DOH Reminds Nursing Homes of COVID Infection Prevention Guidance Amid COVID Uptick
The Department of Health (DOH) has issued a Dear Administrator Letter (DAL) alerting nursing homes to the upward trend in COVID infections in nursing homes over the past month and reminding providers of the steps they should be taking to protect residents, staff, and visitors. The DAL also provides links to various Centers for Disease Control and Prevention (CDC) guidance documents and resources. Members are urged to read the letter in its entirety and review the relevant guidance documents. The following are some highlights:
- Roughly 24 percent of nursing homes in NY reported at least one COVID infection among residents on Aug. 18th, compared to 9 percent on July 18th.
- Nursing homes should adhere to the Centers for Medicare and Medicaid Services (CMS)-recommended Core Principles of Infection Prevention and Control, which include:
- Signage and visual alerts about recommended infection prevention actions for individuals who have COVID infection, symptoms, or close contact with an infected person;
- Hand hygiene;
- Face coverings or masks in accordance with CDC guidance;
- Appropriate staff use of personal protective equipment (PPE);
- Effective cohorting; and
- Testing following CDC recommendations.
- DOH endorses CDC recommendations regarding staying up to date with COVID vaccinations and reminds providers to offer resources and counsel staff, patients, and visitors about the importance of COVID vaccinations. It reiterates nursing homes’ obligation to offer the COVID vaccine to ensure that eligible and consenting residents and staff are up to date and to document those efforts. The DAL recognizes that an updated monovalent COVID vaccine tailored to today’s XBB-lineage variants will be available in the fall and urges providers to monitor the CDC and DOH websites for the most current recommendations.
- DOH reminds providers to review CDC guidance on clinical management and treatment of people with COVID and follow CDC Infection Prevention and Control recommendations.
- Nursing homes should implement policies for source control based on the CDC recommendations, including the Appendix regarding broader use of masking under certain circumstances, which advises consideration of local trends in COVID infections.
On a related note, although not reflected in the DAL, vaccine manufacturers will be updating their COVID vaccines with a monovalent XBB.1.5 composition, based on the recent recommendation of the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC). The currently available bivalent COVID vaccines appear less effective against today’s variants (i.e., XBB-lineage variants) than against previous strains of virus. More information about the distribution of the new vaccine is available here. It is expected that the updated vaccines will be available by mid-to-late September.
Members should be aware that receipt of the current bivalent vaccine now could delay the ability of a resident or staff member to receive the updated vaccine when it becomes available. Members should work with their medical staff to educate residents and staff about the new vaccine and the implications of receiving the current bivalent vaccine. LeadingAge National received the following statement from the CDC in response to their inquiry regarding the current vaccine:
“Until the fall updated vaccine is available, those who have never been vaccinated or feel they need additional protection beyond their most recent vaccination might consider getting the currently available bivalent COVID vaccine in consultation with their healthcare provider. However, that decision should take into consideration that receiving the COVID-19 vaccine now or in early September could delay their ability to get the updated vaccine this fall.”
This statement did not offer any specific guidance for nursing home settings or residents.
Nursing homes with questions about the DAL may contact DOH via the following mailboxes: firstname.lastname@example.org or email@example.com. Members may also contact Karen Lipson (firstname.lastname@example.org) or members of our LeadingAge NY ProCare team with questions.