CDC's new COVID guidance for healthcare workers loosens masking, adjusts asymptomatic screening due to new variants

The Centers for Disease Control and Prevention (CDC) Friday loosened several pandemic infection control recommendations in healthcare delivery settings and specified guidance relevant to certain types of long-term care settings.

The latest changes discard healthcare workers’ vaccination status when determining whether to screen, quarantine or use “source control” measures such as face masks and respirators.

In settings where healthcare workers could encounter a patient, the agency no longer recommends source control for those in communities without high levels of COVID-19 spread.

The CDC currently considers nearly three-quarters of the country’s counties to be high-transmission communities, meaning masking would still be recommended for most healthcare settings.

Additionally, those who have a suspected or confirmed respiratory infection, had close contact with someone with COVID-19 in the last 10 days, are in a facility experiencing a COVID-19 outbreak or have other circumstances normally requiring source control are still recommended to use it.

COVID-19 screening of asymptomatic workers, including those in nursing homes, is now “at the discretion of the healthcare facility.”

New research on variants with shorter incubation periods and “challenges” with false negative antigen tests, however, have the agency rethinking its stance on screening exposed but asymptomatic workers who had recently recovered from COVID-19.

The CDC now says testing is “generally not recommended” for these workers in the first 30 days after recovering but that an antigen test “should be considered” for asymptomatic, exposed workers who had recovered during the 31 to 90 days prior. Nucleic acid amplification tests are not recommended for these workers.

The CDC’s update also specified that, excluding nursing homes, long-term care settings with staff thatg provide “non-skilled personal care” should be following its guidance for high-risk congregate care settings. Visiting or shared healthcare personnel providing care to one or more residents should also be following the guidance’s infection prevention and control recommendations, the CDC wrote.

The healthcare setting recommendations follow a similar overhaul for the general population in August. A CDC official said at the time that the agency’s revision “helps us move to a point where COVID-19 no longer severely disrupts our daily lives.”  

Nationwide reported COVID-19 cases, hospitalizations and nursing home admissions have all been trending downward since July, while deaths (a lagging indicator) have declined since August. 

Some experts are still concerned that another COVID-19 surge could accompany the cooling weather, particularly if a new highly transmissible variant or subvariant picks up steam.