Compared to two weeks ago, we in the Greater Cincinnati Area are in a better place when it comes to COVID-19. The current community levels in Hamilton County, and all abutting counties, is now “MEDIUM” compared to “HIGH” two weeks ago. Around the country 40% of US counties are “HIGH” and 41% are MEDIUM, with approximately 20% being “LOW”. The level nationally was over 90% “HIGH”. Just to reiterate, when community level is “MEDIUM” then wearing a well-fitted mask is recommended when you are indoors in public if you are a person at high risk of becoming severely ill from a COVID-19 infection. Additionally, if you have household or social contact with someone at high risk of severe illness then you should consider testing before contact and consider masking when around these susceptible individuals, for their protection.
In the face of the extensive immunity afforded the US public by vaccinations and to a lesser extent by prior infection, the CDC has significantly altered its recommendations (https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-childcare-guidance.html). These changes are very much driven by the absolute understanding that our children need to be in school as much as possible. This updated approach recognizes the reality that the educational loss from being absent from the classroom is more of an impact on a larger number of children than the unfortunate health effect of COVID-19 on a small number of kids that get severely ill. Ironically, and tragically, children of color and those of poor communities suffered disproportionately from the educational loss AND the health impact of COVID-19 due to preexisting healthcare, environmental, financial, and workplace disparities. The new guidance was issued on August 11, 2022, and affects every aspect of our day-to-day existence.
One of the major changes is the elimination of the need to be socially distanced. The “Watch your distance” mantra recommending six (6) feet of separation has been in place since the beginning of the pandemic (March 2020). It is essential to recognize that this change in CDC recommendation is not a license for everyone to be crowded shoulder to shoulder indoors amongst non-household members. Our government health authority is officially placing the onus on each of us for our individual well-being and survival during this pandemic. Each of us needs to consider our individual risk and the risk factors of those with whom we live. If you are unvaccinated, have significant preexisting health conditions, or have household members who are at high risk of severe COVID-19 illness, your safest course is to keep social distancing in your daily activities.
The CDC’s recommendation for quarantine after being in “close contact” with an infected person no longer exists unless the person is in “high risk congregate settings such as correctional facilities, homeless shelters, and nursing homes”. The “test to stay” recommendation for schools and early care education (ECE) facilities which required testing after exposure, has been eliminated. Instead, wearing a well-fitted mask followed by testing is recommended, where deemed appropriate. What has not changed is if a person tests positive or is symptomatic, they should quarantine for five days, test negative, and then mask up for five more days.
Contact tracing, which has been a hallmark of combating communicable diseases and a major goal while dealing with this pandemic, has now been deemed to be unnecessary except in hospitals, correction facilities, and nursing homes. Routine screening and testing is also no longer recommended except in group-living situations (e.g. nursing homes, prisons).
We have discussed above two of the three W’s of the COVID-19 battle, (Wear a mask, Watch your distance). The third component of this triad is “Wash your hands”. Following proper handwashing procedures remains beneficial in fighting viral diseases including SARS-CoV-2 and monkeypox. Be reminded that seasonal influenza has been much less of a problem over the last two winters due to vaccination, hand washing, and social distancing.
The evolving CDC COVID-19 guidelines are an indication that the agency is saying, in no uncertain terms, that personal responsibility is how we will live with COVID-19. Our best course of survival is through vaccination and boosting, masking and distancing based on community level, quarantining when sick, testing if symptomatic, and having your physician assess your eligibility for oral medication.
Clyde E. Henderson, MD
Cincinnati Medical Association