Prevention Strategies for COVID-19
Monitoring COVID-19 community levels to guide COVID-19 prevention efforts. Individuals can use information about the current level of COVID-19 impact on their community to decide what prevention behaviors to use and when (always or at specific times), based on their own risk of serious illness and that of their family members. their risk tolerance and environment-specific factors. CDC’s COVID-19 Community Levels reflect the current impact of COVID-19 on communities and identify geographic areas that may experience an increase in severe COVID-19-related outcomes, based on hospital admissions, hospital bed occupancy and COVID-19 incidence during the previous period*** (1). Prevention recommendations based on COVID-19 community levels have the explicit goal of reducing medically significant diseases and limiting pressure on the healthcare system. At all COVID-19 community levels (low, medium and high), the recommendations emphasize staying up-to-date with vaccination, improving ventilation, testing symptomatic individuals and those exposed, and isolating of infected persons. At the average COVID-19 community level, recommended strategies include adding protection for individuals at high risk of serious illness (for example, using masks or respirators that provide a higher level of protection for the wearer). At the high COVID-19 community level, additional recommendations are aimed at all individuals who wear masks indoors in public and to further increase the protection of high-risk populations.I As SARS-CoV-2 continues to circulate, changes in COVID-19 community levels for a jurisdiction help signal when to discontinue or increase the use of some prevention strategies, based on their individual’s or their household’s risk of serious illness. or social contacts. The COVID-19 Community Levels provide a broad framework for public health officials and jurisdictions to use and adapt as needed based on the local context by combining local information to assess the need for public health interventions.
Non-pharmaceutical interventions. Implementing multiple prevention strategies helps protect individuals and communities from SARS-CoV-2 exposure and reduce the risk of medically significant illness and death by reducing the risk of infection (Table). The implementation of multiple non-pharmaceutical preventive interventions may complement the use of vaccines and therapies, especially as COVID-19 community levels increase and in individuals at high risk for serious disease. CDC’s COVID-19 prevention recommendations no longer differentiate based on a person’s vaccination status because breakthrough infections do occur, although they are generally mild (16), and individuals who have had COVID-19 but have not been vaccinated have some degree of protection against serious illness from their previous infection (17). In addition to the strategies recommended at all levels of COVID-19 in the community, education and messaging to help individuals understand their risk for medically significant disease complement recommendations for risk-based prevention strategies.
Test for current infection. Diagnostic testing can identify infections early so that infected individuals can take action to reduce their risk of virus transmission and receive treatment, if clinically indicated, to reduce their risk of serious illness and death. All individuals should be tested for active infection when they are symptomatic or have known or suspected exposure to someone with COVID-19. When considering whether and where to conduct screening tests of asymptomatic individuals with no known exposure, public health officials may consider prioritizing high-risk settings, such as long-term care facilities, homeless shelters and correctional facilities, and workplace environments with limited-access housing to medical care.I In these types of high-risk situations, screening tests can complement diagnostic testing of symptomatic individuals by identifying asymptomatic infected individuals (18,19). When implemented, screening testing strategies should include all individuals regardless of vaccination status. Screening testing may not be cost-effective in general community settings, 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 mask or high-quality respirator if they must be around others. Infected individuals may end isolation after 5 days, only if they have been fever-free for 24 hours without medication and all other symptoms have improved, and they must continue to wear a mask or respirator around others at home and in public. day 10I (Figure) (22,23). Individuals who have access to antigen testing and who choose to use testing to determine when to stop masking should wait with the first test until at least day 6 and they are ≥24 hours without the use of fever-reducing medication and all other symptoms have improved. Using two antigen tests with ≥48 hours between tests provides more reliable information due to the improved test sensitivity (24). Two consecutive test results must be negative for individuals to stop masking. If any of the test results are positive, individuals should continue to wear a mask around others and continue testing every 48 hours until they have two consecutive negative results.****
Management of SARS-CoV-2 exposures. CDC now only recommends case research and contact tracing in health care settings and certain high-risk settings.I In all other circumstances, public health efforts may focus on reporting cases and providing information and resources to exposed individuals about access to testing. Individuals who have recently had confirmed or suspected exposure to an infected person should wear a mask for 10 days around others when they are indoors in public and should be tested ≥5 days after exposure (or sooner if they are symptomatic). are), regardless of their vaccination status.I In light of high population levels of anti-SARS-CoV-2 seroprevalence (7,16), and to mitigate the social and economic impact, quarantine of exposed individuals is no longer recommended, regardless of vaccination status.