New CDC Guidance on Infection Prevention and Up-to-Date Vaccination Status

The Centers for Disease Control and Prevention (CDC) has issued new guidance on infection prevention and up-to-date status in vaccination to qualify for exemption from transmission-based precautions (TBP) and certain infection control measures. The guidance reads as follows:

Admissions and readmissions (guidance here):

Residents with confirmed SARS-CoV-2 infection who have not met criteria to discontinue TBP should be placed in the designated COVID-19 care unit, regardless of vaccination status.
In general, all residents who are not up to date with all recommended COVID-19 vaccine doses and are new admissions and readmissions should be placed in quarantine, even if they have a negative test upon admission, and should be tested as described in the testing section of the guidance; COVID-19 vaccination should also be offered.
- Facilities located in counties with low community transmission might elect to use a risk-based approach for determining which of these residents require quarantine upon admission. Decisions should be based on whether the resident had close contact with someone with SARS-CoV-2 infection while outside the facility and if there was consistent adherence to infection prevention and control (IPC) practices in health care settings, during transportation, or in the community prior to admission.
In general, residents who are up to date with all recommended COVID-19 vaccine doses and residents who have recovered from SARS-CoV-2 infection in the prior 90 days do not need to be placed in quarantine, but should be tested as described in the testing section. Quarantine might be considered if the resident is moderately to severely immunocompromised.

Guidance addressing duration and recommended personal protective equipment (PPE) when caring for residents in quarantine is described here.

Newly admitted residents and residents who have left the facility for >24 hours, regardless of vaccination status, should have a series of two viral tests for SARS-COV-2 infection immediately and, if negative, again five to seven days after their admission, unless recently recovered and asymptomatic.

Exposures (guidance here):

Residents who are not up to date who have had close contact should be placed in quarantine for 10 days (or seven days with a negative test) after their exposure (day of exposure is Day 0), even if viral testing is negative. Health care personnel (HCP) caring for them should use full PPE (gowns, gloves, eye protection, and N95 or higher-level respirator).

Residents who are up to date and residents who have recovered from SARS-CoV-2 infection in the prior 90 days:

Should wear source control and be tested as described in the testing section.
Do not need to be quarantined, restricted to their room, or cared for by HCP using the full PPE unless they develop symptoms of COVID-19, are diagnosed with SARS-CoV-2 infection, or the facility is directed to do so. Quarantine might also be considered if the resident is moderately to severely immunocompromised.

Members are urged to review the guidance documents in their entirety and reach out to Amy Nelson with any questions.

Contact: Amy Nelson, anelson@leadingageny.org, 518-867-8383 ext. 146