs. The CDC says most of H3N2 viruses identified so far this season are genetically closely related to the vaccine virus, but some antigenic differences have been observed as the viruses continue to evolve.” (CIDRAP). Cases of flu are rising in some parts of the U.S. (including South Dakota) while falling in others (Louisiana).
• Denmark has reported its first case of variant swine flu discovered in a slaughterhouse worker (CIDRAP).

Public Health:

• In the DRC, Nigeria, and Ukraine, there are an increasing number of vaccine-derived poliovirus type 2 cases (CIDRAP).
• The first E. coli O103 outbreak has been found in raw celery (Food Safety News).