It is the last week in August and there are some things to share with the Admin EM family. I hope you find this newsletter helpful.
- White House declares teachers essential workers: The White House issued a declaration, published by the Dept of Homeland Security, on August 18th. This update included the addition of teachers, pre-K through university level. The inclusion of teachers in this category allows them to follow the CDC recommendations for essential workers. The biggest change would be allowing a COVID-19 exposed teacher to return to work without quarantine, with a mask at all times, provided they remain asymptomatic. This declaration is “advisory” in nature only and may or may not be echoed by individual states.
- It is possible to be reinfected with COVID-19 : This week brought multiple case reports of people being “reinfected” with COVID-19. One in Hong Kong and two in Europe. These cases prove that it is possible to get the infection more than once. Each of them were infected with proven mutated strains, different from their initial infections. The case in Hong Kong had no symptoms when he was reinfected and he had an appropriate antibody response. These are all positive signs that a vaccine is likely to be protective, when available, if it can induce an antibody response. So this is good news !
- The COVID-19 Algorithm : The CDC is improving its information regarding contact tracing. With this comes some insight into how local health departments will handle outbreaks and suspected cases. Case tracking and protocols begin with a positive viral test being reported. There have been several questions form schools about how to handle symptomatic individuals. Taking into account the CDC information on testing, it is still strongly recommended that anyone with symptoms be isolated immediately (in a separate room if already in the building) and then sent home with instructions to call their doctor and discuss testing. However, there is currently no recommendation to quarantine all possible exposures (like the classroom) until a positive test is obtained. Therefore, the ADMIN EM symptom algorithm has been updated. Version 3 is now available on the website and the schools algorithm included here. The updated algorithm for businesses is available on the website. The changes is relatively minor but stresses the importance of a positive test result before closing a classroom and beginning quarantine.
- Exposure : We have had several discussions and questions regarding quarantine. As a reminder, exposure is from a person with COVID-19 to someone else who has been within 6 feet for >15 minutes (10 minutes by NY State Dept. Of Health Guidelines), even with a mask. There is no need to quarantine others who are around the exposed person. Mask use is required, and the person exposed is asked to avoid being within 6 feet of others until they have completed their quarantine. Additionally, a negative test while in quarantine unfortunately does not allow for early termination of quarantine. A full 14 days is necessary to see if the exposed person develops symptoms.
- Cases numbers are improving in Florida: For our Florida members, the total number of cases and the percent of tests returning positive (case positivity) is improving. On the COVID Act Now website, Florida has been downgraded from condition red to orange. All of this is positive. Continued vigilance with our mitigation strategies is still needed.
- School reopening: Schools reopened for some of our members in Florida last week and others this week. Thankfully, the reopening plans went well and so far everyone is healthy. More good news !
- New York Case Positivity: This metric continues to remain low, currently 0.8%. The state benchmark is 5% averaged over 14 days, and the NY City benchmark is 3% averaged over 7 days. The state overall remains in one of the best positions in the country for reopening. Daily updated information on these key metrics is available on the NY Dashboard of our website.
As always, we are here to support you and your safe re-opening. Please do not hesitate to log on and post your questions in the Q&A section, or email with new questions.
Sam Ashoo, MD
Founder / CEO