On September 23, 2022, the CDC updated its Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic and revised the recommendations on use of source control/masks in healthcare settings. To best comply with the updated guidance, it is critical to have a clear understanding of the criteria used by the CDC regarding source control, so first, let’s take a step back.
There are two data metrics the CDC provides in its COVID-19 Data Tracker: Community levels and Transmission levels. These define very different points. CDC recommends use of COVID-19 Community Levels to determine the impact of COVID-19 on communities and how to take action. Transmission Levels (also known as Community Transmission) are used to describe the amount of COVID-19 spread within each county and tell the infectivity level of the virus. Healthcare facilities are directed to use Transmission levels to determine infection control interventions.
The best way to find out your county Community and Transmission levels is by visiting https://covid.cdc.gov/covid-data-tracker/#datatracker-home. On this site, you can search for your county under “COVID in Your Community.” Once you get to your county’s page, click on “COVID-19 Community Levels” or “Community Transmission” among the choices on the dropdown menu under “Data Type” to determine your source control/masking needs.
Here is the new updated guidance for source control/masking in dental healthcare settings:
- When Transmission levels are HIGH, source control is recommended for everyone in a healthcare setting when they are in areas of the healthcare facility where they could encounter patients.
- When Community levels are also HIGH, source control is recommended for everyone in ALL areas of the facility, even those restricted from patient access (e.g., staff rooms, lunchrooms, meeting rooms).
- When Transmission levels are NOT high, healthcare facilities could choose NOT to require universal source control.
- However, the guidance states, even if source control is not universally required, it remains recommended for individuals in healthcare settings who:
- Have suspected or confirmed SARS-CoV-2 infection or other respiratory infection (e.g., those with runny nose, cough, sneeze); or
- Had close contact (patients and visitors) or a higher-risk exposure (HCP) with someone with SARS-CoV-2 infection, for 10 days after their exposure: or
- Reside or work on a unit or area of the facility experiencing a SARS-CoV-2 outbreak; universal use of source control could be discontinued as a mitigation measure once no new cases have been identified for 14 days; or
- Have otherwise had source control recommended by public health authorities
- When Community levels are NOT high, healthcare personnel could choose NOT to wear source control when they are in well-defined areas that are restricted from patient access (e.g., staff rooms, lunchrooms, meeting rooms) if they do not otherwise meet the criteria described above.
(As a side note, this information on source control/masking does not apply to PPE requirements; that is addressed in the updated section titled, “Implement Universal Use of Personal Protective Equipment for HCP.” The CDC Division of Oral Health refers the dental profession to the general healthcare guidance listed above for any recommendations regarding infection prevention interventions for COVID-19, and this guidance states that it “applies to all U.S. settings where healthcare is delivered, including nursing homes and home health.”)
The CDC states changes and updates were made to reflect the high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools for COVID-19. While this is true, dental healthcare providers cannot make a blanket decision to not implement source control/masks. Remember that the determination for when and where to mask depends on the Transmission as well as Community levels in the county. Use these data metrics to provide the safest dental workplace for both dental team members and patients.
References:
- CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, September 23, 2022. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Accessed September 30, 2022.
- CDC Covid-19 Data Tracker. Available at https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed September 30, 2022.
Dr. Schrubbe specializes in helping practices implement and maintain compliance with current federal regulations and best practices for infection prevention. She is a frequent contributor to WDA communications. Reach her at 414-795-7630 or [email protected].
