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Key Points
November 20, 2020
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In today’s Recommendations for Industry, we discuss Potential Strategies for Testing and Exiting Quarantine as Increasing COVID-19 Close-Contacts Continue to Impact the Critical Workforce. Read more here.
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The CDC recommends that due to to more than 1 million COVID-19 cases being reported in the U.S. over the last 7 days, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with. This will limit your chances of getting and/or spreading COVID-19 or the flu.
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A recent pre-print, titled “Optimal COVID-19 quarantine and testing strategies,” used data and modeled the optimal timing of testing during quarantine to reduce the probability of post-quarantine transmission.
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Join our own Dr. Ben Miller, MPH with CIC Health and the University of Minnesota's Genomics Center on a webinar today Friday (November 20) at 12:00 PM E.T. as they discuss COVID-19 testing on campus, including how surveillance testing can help bridge the gap between now and widespread vaccination programs. Register here: https://link.achesongroup.com/0fdb2
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As a reminder, a mask is not a substitute for social distancing (maintain 6 feet or more from others around you). Masks should still be worn in addition to staying at least 6 feet (2 meters) apart.
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The “COVID-19 Symptoms Comparison Chart” is now downloadable at our COVID-19 Resources page.
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The FDA has issued and authorized the first COVID-19 test for self-testing at home. TAG has quickly looked into the Lucira COVID-19 All-In-One Test Kit. While the test is currently unavailable, it “will initially only be available on a limited basis in point of care settings and healthcare networks that prescribe the test for patients to use at home”. The anticipated cost of the test is: ~$50.
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In Case You Missed It:
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On Monday, we discussed and answered the question: How Risky is International – and Domestic – Travel Today?
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On Wednesday, we explored the TAG’s U.S. Risk Matrix. This week, all states except for Hawaii (and D.C.) have moved to into the High or Highest-Risk Quadrants. Twenty-seven (27) states have a TPR greater than 10% and a case rate ≥ 25/100K, indicating that testing may not be adequate to characterize the true severity of outbreaks across the U.S fully.discuss TAG’s 50 State Risk Matrix. Read more about it here.
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In last Friday’s Recommendations for Industry we explored testing and When and What COVID Tests Facilities Should Conduct.
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OSHA and the U.S. Department of Labor have issued Guidance Alerting Employers to Frequently Cited Standards Related to COVID-19 Inspections. The most frequently cited standards and requirements for employers to follow include:
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Providing a medical evaluation before a worker is fit-tested or uses a respirator.
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Establishing, implementing, and updating a written respiratory protection program with required worksite-specific procedures.
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Training workers to safely use respirators and/or other PPE in the workplace, and retrain workers about changes in the workplace that might make previous training obsolete.
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Storing respirators and other PPE properly in a way to protect them from damage, contamination, and, where applicable, deformation of the facepiece and exhalation valve.
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Keeping required records of work-related fatalities, injuries, and illness.
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OSHA is also providing upated guidance for Holiday Workplace Safety. There is guidance for those in Retail Sales, for Delivery, and for Order Fulfillment.
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This winter season, protect yourself and your family from fraudulent flu or antiviral products. Like with COVID-19, there are no legally marketed over-the-counter drugs to prevent to prevent, mitigate, treat, or cure the flu. The FDA advises that the flu vaccine is the best prevention against the influenza and its serious complications.
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Be Antibiotics Aware. November 18 – 24th is Antimicrobial Awareness Week. Antimicrobial resistance (which includes antibiotic resistance) is a significant threat to both human health and sustainable food production. Drug resistance has made infections harder to treat; however, good hygiene can help stop the spread of infection (especially during the COVID-19 pandemic). Find out more about the effects antimicrobial resistance has on food, health, and more.
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Did you miss the October’s FSMA Friday in which TAG’s own Eric Edmunds discussed DA’s proposed Food Traceability Rule, the affected foods and ingredients on its Food Traceability List (FTL) and the rule’s foundational elements: Critical Tracking Events (CTEs) and Key Data Elements (KDEs), along with other key elements of the rule? Find the main points and recording here.
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China continues to report the presence of coronavirus on imported food products and packagingof shrimp, fish, beef, and pork. However, guidance from World Health Organization and other organizations continue to indicate that it is highly unlikely that people can contract COVID-19 from food or food packaging. Read the news from Food Safety News.
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Recommendations for Industry
Potential Strategies for Testing and Exiting Quarantine as Increasing COVID-19 Close-Contacts Continue to Impact the Critical Workforce
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The US is quickly approaching 1 million new COVID-19 cases weekly. With this staggering level of community transmission occurring, the number of people who are considered “close-contacts” and should therefore quarantine for 14 days is skyrocketing. However, the number of people in quarantine is also significantly impacting the workforce in critical sectors such as health care and manufacturing. This impact also contributes to hospital bed shortages and supply chain disruptions.
Since April, the Centers for Disease Control and Prevention (CDC), has provided guidance allowing, “Workers in critical infrastructure sectors […] to work if asymptomatic after potential exposure to a confirmed case of coronavirus disease 2019 (COVID-19), provided that worker infection prevention recommendations and controls are implemented.”
Although the CDC provided this guidance, some states and local health departments require all close-contacts to quarantine for 14-days after exposure to a suspect or confirmed COVID-19 case. In these instances, companies have found they must follow state and local requirements. In areas where companies are allowed to follow the CDC guidance, TAG has recommended taking a tiered approach to assessing an employee’s risk before allowing them to work as a close-contact, including:
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If an employee lives with, carpools with, or has sustained close-contact with a tested-positive COVID-19 individual, the employee should stay home and quarantine. In these instances, it is highly probable that the close-contact will develop a symptomatic or asymptomatic infection.
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Employees with less-sustained close-contact with a positive case (short duration exposures in excess of 15 minutes over a 24 hour period) could be allowed to continue working, per the CDC guidance.
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The CDC has also provided testing guidance for High-Density Critical Infrastructure Workplaces after a COVID-19 case has been identified. This guidance offers a tiered approach to testing that allows asymptomatic close-contacts to continue to work after baseline testing and with some testing every three days thereafter until no cases are identified in the workforce cohort. Again, TAG recommends considering the nature of an employee’s close-contact exposure before allowing them to return early.
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Currently, the CDC has not provided guidance on “testing out of quarantine.” This approach presents an opportunity to have close-contacts quarantine through the period where the probability of asymptomatically transmitting the infection to others is greatest while not needing to quarantine for a full two-week period. A recent pre-print, titled “Optimal COVID-19 quarantine and testing strategies,” used data and modeled the optimal timing of testing during quarantine to reduce the probability of post-quarantine transmission. This study found that “testing on exit was most effective for quarantines lasting up to six days” and results in less than a 1% probability of post-quarantine transmission and is comparable to a 14-day quarantine with no testing on exit.
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As case-rates increase and more individuals in the workforce become close-contacts, a data-driven strategy of “testing out of quarantine” may become more necessary. Please reach out to TAG if you have questions about developing testing and quarantine strategies for your unique situation.
Outbreak Updates
As of November 20, 2020 (12:13 ET), there are over >57,164,000 cases (>1,364,020 deaths) worldwide.
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Due to the increasing number of cases in the United States, TAG will move from reporting counts per country to focus on the United States, please see here for the data. For further information regarding worldwide numbers, please refer to John Hopkin University’s aggregate map.
Keep up to date with COVID-19:
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