Key Points:

• In today’s Recommendations for Industry, we discuss the slight increase in cases around the U.S. Read more below.
• The FDA is warning consumers of counterfeit over-the-counter COVID-19 diagnostics (at-home) tests. Find out more about the tests that are now considered counterfeit.
• As consumers also have been wondering about the shelf-life/expiration of their at-home over-the-counter COVID-19 diagnostic tests, the FDA has just updated its guidances and provided expiration dates for the different types of OTC COVID-19 tests.
• Although the mask mandate in public transportation spaces has been struck down and not reinstated, the CDC “has reissued a recommendation for wearing face coverings on public transit and in transportation hubs like airports” (CIDRAP).
• Globally, the WHO reports that the COVID-19 pandemic has taken the lives of almost 15 million individuals (New Scientist). While COVID-19 cases are declining globally, cases in the Americas and Africa are rising. “In Africa, 12 countries last week saw cases rise by more than 20%, but most of the new infections were reported by South Africa, which saw a 67% increase compared with the previous week.” (CIDRAP). As we’d discussed on Tuesday, BA.4 and BA.5 subvariants may be driving this 5^th surge. In fact, WHO emergencies chief, Dr. Michael Ryan believes it is still too “soon to tell if COVID-19 was entering a seasonal pattern and warned against countries dropping all of their restrictions too quickly” (ABC).
• In the U.S., due to rising community transmission moving NYC’s COVID alert from low to medium, NYC may bring back mask mandates and vaccine checks if hospitalizations continue to rise to high risk (CNBC). Additionally, as Puerto Rico has lifted its COVID-19 restrictions, it is seeing an average of 4,000 reported cases daily (NYT). On Wednesday, the COVID-19 death toll had reached 1 million deaths; this is “equivalent to the population of San Jose, CA, the 10^th largest city in the U.S.” (NBC News).

Public Health & Food Safety:

• This year’s White House Conference on Food, Nutrition, and Health will focus on “end[ing] hunger and increas[ing] healthy eating and physical activity by 2030, so that fewer Americans experience diet-related diseases like diabetes, obesity, and hypertension.” Find out more about this conference from Health.gov.
• It is tick season, everyone! The first human case of Powassan virus has been detected in Connecticut (WFSB).
• Australia’s Nutricia infant formula tests positive for Cronobacter (FSN).
• BusinessWire has put together a new trend report, specifically focusing on, “North America Insect Protein Markets Size, Shares, Industry Trends, & Analysis Report 2021-2022 & 2027.”

Recommendations for Industry

Weekly COVID Matrix Shows “Smoldering” of Cases

TAG’s weekly COVID risk matrix is showing some increase in cases around the U.S., with nearly all states having a transmission rate of 1+. However, we are not seeing anything dramatic; it appears to be more of a smoldering of cases with a flat, non-accelerating rate of change. This is not unexpected as it is the subvariants of the Omicron, specifically BA.2.12.1, that are responsible for many of the cases, which are known to have higher rates of transmission, but lower severity. In fact, deaths have declined over the past month, and cases in the UK are way down – which has historically been a predictor for expectations in the U.S. We’re still working through the subvariant ripple, and not seeing anything on the world front that indicates that a surge would be coming.

So, once again, we reiterate our ongoing advice to “stay the course.” We see no need to recommend any changes needed to control the risk. TAG also recommends that businesses allow for individual use of protections, according to worker preference. Although we no longer see public health benefits of mandatory masking, masks that are properly fitted and properly worn can continue to provide an incremental level of protection for individuals who prefer to wear them.

Risk Matrix:

In Case You Missed It:

