Summary of Guidance on Minimizing the Impact of COVID-19 on Individuals, Communities, and Health Care Systems — United States, August 2022

Strategies for the prevention of COVID-19

Monitoring community levels for COVID-19 to guide COVID-19 prevention efforts. People can use information about the current level of exposure to COVID-19 in their community to decide which preventive behaviors to use and when (anytime or at certain times) based on their own risk of severe disease and the risk of their family members, their tolerance to risk and factors specific to settings. CDC’s COVID-19 Community Levels reflect the current impact of COVID-19 on communities and identify geographic areas that may experience increased severe outcomes related to COVID-19, based on rates of hospitalizations, hospital bed occupancy, and the incidence of COVID-19. 19 during the previous period. period*** (1). Community-based prevention recommendations for COVID-19 have the clear goal of reducing medically significant disease and limiting the burden on the health care system. At all levels of community exposure to COVID-19 (low, medium, and high), recommendations emphasize keeping up with vaccinations, improving ventilation, testing symptomatic and infected individuals, and isolating infected individuals. At moderate levels of COVID-19 in the community, recommended strategies include adding protection for individuals at high risk of severe disease (eg, using masks or respirators that provide a higher level of protection for wearers). At a high level, additional community guidance for COVID-19 focuses on all individuals wearing masks in public and further increasing protection for high-risk groups.††† As SARS-CoV-2 continues to spread, changes in community levels of COVID-19 for a jurisdiction help signal when the use of certain prevention strategies should be stopped or increased, depending on the level of risk of severe illness for an individual or their family or social contacts. Community levels of COVID-19 provide a broad framework for use and adaptation as needed by health officials and jurisdictions based on local context by pooling local information to assess the need for public health interventions.

Non-pharmaceutical interventions. Implementing multiple prevention strategies helps protect individuals and communities from exposure to SARS-CoV-2 and reduce the risk of medical illness and death by reducing the risk of infection (table). The use of several non-pharmaceutical preventive measures can complement the use of vaccines and therapeutics, especially in the face of increased incidence of COVID-19 in the community and among individuals at high risk of severe disease. CDC recommendations for prevention of COVID-19 no longer differentiate by a person’s vaccination status because breakthrough infections do occur, although they are usually mild (16), and individuals who have experienced COVID-19 but are not vaccinated have some degree of protection from severe disease due to previous infection (17). In addition to the strategies recommended at all levels of the community for COVID-19, education and messaging to help individuals understand their risk for medically significant disease complements recommendations for risk-based prevention strategies.

Testing for current infection. Diagnostic testing can detect infections at an early stage so that infected people can take steps to reduce the risk of transmission and receive treatment when clinically indicated to reduce the risk of severe illness and death. All individuals should seek testing for active infection if they have symptoms or if they have known or suspected contact with someone with COVID-19. When deciding whether to screen asymptomatic individuals with unknown contacts, public health officials may consider prioritizing high-risk congregants, such as long-term care facilities, homeless shelters and correctional facilities, and workplaces , which include clusters. housing with limited access to medical care.§§§ In these types of high-risk clusters, screening testing can complement diagnostic testing of symptomatic individuals by identifying asymptomatic infected individuals (18,19). Once implemented, screening testing strategies should include all individuals, regardless of vaccination status. Screening testing may not be cost-effective in the general community setting, especially if the prevalence of COVID-19 is low (20,21).

Insulation. Symptomatic or infected individuals should isolate immediately, and infected individuals should remain in isolation for ≥5 days and wear a well-fitting, good-quality mask or respirator if they must be around others. Infected individuals may end isolation after 5 days only when they have been fever-free for ≥24 hours without medication and all other symptoms have improved, and they should continue to wear a mask or respirator around others at home and in public day 10¶¶¶ (Figure) (22,23). Individuals who have access to antigen tests and who choose to use testing to determine when they can stop unmasking should wait until at least day 6 and have been afebrile for ≥24 hours without the use of antipyretics before taking the first test drugs and all other symptoms improved. Using two antigen tests with an interval of ≥48 hours between tests provides more reliable information due to improved test sensitivity (24). Two consecutive test results must be negative for people to stop masking. If any test is positive, people should continue to wear a mask around others and continue testing every 48 hours until they have two consecutive negative results.****

Management of exposure to SARS-CoV-2. The CDC currently recommends that case investigations and contact tracing be conducted only in healthcare facilities and certain high-risk locations.†††† In all other circumstances, public health efforts can focus on reporting cases and providing affected individuals with information and resources to access testing. Individuals with recent confirmed or suspected contact with an infected person should wear a mask for 10 days in public indoors and be tested ≥5 days after exposure (or sooner if symptomatic), regardless of their vaccination status. .§§§§ In light of the high levels of anti-SARS-CoV-2 prevalence in the population (7,16), and to limit social and economic consequences, quarantine of exposed individuals is no longer recommended, regardless of vaccination status.

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