Episode #48 CDC Updates Masking Recommendations Based on Incidence of COVID-19 Cases

The CDC has once again updated its guidance on masking for the public and those entering health care facilities. This episode discusses what those new recommendations are and how they apply to your dental practice.

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Transcript

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SPEAKER_02 0:04

Welcome. I'm Leslie Cannon. I'm Mary Gavoni.

SPEAKER_01 0:09

I'm Linda Harvey. I'm Olivia Juan. And together we are the Compliance Divas.

SPEAKER_02 0:19

Welcome to the Compliance Divas podcast. I'm Mary Gavoni and I'll be your moderator for this episode. We bring clarity and simplicity to compliance by navigating the regulatory world to keep you on course. You can subscribe to the Compliance Divas podcast through your favorite podcast channel or on our website, thecompliancedivas.com. Any of the resources that we mentioned during this episode will be on our compliance divas website. You can just click on the resources tab. And if you have questions as a follow-up to this episode, you can submit those to support at thecompliancedivas.com. Many dental practices have been dealing with a little bit of confusion from patients and questions, even from team members, about the updates to the CDC masking guidelines. And what we want to do is clarify what it is that the dental practices need to do and why it's different from the guidelines that were issued for the general public and the criteria for whether you need to be wearing a mask or not. So, Linda, can you give us some information about the new criteria that are being used by the Centers for Disease Control and how that affects us?

SPEAKER_03 1:46

Mary, with all the confusion about which CDC guidelines to follow, we must now keep in mind that the CDC has different COVID reporting tools. So I'd like to discuss those briefly and help our followers to understand that there's one more thing they need to really key in on when deciding what to do in their practice following the CDC guidelines. First, the CDC's COVID-19 community levels tracking is used to determine the impact of COVID-19 on communities, not healthcare facilities. And it's intended to be available to public health departments at the county and state levels, so those agencies can take the appropriate action for their communities. And maybe it's easiest for our listeners to think of that community levels in terms of general purposes, in other words, not healthcare. So briefly, when the CDC is determining the community levels, they look at a combination of three metrics. They look at the new COVID-19 admissions per 100,000 population in the past seven days. Second, they look at the percentage of staffed inpatient beds occupied by COVID-19 patients. And third, they look at the new total of COVID-19 cases per 100,000 population in the past seven days. And that's how they determine the community level. And so it's important not that we have to memorize those three metrics, but we realize that they are different than what's used to compute the healthcare metrics. So it's important to keep that in mind. So the other side, well, before I go on to the other side, those three metrics that I just mentioned are then organized into the three categories, high, medium, and low. And that's what we've been hearing about on the news that most of the countries in the medium or low category. Well, we just can't take and run with that for a healthcare setting, especially in dentistry where we're producing aerosol generating procedures. That's what's happening in the community. So the second level that we look at, to which is where healthcare facilities should be watching and tracking, is the community transmission levels. And the key word here is transmission levels. Those levels are provided for healthcare use only. So when checking the transmission level in your county, be sure you use the right CDC healthcare tracking tool for healthcare facilities because those ratings are still in the four category groups: high, substantial, moderate, or low. So just to draw that distinction again, the community levels are grouped into three categories: high, medium, and low. But for healthcare facilities, we have to look at the right tracking tool to ensure we're determining whether we're in one of the four categories: high, substantial, moderate, or low. And then very clearly, it says on the CDC website, on the community levels page, the CDC has a disclaimer for healthcare facilities, which states that COVID-19 community levels do not apply in healthcare settings such as hospitals and nursing homes. Now remember, just because dental offices or medical offices aren't specifically listed, we are a healthcare setting. So instead, healthcare settings should continue to use the community transmission rates and follow the CDC's infection prevention and control recommendations for healthcare workers. So we know over the past several years, Mary, there's been many times when the CDC has made an update for the general public or for even schools. And how many of us hear questions from our friends and colleagues and clients? Oh, the CD said CDC just said that we can uh we don't have to be six feet distance, we can do three feet. And clearly that was for school settings. So I just want everybody to still keep your radar up because there is a distinction and it's and it's just calling us all to pay attention at a level, very, very uh detailed level, Mary.

SPEAKER_02 5:48

Thank you, Linda. That was a great, great explanation. And unfortunately, there's been some information circulated around in the profession that implies that these community settings apply equally to dentistry or to healthcare settings, and they do not. That's really important. And keep in mind, even though the community levels tend to be lower right now in many parts of the country, we still have looming on the horizon the potential for another surge with yet another variant of the Omicron virus. So, Leslie, can you talk to us a little bit about the differences between what the CDC guidance may say and what local states or local health departments may say about masking guidance?

