Key Points:

• In today’s Recommendations for Industry, we have a short discussion on increasing influenza cases around the US (as you’ll see in the Influenza Update below) and also how COVID-19 is trending across the country. Read more below.
• The WHO is encouraging countries, “especially those that have received the multiplex influenza and SARS-CoV-2 reagent kits from GISRS, to conduct integrated surveillance of influenza and SARS-CoV-2 and report epidemiological and laboratory information in a timely manner to established regional and global platforms” (WHO).
• Recent research published in JAMA has found that “alcohol-related deaths increased by 25% in the United States during the first year of the COVID-19 pandemic,” with deaths caused by alcohol overdoses also increasing by ~26% (CIDRAP).
• Even those with “less severe or asymptomatic forms” of COVID-19 infection had a greater likelihood of developing Type 2 diabetes (Washington Post).
• As the BA.2 COVID-19 subvariant may be rising, the FDA will be meeting on April 6, 2022, to discuss future booster shots as well as Pfizer and Moderna’s 4^th booster dose. Additionally, “AstraZeneca today said its antibody preventive treatment Evusheld retains neutralizing antibody activity against the BA.2 subvariant, as well as the Omicron variant” (CIDRAP).
• From CIDRAP, “The estimated overall accuracy of a second COVID-19 rapid antigen test among asymptomatic New York City workers was 94% in a comparative effectiveness study published late last week in JAMA Network Open. The study authors noted that while the gold-standard diagnostic test for COVID-19 is real-time quantitative polymerase chain reaction (RT-qPCR), rapid antigen tests are often used to screen asymptomatic populations because they produce results faster and are less expensive.”

Influenza:

• There are continuing reports of rising flu cases in France, Latvia, and the US as COVID protocols are relaxed.
• Within the US, influenza activity is increasing in most of the country. Influenza activity is high in Oklahoma and Arkansas. Levels are moderate in Idaho. 
• From the WHO: The WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2022-2023 Northern Hemisphere Influenza Season was held on 21-24 February 2022 in Geneva, Switzerland. The recommended composition of influenza virus vaccines for use in the 2022-2023 northern hemisphere influenza season can be consulted here.

Food Safety & Public Health:

• Health officials in Ukraine worry about a surge in other infectious diseases: polio, cholera, and measles.  Historically, Ukraine had low vaccination rates against these diseases.
• There is a norovirus outbreak in the Vancouver area linked to locally sourced oysters.

Recommendations for Industry

On the whole: Each week is looking better!

Each Thursday evening, the CDC updates its U.S. COVID-19 Community Levels by County Map, and each week, the number of counties listed as having high levels (orange) of COVID hospitalizations decreases and the number with low levels (green) increases.

The most recent map (at top, March 17) shows a number of states as being entirely in the green with many more having just splashes of yellow (medium), and very few having any significant orange.

This is a very positive sign and shows much of the U.S. continuing in a positive direction. It is yet to be seen if there will be any spike like that which has occurred in Europe, but there are at least indicators in the northernmost U.S. (e.g., Maine and Minnesota) of regression from green to yellow and yellow to orange. We also are continuing to see flu somewhat increasing in areas where COVID protections are decreasing.

In Case You Missed It:

• In last Thursday’s Recommendations for Industry, we discussed the continued decline of COVID-19 cases and hospitalizations in the US and what Europe’s trends may mean here. Read more here.
• Senate votes to overturn mask mandate on airplanes, transit. The Senate yesterday voted to end the federal masking requirement for passengers on planes and other public transportation. But the measure isn’t certain to pass in the House of Representatives, and President Biden has said he would veto it. (CIDRAP)
• Canada to end prearrival COVID-19 testing rule for all fully vaccinated travelers. Canada will end its pre-entry COVID-19 testing requirement for all fully vaccinated travelers in two weeks after facing intense pressure from business and tourism groups to ease border restrictions. A federal source said the rule will be lifted on April 1, but that on-arrival random testing will remain in effect to track new variants. People who travel internationally risk getting stuck abroad if their prearrival test is positive under the current rules. The coming change won’t help families returning home in the March break travel rush, who will still need to get tested before their arrival in Canada.
• Global COVID cases rising again. After 5 weeks of declining cases, global COVID-19 cases rose last week, fueled by increasing cases in three regions, according to the WHO weekly update. One factor suspected in current rises overseas, alongside eased restrictions and waning immunity, is increased spread of BA.2. Roughly half of last week’s cases were from the Western Pacific region, with surges in Hong Kong, South Korea, and Vietnam. Hong Kong today reported nearly 29,272 new cases and 217 deaths; China reported 3,045 new cases; South Korea reported a new record daily high of more than 400,000 cases. At a WHO media briefing , Director-General Tedros Adhanom Ghebreyesus, PhD, said the new rises are occurring despite reduced testing in some countries, “which means the cases we are seeing are just the tip of the iceberg.” Each country is facing a different situation with different challenges, but the pandemic is not over,” Tedros said.
• Despite case uptick, UK easing COVID-19 testing, monitoring . After dropping nearly all coronavirus restrictions last month, Britain is now ending some of its most widespread COVID-19 testing and monitoring programs, a move some scientists fear will complicate efforts to track the virus and detect worrisome new variants.
• In the US, BA.2 levels are also showing more signs of rise. The CDC estimates that BA.2 made up 23.1% of the nation’s circulating variants during the week ending on Mar 12, up from 13.7% the previous week. The CDC’s wastewater surveillance tracker shows that 165 U.S. sites have experienced an increase in SARS-CoV-2 levels in the last 15 days. The 165 sites make up less than half of the 419 sites currently reporting data and “may simply reflect minor increases from very low levels to still low levels,” a CDC spokeswoman said. However, as we reported Tuesday, the number of sites with rising signals of COVID-19 cases is nearly twice what it was during the Feb. 1 to Feb. 10 period, when the wave of Omicron-variant cases was fading rapidly.
• With the UK, Germany, France, and others experiencing a new wave in the past couple weeks, “The US should get ready.” At least 12 countries are experiencing new increases in cases, some quite marked, such as Austria exceeding its pandemic peak, and Finland with an 85% increase from the prior week. Many are also showing a rise in hospital admissions. Over the last two years, the UK and Europe have provided five unmistakable warnings to America that a new surge was occurring. Each time, the US experienced a new wave within weeks, some not as severe (e.g., Alpha), some worse (Delta and Omicron). It has shown that what happens in the UK and Europe doesn’t stay in the UK and Europe.
• Twice as many Black COVID patients deemed lowest priority in ICU triage system. A crisis-standards-of-care (CSOC) scoring system used to triage COVID-19 intensive care unit (ICU) patients assigned twice the proportion of Black patients as other patients to the lowest-priority group, finds a modeling study published yesterday in JAMA Network Open. Relative to other participants, Black patients were more likely to be assigned to the lowest-priority group (15.2% vs 8.1%). An exploratory simulation using the score for allocation of ventilators (with only high-priority patients receiving ventilators) showed 43.9% excess deaths among Black participants, compared with 28.6% among all other patients.

Food Safety & Public Health:

• Avian flu appears in Nebraska backyard flock. Raising the number of states to report highly pathogenic avian flu in backyard flocks or commercial poultry to 15, federal and state officials today announced the first outbreak in Nebraska. In related developments, Missouri reported another outbreak in backyard poultry, and federal officials reported more H5 detections in wild birds, including the first from Ohio and Illinois.