Key Points:

• In today’s Recommendations for Industry, we discuss COVID-19 trends stabilizing and declining. Read more below.
• The CDC released research done on post-COVID conditions among adult COVID-19 survivors aged 18-64 and younger than 65, here are some results:

• Another figure shows additional areas of the body that were included in the research conducted. Independent of age group, the highest risk ratios were for acute pulmonary embolism and respiratory symptoms.
• A study in BMJ showed that the effectiveness of a fourth dose of Pfizer-BioNTech mRNA vaccine waned faster than the third dose in adults 60 and older. The study took place over 10 weeks and at the end, 106 participants had passed- 77 who had the third dose and 23 with the fourth dose.
• COVID- 19 vaccine protection lower, wanes faster in cancer patients, concludes a Lancet study. The COVID-19 vaccine offered more protection against hospitalization (83.3%) and death (93.4%) than against infection in cancer patients but also waned after 3 to 6 months. Vaccine effectiveness was much lower among patients with the blood cancers leukemia or lymphoma, a recent cancer diagnosis, or chemotherapy or radiotherapy within the past year.
• Global COVID-19 cases start to drop again. After a week of stabilization, global COVID-19 cases are declining again, with downturns in two of four regions that have seen recent upticks, according to WHO. Part of the decline came from South Africa, which had experienced a spike involving the more transmissible BA.4 and BA.5 Omicron subvariants in late April. Of more than 3.7 million cases reported to the WHO last week, the five countries with the most cases were the United States, China, Australia, Germany, and Japan. More than 9,000 people died from their infections, with the United States reporting by far the most (1,957). Omicron continues to be the dominate strain.

Public Health & Food Safety:

• The FDA provides new guidance to decrease pathogen growth in sprout seeds and their final guidance suggests that individuals become as informed as possible about food safety practices, processes, and procedures. There have been 52 outbreaks between 1996 and 2020- 2,700 people were sick because of the outbreaks. Outbreaks have consisted of Salmonella findings. Sprouts are grown in warm and moist environments which is perfect for bacterial growth inside the seed coat. The FDA deemed grower’s cleaning methods were ineffective in killing the bacteria inside the seed coat.
• People are being urged to cook frozen fruit and vegetables because of Listeria findings. There have been low findings, but the risk is greater with frequent consumption. Of 906 samples tested, 27 were positive and 21 of those were non-ready to eat frozen vegetables.
• Officials confirm 226 monkeypox cases in 21 countries. Clusters of monkeypox cases are in young men who have sex with other men. Though not sexually transmitted, monkeypox is spread through close contact. UK has 78 cases according to the European Centre for Disease Prevention and Control. Spain has 51 cases, Portugal has 37, and Canada has 15.

Recommendations for Industry

COVID Showing Stable and Declining Global Rates

As both TAG’s matrix and the WHO weekly update are showing, the spread of COVID is stabilizing and TAG’s predictors are tracking with what is being seen. In the U.S. we are seeing a shifting stability, with COVID cases continuing to move from east to west with no storm clouds seeming to appear on the horizon.

As we’ve done for much of the pandemic, we’re seeing the U.S. following the trends of other geographic areas, such as Europe and the UK. Overall, as shown in the WHO report, global cases are declining again, with downturns in South Africa, which had experienced a spike involving the more transmissible BA.4 and BA.5 Omicron subvariants in late April.

This week the BA.2.12.1 Omicron variant became the predominant variant in the US, with case numbers starting to plateau in some parts of the Northeast. While case counts are lower than in January and February, the availability of at-home antigen testing is now much greater and current case counts significantly underestimate the true number of new daily infections as they go unreported (perhaps by 4 to 5 times the true number). Therefore, TAG continues to recommend that businesses keep managing protections as you have with symptom tracking and ensuring those who are ill stay home.

As a side note, CDC has updated its COVID-19 vaccine recommendations, changing its terminology from “fully vaccinated” to “up to date.” As such, you are considered to be up to date “when you have received all doses in the primary series and all boosters recommended for you, when eligible.” The specifics are available on the CDC COVID-19 Vaccine page.

