The U.S. Centers for Disease Control and Prevention has once again quietly changed its COVID-19 recommendations and no longer recommends universal masking in health care settings.
Without fanfare, the agency made sweeping changes to its infection prevention and control recommendations for health care workers on Friday, notably removing the masking recommendation except in areas with high COVID-19 transmission. Additionally, the CDC says vaccination status is no longer used to inform use of face masks, screening testing, or post-exposure recommendations.
“Updates were made to reflect the high levels of vaccine- and infection-induced immunity and the availability of effective treatments and prevention tools,” the updated guidance states.
The CDC is recommending that health care facilities in areas without high virus transmission develop their own protocols for masking. They can "choose not to require" all doctors, patients, and visitors to mask. However, masking is still recommended for individuals in health care settings who have suspected or confirmed COVID-19 cases or have another respiratory illness.
Health care settings "refers to places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute-care facilities, nursing homes, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, dental offices, and others," the CDC said.
Facilities in counties with high transmission are encouraged to continue universal masking. The CDC says community transmission is the metric used to evaluate whether an area has high transmission, and it refers to the presence and spread of SARS-CoV-2.
About 70% of U.S. counties have high community transmission, according to the CDC.
Community transmission is a different metric from the community level measure used for non-health-care settings.
"COVID-19 Community Levels place an emphasis on measures of the impact of COVID-19 in terms of hospitalizations and healthcare system strain, while accounting for transmission in the community," the CDC says.
Under that metric, only about 7% of U.S. counties are at high risk.
Health care providers were given several other recommendations for COVID-19 protocol in case of an outbreak at their facility. When there is an outbreak, or when doctors are providing care to immunocompromised patients, they are recommended to wear a face mask.
Even in areas with high transmission, providers may establish "well-defined areas" removed from patients where workers can remove their masks. An example might be a staff meeting room.
Health care providers must still abide by the COVID-19 recommendations imposed by state and local governments where they are. In New York, for example, the state still requires masks in medical settings regardless of the CDC's recommendations.