Jean Wendland Porter

By now, we’ve all heard how the CDC has lowered requirements for infection control in the new world of endemic COVID-19. But here’s an abridged list anyway: 

  • Vaccination status is no longer used to inform source control, screening or post-exposure  recommendations 
  • Source control recommendations have changed 
  • Standard precautions for PPE have decreased 
  • Testing frequency is at the discretion of the facility for all except those with active symptoms
  •  Asymptomatic residents no longer need transmission-based precautions after exposure 
  • Testing is recommended for new admissions but not required 

The updated guidance was made to reflect the high levels of vaccine- and infection-induced immunity and the availability of therapeutics, and is applicable to healthcare settings across the board. In Ohio, we have been encouraged to remain up to date with all recommended vaccine doses, yet only 60% are fully vaccinated, lower than the national average (I got my bivalent vaccine three days after it became  available.) As of this writing, here in Ohio, only one county is still considered “red.” The other 87  counties are free to drop their masks in healthcare settings.  

I visited a friend in an assisted living facility this week, and no one was wearing a mask but me. I wasn’t screened at the entrance with a temperature check. There was a “check off” form at the front desk  asking if I tested positive recently (it is difficult to believe anyone would visit a geriatric facility with a  positive test, but here we are.) 

But one of the new CDC recommendations is “visitors with confirmed  SARS-CoV-2 infections should defer non-urgent in-person visitation until they have met the healthcare criteria to end isolation,” so it’s still possible that it would happen. 

When the county is not considered “red,” and has a low incidence of infection per 100,000, facilities can choose not to wear source control, i.e. masks. A friend who performs contracted Fiberoptic Endoscopic Evaluations of Swallowing (FEES) in SNFs and ALFs said she was shocked to walk into a building where no one wore masks. She wore hers.

The reduced requirements have resulted in some confusion. One facility was struggling with what to do with a resident whose roommate tested positive. Who moves temporarily? Does anyone move, or can the uninfected roommate ride it out? 

On a recent conference call with the Department of Health, one of the callers asked if they still had to report a positive test and take appropriate infection-control precautions if their employee didn’t get infected at work. I nearly drove off the road.

I appreciate and adhere to all the guidance that has been communicated by the CDC, and completely accept and understand that their guidance may change day-to-day and minute-to-minute as the virus mutates, new variants appear, and new options for treatment arise. 

But a vaccinated friend was admitted to the hospital this week with a serious COVID infection, I lost a vaccinated friend last winter from COVID, and I would hate to see more illness and death as a result of relaxed precautions. Way back in early 2020, I was asked by a friend how long this pandemic would last, and I replied, “I think it should be burned out by June” because it’s clear I had no idea what I was talking about and couldn’t conceive of a virus that continued to devastate for nearly three years.  

I still wear a mask when I’m with non-vaccinated people. I still require vaccinations for everyone who comes to my house, and I still test myself every time I get a bad headache or the sniffles. I trust the CDC,  but after all we’ve seen, I’m a little nervous. As Fox Mulder on the X-Files used to say, “I want to  believe.” It’s going to be a process.

Jean Wendland Porter, PT, CCI, WCC, CKTP, CDP, TWD, is the regional director of therapy operations at Diversified Health Partners in Ohio.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.