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Acheson Group February 24, 2021 0 Comments

Key Points:

Recommendations for Industry

Post-Vaccine Symptomatic Return to Work

When considering return to work of post-vaccine persons with COVID-like symptoms, there is a fine line between unnecessarily excluding those with vaccine reactions and inadvertently allowing those who do have COVID to return to work.

 In its Post-Vaccine Considerations for Healthcare Personnel, CDC guidance recommends that a person with any systemic signs and symptoms consistent with COVID-19 infection (e.g., cough, shortness of breath, rhinorrhea [runny nose], sore throat, loss of taste or smell) that are not typical for post-vaccination signs and symptoms (e.g., pain, swelling or redness at the injection site) be excluded from work pending evaluation for the virus. Those with only symptoms that are more commonly associated with post-vaccination side effects (e.g., fever, fatigue, headache, chills, myalgia, arthralgia) could return to work if they feel well enough to do so. However, if symptoms persist for more than two days, they should be excluded from work and tested for COVID-19.

These recommendations are for Healthcare Personnel where access to adequate PPE is expected, and currently there is no similar guidance for those working in other critical infrastructure settings, such as the Food and Ag Sector.  Because of this, we at TAG recommend, for the time being, a more conservative approach that anyone with symptoms be tested or wait until symptoms resolve to return to work.

TAG recommends that businesses prepare by securing access to rapid home tests prior to your state’s authorization of vaccines for your workforce. While these tests can be less sensitive than PCR tests, they have good sensitivity in terms of confirming or negating COVID-19 in those who are symptomatic. To assist you in assessing these tests, TAG has summarized current research to provide general information on three key tests in the table below.

FDA EUA?

 

Test Type

Sample Type

 

Prescription?

 

Sensitivity / Specificity

Relevant

Links

Ellume COVID-19 Home Test

Yes

Antigen

Mid-turbinate nasal swab

No – OTC

Symptomatic – 96% Sensitive / 100% Specific

Asymptomatic:

91% Sensitive / 96% Specific

FDA 

Ellume Health

Abbott BinaxNOW COVID-19 Ag Card Home Test

Yes

Antigen

Bilateral anterior nasal swab

Yes

Symptomatic – 64% Sensitive / 100% Specific

Asymptomatic:

35% Sensitive / 100% Specific

FDA

CDC

Lucira COVID-19 All-In-One Test Kit

Yes

LAMP (real-time loop mediated amplification reaction)

Nasal swab

Yes

According to an unpublished study by Lucira [PDF], symptomatic individuals suspected to have COVID-19 self-collected nasal swabs for testing. The self-administered results were compared to a “high sensitivity molecular FDA authorized SARS-CoV-2 assay” that is not specifically named. In 101 participants, the total positive percent agreement across all samples was 94.1% (48/51) or 96.0% (48/50). When samples with high Ct values (>37.5) were excluded, the test achieved 100% (45/45) positive percent agreement.

FDA

Lucira Health

IDSA

For further assistance in setting a return-to-work strategy for your workforce, give TAG a call.

TAG Risk Matrix.

Based on TAG’s matrices since last week:

  • The Government Stringency Index is 46 this week. It is the same as the previous week’s GSI. There are no states in the U.S. where businesses are completely closed. Eight (8) states’ (Arizona, California, Colorado, Connecticut, Hawaii, Massachusetts, New Mexico, and Oregon) businesses are in mixed opening stages.
  • Five (5) states are in the Highest-Risk Quadrant (Outbreak Index > 50). This is down from 6 last week. States in the High and Highest-Risk Quadrants are Alabama, Idaho, Iowa, Kansa, and South Dakota.
  • In Figure 1, this week, we compare the case rate/100K in the population to the percentage of a state’s population that has been vaccinated. We look at the percentage of population (within a state) that has received both the 1st and 2nd Table 1 compares the last week and this week’s percentage of states’ populations that have been vaccinated.

[Figure 1]

[Table 1]

[Table 2]

  • Three (3) states have a TPR ≥10% and a case rate ≥ 25/100K people (Table 3). This is down from 11 states last week. This indicates that testing may not be adequate to fully characterize the true severity of the outbreak in the states. On the other hand, 6 states have a TPR < 10% and a case rate≥ 25/100K people indicates adequate testing that is likely finding most symptomatic cases of illnesses.

[Table 3]

  • In Figure 2, we compare case rate/100K in the population to the number of COVID-19 tests administered and change in Test Positive Rates.

[Figure 2]

In Case You Missed It

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