San Francisco has hired a hawk to scare pigeons away from metro stations. That may seem like a lot of effort to prevent pigeon poop, but apparently you can’t argue with the results. 

Today in health care, the CDC loosened its COVID-19 guidance, representing a major shift toward living with the virus.  

Welcome to Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. For The Hill, we’re Nathaniel Weixel and Joseph Choi.

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CDC loosens COVID guidance, scraps quarantine

The Centers for Disease Control and Prevention (CDC) on Thursday relaxed many of the guidelines for COVID-19 in communities, a major shift that emphasizes living with the virus rather than strict prevention of infection. 

• The new guidance puts the onus on individuals to assess their own personal risk levels, rather than businesses, governments or schools. CDC indicated it will focus on protecting people at high risk for severe illness.
• CDC officials told reporters the new guidelines are an acknowledgement that 95 percent of the population has some form of protection, either from prior infection or from vaccination, and are unlikely to become seriously ill. 

“The current conditions of this pandemic are very different from those of the last two years,” CDC epidemiologist Greta Massetti said during a briefing.  

Key Changes: If you’ve been exposed to the virus, you no longer need to quarantine, regardless of vaccination status.

• Routine surveillance testing in schools and other community settings is no longer recommended. Neither is contact tracing.
• The six-foot physical distancing recommendation? No longer needed. 

Context: The changes show a tacit shift from the Biden administration, which has faced criticism for continuing to recommend strict prevention methods even as vaccines and antiviral treatments have been widely available.  

“This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” Massetti said.

Read more here.

Monkeypox vaccine maker raises concerns on doses

The CEO of the company that makes the only vaccine approved by the Food and Drug Administration (FDA) to prevent monkeypox told Biden administration health officials he was concerned about a new strategy to split doses and change the way the vaccine is injected.

In a letter shared with The Hill, Bavarian Nordic CEO Paul Chaplin said the company has “some reservations” about the new approach, “due to the very limited safety data available,” as well as the fact that more people experienced adverse reactions after vaccination. 

Chaplin said the company fully supports approaches to conserve limited supply, but “it would have been prudent” to roll out the new strategy with much more comprehensive guidance that would allow additional safety data to be collected. 

Flashback: The letter was dated Aug. 9, the day the administration announced a major change to its monkeypox vaccination strategy.  

The new method splits up the doses and uses one-fifth as much vaccine per shot. The partial dose of the vaccine is injected into the upper layer of skin, rather than the full dose into the underlying fat, which is how shots are typically administered. 

Public health officials confused: Chaplin said the company has been “inundated with calls from U.S. state government officials with questions and concerns” since last Thursday regarding the new vaccination plan. 

Read more here.

CDC OFFICIAL: SEVERAL HUNDRED POLIO CASES LIKELY IN NEW YORK

An official from the Centers for Disease Control and Prevention (CDC) said Thursday that a polio case detected in New York last month, the first confirmed U.S. case in nearly a decade, could very well be an indication of “several hundred cases” within that community. 

In late July, a 20-year-old man from New York’s Rockland County was found to have developed symptoms of polio, including paralysis. The man was unvaccinated, and no other cases have been identified thus far. 

José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, told CNN the one case detected last month could be “just the very, very tip of the iceberg.” 

“There are a number of individuals in the community that have been infected with poliovirus. They are shedding the virus,” Romero said. “The spread is always a possibility because the spread is going to be silent.” 

A vulnerable community: Rockland County is known to be a vaccine-resistant area, with the populace having a polio vaccination rate nearly 20 percentage points lower than the general U.S. population, according to the New York State Department of Health. 

Last week, the New York State Health Department said the CDC had detected poliovirus through its wastewater surveillance. Six samples were collected from Rockland County across two months and five samples came from neighboring Orange County, which has a lower polio vaccination rate than Rockland. 

Read more here.

WHAT IS THE NEW LANGYA VIRUS THAT HAS INFECTED DOZENS IN CHINA?

A new virus has infected dozens of people in China, with researchers suggesting shrews might be a “natural reservoir” for the virus. 

Research published in The New England Journal of Medicine last week said that the Langya henipavirus was found in 35 people in the Chinese provinces of Henan and Shandong. 

Scientists said that 26 of those people had no other pathogen detected in their body besides Langya and had a range of symptoms, including nausea, fever, vomiting and cough. 

“Among 25 species of wild small animals surveyed, [Langya] RNA was predominantly detected in shrews (71 of 262 [27%]), a finding that suggests that the shrew may be a natural reservoir of [Langya],” researchers said.  

Researchers think there may be only “sporadic” infection among humans. 

“There was no close contact or common exposure history among the patients, which suggests that the infection in the human population may be sporadic. Contact tracing of 9 patients with 15 close-contact family members revealed no close-contact [Langya] transmission, but our sample size was too small to determine the status of human-to-human transmission for [Langya],” they said.   

Read more here.

FDA: Repeat at-home tests to avoid false negatives

The Food and Drug Administration (FDA) issued guidance on Thursday recommending that people testing themselves for COVID-19 at home take a repeat test within 48 hours to rule out a potential false negative. 

• In its guidance, the FDA noted that at-home tests are less likely to detect the coronavirus than PCR lab tests. This inaccuracy is more likely to occur early in the infection in people who display no symptoms.
• “Currently, all at-home COVID-19 antigen tests are FDA-authorized for repeat, or serial use. This means people should use multiple tests over a certain time period, such as 2-3 days, especially when the people using the tests don’t have COVID-19 symptoms,” the FDA said. 

People should keep multiple tests on hand for the purpose of this new guidance, the agency said. Most over-the-counter, at-home COVID-19 tests are sold in multipacks. 

The guidance: 

• The FDA recommended that people take one initial test if they suspect they may be infected or exposed to COVID-19. If they test negative and have some symptoms, then they should test again 48 hours after the first test. If the second test is still negative, a laboratory molecular-based test should be considered.
• If a person has no COVID-19 symptoms but believes they have been exposed to the virus, the FDA said they should also test themselves a second time, also 48 hours after their first at-home test. If the second test is negative, they should take an additional third test another 48 hours afterward. 

If any of these at-home tests come back positive, then the individual likely has COVID-19 and should follow guidance from the Centers for Disease Control and Prevention. 

Read more here.

WHAT WE’RE READING

• Most parents are saying no to COVID-19 vaccines for toddlers (Wall Street Journal) 
• With support on monkeypox hard to come by, queer communities turn to one another (Stat) 
• Social media posts warn people not to call 988. Here’s what you need to know (NPR) 

STATE BY STATE

• Medicaid patients and county workers brace for the end of the COVID public health emergency (North Carolina Health News) 
• Gov. Kay Ivey’s office dismisses rumors of health concerns (Associated Press) 
• Michigan health department offering lead abatement training scholarships (ABC57) 

OP-EDS IN THE HILL

Saving the Veterans Administration means adequately staffing it 

That’s it for today, thanks for reading. Check out The Hill’s Health Care page for the latest news and coverage. See you tomorrow.

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