SPEAKER_00 6:38

Certainly, Mary. You know, we always have to look at what's going on in our community. Our public health department will give us guidance on that. And also we have to look to see what state regulations apply, because they may be different and actually contradict what CDC is saying, particularly when it comes to uh masking based on the community spread versus transmission, as Linda had explained. In California, we had some pretty uh succinct information on how to proceed. And it does uh contradict a little bit what CDC says, but at the beginning of March of this year, 2022, the California Public Health Department strongly recommends that all persons, regardless of vaccination status, continue to mask indoors. And the guidance replaces the former requirement that unvaccinated individuals wear a well-fitting face mask in indoor public settings. So we're talking all individuals. That's a strong recommendation. Um, and then uh we also want to make sure that we understand that the public health department guidance clearly states that face masks are still required for everyone, regardless of vaccination uh status, in specified high-risk settings, which does uh is copostatic with what CDC says, uh, but it also uh identifies dental offices and other healthcare settings that were specifically spelled out by California Public Health Department. Now, again, that part's consistent with CDC guidelines, and a lot of times our patients don't recognize that. So dental office staff and patients must continue to wear face masks. And dental offices in California are still required to screen patients for COVID-19 prior to their appointments, and any of the healthcare personnel that are involved in aerosol generating procedures are still required by OSHA to wear N95 respirators or equivalent or better when uh involved in an aerosol generating procedure, in accordance with Cal OSHA's emergency temporary standard for COVID-19. So we need to look at the public health department first for the state. We need to look at what county ordinances might be for the location of your practice, and we also need to look at OSHA when we are making a determination of wearing PPE and masking requirements.

SPEAKER_02 9:10

Thanks, Leslie. I appreciate that that clarification. So the bottom line is, and I think it bears repeating over and over, the pandemic isn't over yet, even though the numbers of cases and hospitalizations are declining. As I mentioned earlier, there's still the possibility of another surge because we have yet another variant. But in so many cases, both the general public and those dental professionals working in our dental practices across the country are tired of it. We don't want to hear about it anymore. We don't want to do all these special things anymore. But the bottom line is it's not time to let our guard down yet. So, Olivia, can you help us with some ideas about how do we help the patients to understand that just because CDC says, I don't have to wear a mask when I go to the grocery store, why do we still have to wear a mask when I come into your dental practice?

SPEAKER_01 10:06

Sure, Mary. I think it's important to remind them, as we've stated previously, that we are following CDC guidance for healthcare settings and that a dental office is not the same as a public setting, such as a grocery store, Walmart, or whatnot. And one of the ways that we can avoid a confrontation with a patient or a pediatric patient's parent would be to provide advanced notification that your office continues to require source control in the lobby area and follows the CDC's latest guidance for healthcare settings. So it's a it's a good idea to advise the patient ahead of time. You can do that through your automatic text reminders that they must bring a mask or a mask would be provided. Also make sure that the signage is displayed on the entrance door so they are aware. Now, I can tell you personally, I've had a couple of doctor appointments recently, medical doctor appointments. All of those offices required patients to be masked up. And so, as dental professionals, we cannot let our guard down and follow the wrong set of guidance that we are following CDC's guidance for healthcare facilities. So I think, Mary, the best thing is to inform the patient in advance of the appointment and continue to support the guidance that we have from CDC and also any state and local health departments that would have input for us and following those trackers to see what the risk level is. So, Mary, that's that's the best we can do. And I realize it causes patients to be upset, but as you stated earlier, we're still in the pandemic.

SPEAKER_02 12:08

You're so right, Olivia. And I think the other thing we need to do is make sure the patients understand that we're trying to create the safest environment for them and we're doing it for their safety, not to punish them as some people see it as punishment to have to wear a mask. So as we continue through the remainder of the pandemic, we don't know how long it's going to be. We hope it's over sooner rather than later. We need to be diligent. We need to keep reminding not only our patients, but the rest of our team that we still need to take these precautions to keep ourselves as safe as we can. So we hope that this episode helped to clear up some of the confusion that's out there about masking guidelines. If you do have any questions, please submit them to support at the compliancedivas.com. And also make sure that you take a look at the references that we will have in the resources um section on our compliance divas website, thecompliancedivas.com. So thank you for listening and we'll see you next time.