• In Tuesday’s Recommendations for Industry, we discussed how well the various COVID vaccines work against the variants. Read more here.
• The CDC estimates that, until now, about “60% of adults and 75% of children” have antibodies indicating that they’ve been infected with COVID-19 (CNN). 
• Moderna has asked the FDA to authorize its vaccine for children under 6 years old (NYT). Similarly, the FDA has “laid out a tentative timetable” leading to June in which they may authorize the COVID-19 vaccine(s) for children (NYT).
• COVID cases around the world are fluctuating, yet again. In the U.S., a newer Omicron subvariant BA.2.12.1 “is responsible for 29% of new coronavirus infections as of mid-April, according to data from the Centers for Disease Control and Prevention. That’s up from 19% of cases the week prior and 14% of infections the first week in April” (US News). Although cases have risen, deaths have decreased by 20% over the past two weeks (CIDRAP). China’s battle with COVID-19, moving towards “zero-COVID” policy continues. Not only does the lockdown in Shanghai continue, cases in Beijing are rising and “authorities in Beijing imposed restrictions over the Labor Day 5-day holiday celebration, which is typically a busy travel season” (CIDRAP). As noted, South Africa’s COVID-19 test posivitity has also risen by 22% with another subvariant (BA.4 and BA.5); there is increasing concern that this is the start of its fifth COVID wave (CIDRAP/MarketWatch/The Guardian).
• Throughout the world, countries are lifting travel restrictions. In the most recent, Greece has officially removed all COVID-19 entry rules (Schengen Visa Info). Additionally, Italy has lifted its passenger locator form requirement; however, it has extended other COVID-19 entry measures (Schengen Visa Info).
• A recent publication in Nature Communications has found “Relative to the Pfizer/BioNTech COVID-19 vaccine, the Moderna version confers slightly more protection against infection—but not hospitalization, intensive care unit (ICU) admissions, or death—90 days after the second dose,” suggests a modeling study of more than 3.5 million fully vaccinated Americans published today in Nature Communications (CDIRAP).
• A new medication (CDC) to protect against COVID-19 has been allowed, Evusheld. One is eligible for Evusheld if:
  • Are moderately or severely immunocompromised and may not mount an adequate immune response to COVID-19 vaccination OR have a history of severe allergic reactions to COVID-19 vaccines, and
  • Do not currently have COVID-19 and have not recently had close contact with someone with COVID-19, and
  • Are an adult or adolescent 12 years older weighing at least 88 pounds (40 kg)

Influenza:

• In the U.S., “seasonal influenza activity continues to increase in some areas of the country. The first human detection of avian influenza A(H5) in the United States was reported this week” (CDC). More on the first human U.S. avian flu case below.
• As we’ve discussed the increasingly deadly and widespread avian flu, nearly two-thirds of all American states have now seen affected flocks; confirmed in 23 states. To that end, CIDRAP reports, “In the wake of the recent announcement of the first human H5 avian flu case—involving a poultry culler in Colorado who had few symptoms—the CDC a few days ago issued a Health Alert Network notice that covered recommendations for human health investigations and response. The CDC said it’s impossible to determine if the H5 virus in the patient’s original respiratory sample was transient surface contamination of the man’s nasal passages or the result of an infection. The agency added that public health officials are pursuing the right approach by assuming that the man was infected and taking actions to contain and treat the virus.” (CIDRAP)
• Vaccinations are encouraged as the majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus.
• Globally, flu cases continue; however, the majority of cases are from the Influenza A family type.

Food Safety:

• Abbott will release its metabolic nutrition formulas “free of charge to patients, in coordination with healthcare professionals based on need and on a case-by-case basis. The lots being released were not included in the February recall and are now being released at the request of the U.S. FDA” (PR Newswire).
• FMI discusses the importance of “keeping food safety top of mind when sourcing produce grown indoors” (FMI).
• Raw milk is back on the platform with Georgia recently passing a bill driven by consumer demand. Food Safety News provides thoughts on this.
• Nigeria, Somalia, Yemen, Afghanistan, and Ethiopia have been confirmed as countries with largest measles outbreaks attributed to lack of vaccination.

Hepatitis:

• Hepatitis cases continue to remain dominant.
• As of 21 April 2022, at least 169 cases of acute hepatitis of unknown origin have been reported from 11 countries in the WHO European Region and one country in the WHO Region of the Americas. Cases have been reported in the United Kingdom of Great Britain and Northern Ireland (the United Kingdom) (114), Spain (13), Israel (12), the United States of America (9), Denmark (6), Ireland (<5), The Netherlands (4), Italy (4), Norway (2), France (2), Romania (1), and Belgium (1).
• The number of children with hepatitis of unknown etiology in the United Kingdom has increased to 145, with 34 cases reported in just the past 4 days. Cases may be associated with adenovirus infection, but because the symptoms of these childhood hepatitis cases are not typical of adenovirus infection, experts are still investigating other possible causes, such as new coronavirus infection or environmental factors.
• In the United States, there are least 25 cases: nine in Alabama, two in North Carolina, three in Illinois, four in Wisconsin, and seven in California. So far there has been one death in Wisconsin, and four of these children have needed liver transplants.
• A UK report suggesting that isolation of children through the pandemic may have weakened immune systems and made them more susceptible to hepatitis.