Risk Matrix:

An increasing number of states have increased TPRs and case rates >25 cases/100k. In Delaware, the overall state community risk level has risen to High-Risk (red) while states like Connecticut, DC, Massachusetts, Maine, New Hampshire, New York, Pennsylvania, Vermont, and West Virginia are in Medium Risk (yellow).

In Case You Missed It:

• In Tuesday’s Recommendations for Industry we discussed COVID-19 variants, BA.4 and BA.5. Read more here.
• Despite what many of us might like to believe, COVID-19 has not gone away. South Africa recently identified two new subvariants of Omicron — designated BA.4 and BA.5. These subvariants have now spread to several other countries, including the United Kingdom and the United States. In the U.S., the CDC has designated BA.4 and BA.5 as variants of concern. Additionally, the new variants can reinfect people who had COVID even just a few months ago. Read more about them here.
• Pfizer reports strong COVID vaccine protection in kids under 5, will file with FDA .There is a strong efficacy for 3 dose vaccines for children between 6 months and 4 years old. Additionally, the FDA is meeting on June 28^th to discuss whether vaccines should be modified to strains, specifically what strain should be selected for fall of 2022.
• CDC now recommends and expands that children 5-11 should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series. Individuals 12 and older who are immunocompromised and those 50 and older should receive a booster dose at least 4 months after their first.
• A large UK study in BMJ suggests that COVID-19 vaccination after infection lowers the odds of persistent symptoms, with a 12.8% initial decline after the first dose and an 8.8% drop after the second—although the long-term effects are unclear. Vaccination after infection may cut risk of long COVID-19.

Influenza:

• The CDC reports that the seasonal influenza viruses continue to circulate, and activity is increasing in parts of the country. This week, 7 jurisdictions experienced moderate activity and 3 jurisdictions experienced high or very high activity. 7.5% of deaths attributed to pneumonia, influenza, or COVID-19 this week (above threshold).
• There is continuing incidence of hepatitis of unknown origin. Currently, there is no evidence of human-to-human transmission. There is question whether this is an infectious disease since reports are sporadic. As of May 18, there have been 575 related cases in at least 25 countries around the world. Most cases have been reported in the US and the UK likely because of strong surveillance systems in these countries. A recent Lancet study suggests that children may have had very mild and undetectable COVID illness that left lingering particles of the coronavirus in the gastrointestinal tract in these children. These could then be priming the immune system to over-react to adenovirus-41F with high amounts of inflammatory proteins that ultimately damage the liver.  
• Monkeypox cases increase across Europe, North America, currently there are about 200 confirmed and suspected cases. A common symptom to be aware of is a genital rash.

Public Health & Food Safety

• As climate change continues to alter weather patterns around the planet including the Midwest, researchers at Michigan State University are modeling the impact on crops such as corn. The researcher’s near-term climate model scenarios found that between 2031-2040, aflatoxin is going to become more of a problem in the U.S. Corn Belt in the Midwest. Fungi Aspergillus flavus and Aspergillus parasiticus produce aflatoxin which can be found in peanuts, tree nuts and corn. Aflatoxin degrades corn quality and causes health problems for consumers. Aflatoxin contamination typically occurs in warmer and dryer climates.
• Danone is sending more infant formula from Europe to the United States to address the shortage.
• The J. M. Smucker Co. Issues Voluntary Recall of Select Jif® Products Sold in the U.S. for Potential Salmonella Contamination. Products with lot numbers 1274425-2140425- across US and Canada. See all of the potentially contaminated peanut butter products here.
• Vertical farming is being affected by zoning in large cities. Rethinking urban zoning laws to accommodate large-scale indoor agriculture, such as vertical farming, will require the many urban jurisdictions in the US to undertake significant hard work that is preceded by consensus building and thoughtful analysis. Healthy Food Policy Project is geared toward small projects such as community gardens and greenhouses. They are permitting on-site sale of produce.