Despite a recent shift in guidance from the Centers for Disease Control and Prevention, now is not the right time for long-term care providers to relax masking and other source control use, an infection prevention expert tells McKnight’s Clinical Daily.

The CDC on Sept. 23 loosened masking requirements and other pandemic guidance for healthcare facilities. Aside from instances where known respiratory illness is present, most facility staff need not wear a respirator, face mask or eye protection when providing patient care, as long as the surrounding county doesn’t have high COVID-19 community transmission levels, the CDC has advised.

Stick with source control

This must bring relief to long-term care providers after years of wearing N95s and goggles or face shields, said infection preventionist Deb Patterson Burdsall, PhD, RN-BC, of the Association for Professionals in Infection Control and Epidemiology (APIC). Even so, the risks of contracting COVID-19, flu and other respiratory illnesses remain high for workers and residents, she said.

“Just being able to work with a well fitting face mask may be a relief for some, but I would suggest it is premature to get rid of source control not only for healthcare personnel but also visitors and even residents in large group activities” as noted by the CDC, she said.

In fact, her organization on Monday asked its more 15,000 members, including long-term care specialists, to continue universal masking policies in all patient care areas.

“With more than 300 Americans still dying each week from COVID-19 and a virulent flu season predicted, now is not the time to risk patient or healthcare worker safety,” APIC said in a statement.

Surges, testing lag  

Other long-term care advocates have supported an easing of pandemic policy in an effort to help residents and staff gain a much-needed return to normal. LeadingAge, for example, has praised the CDC’s expansion of flexibilities for these healthcare providers and “the autonomous individuals they serve.”

But APIC foresees a potential loss public trust if health officials must sway back and forth on their recommendations if new waves of COVID-19 hit.

The organization pointed to predictions of a severe flu season, “with COVID-19 surges looming on the horizon.” It also noted that CDC has a seven-day lag on COVID-19 testing data which it said may limit the ability to detect surges in real time.

“As healthcare professionals, we are obligated to protect the vulnerable patients entrusted to our care,” APIC said in its statement. “Requiring masks of anyone who enters a healthcare setting, including employees, helps to ensure the safest environment for our patients.”

After more than two years of an infectious disease emergency, there may be nostalgia for the pre-pandemic core measures of infection prevention, Burdsall added. But even then, the CDC’s respiratory etiquette in healthcare was wearing masks and/or source control during cold and flu season, she reminded long-term care providers. 

“There is ample evidence that wearing source control reduces transmission of not only COVID-19 but other respiratory pathogens,” she said.

Deb Burdsall is an author of: Between a Rock and a Hard Place: Recommendations for Balancing Patient Safety and Pandemic Response, published in March 2022.