CDC updates and simplifies respiratory virus recommendations

"CDC released today updated recommendations for how people can protect themselves and their communities from respiratory viruses, including COVID-19. The new guidance brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu, and RSV, which can cause significant health impacts and strain on hospitals and health care workers. CDC is making updates to the recommendations now because the U.S. is seeing far fewer hospitalizations and deaths associated with COVID-19 and because we have more tools than ever to combat flu, COVID, and RSV.

“Today’s announcement reflects the progress we have made in protecting against severe illness from COVID-19,” said CDC Director Dr. Mandy Cohen. “However, we still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses—this includes vaccination, treatment, and staying home when we get sick.”

As part of the guidance, CDC provides active recommendations on core prevention steps and strategies:

• Staying up to date with vaccination to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air, such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors.

When people get sick with a respiratory virus, the updated guidance recommends that they stay home and away from others. For people with COVID-19 and influenza, treatment is available and can lessen symptoms and lower the risk of severe illness. The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication.

Once people resume normal activities, they are encouraged to take additional prevention strategies for the next 5 days to curb disease spread, such as taking more steps for cleaner air, enhancing hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses. Enhanced precautions are especially important to protect those most at risk for severe illness, including those over 65 and people with weakened immune systems. CDC’s updated guidance reflects how the circumstances around COVID-19 in particular have changed. While it remains a threat, today it is far less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.  Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19..."
CDC Respiratory Virus Recommendations 

Types of Masks and Respirators, January 14, 2022

"Summary of Recent Changes

• Added information to present similar content for masks and respirators
• Clarified that people can choose respirators such as N95s and KN95s, including removing concerns related to supply shortages for N95s
• Clarified that “surgical N95s” are a specific type of respirator that should be reserved for healthcare settings
• Clarified that some types of masks and respirators provide more protection to the wearer than others

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View Previous Updates

Key Messages:

• Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask.
• To protect yourself and others from COVID-19, CDC continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently.
• Masks and respirators are effective at reducing transmission of SARS-CoV-2, the virus that causes COVID-19, when worn consistently and correctly.
• Some masks and respirators offer higher levels of protection than others, and some may be harder to tolerate or wear consistently than others. It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and that provides good protection.
• While all masks and respirators provide some level of protection, properly fitted respirators provide the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher risk situations, or by some people at increased risk for severe disease.
• CDC’s mask recommendations provide information that people can use to improve how well their masks protect them.

This page describes different types of masks and respirators that you can use to protect yourself and others from getting and spreading COVID-19. Masks and respirators can provide varying degrees of protection, with well-fitting National Institute for Occupational Safety and Health (NIOSH)-approved respirators offering the most protection. Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask.  This page presents options in order of least to most protective. To protect yourself and others from COVID-19, CDC continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently.

Types of Masks and Respirators

Masks are made to contain droplets and particles you breathe, cough, or sneeze out. If they fit closely to the face, they can also provide you some protection from particles spread by others, including the virus that causes COVID-19.

Respirators are made to protect you by filtering the air and fitting closely on the face to filter out particles, including the virus that causes COVID-19. They can also contain droplets and particles you breathe, cough, or sneeze out so you do not spread them to others.

Choosing a Mask or Respirator for Different Situations

Masks and respirators (i.e., specialized filtering masks such as “N95s”) can provide different levels of protection depending on the type of mask and how they are used. Loosely woven cloth products provide the least protection, layered finely woven products offer more protection, well-fitting disposable surgical masks and KN95s offer even more protection, and well-fitting NIOSH-approved respirators (including N95s) offer the highest level of protection.

Whatever product you choose, it should provide a good fit (i.e., fitting closely on the face without any gaps along the edges or around the nose) and be comfortable enough when worn properly (covering your nose and mouth) so that you can keep it on when you need to. Learn how to improve how well your mask protects you by visiting CDC’s Improve How Your Mask Protects You page.

A respirator has better filtration, and if worn properly the whole time it is in use, can provide a higher level of protection than a cloth or procedural mask. A mask or respirator will be less effective if it fits poorly or if you wear it improperly or take it off frequently. A respirator may be considered in certain situations and by certain people when greater protection is needed or desired.

• When caring for someone who is sick with COVID-19.
• If you are at increased risk for severe illness, for example, people who are immunocompromised, older adults, and people with certain underlying medical conditions.
• When working at a job where you interact with large numbers of the public, especially when not everyone is consistently wearing a mask. For example, bus drivers and grocery store workers.
• When riding on planes, buses, trains, or other forms of public transportation*, especially if it is for a long period of time on crowded conveyances.
• When physical distancing is not possible or when you are in crowded indoor or outdoor public settings.
• If you are not up to date on COVID-19 vaccinations.

*Note: The options listed on this page may be used to fulfill the requirements of CDC’s Mask Order for public transportation. Learn more about attributes of masks needed to fulfill the requirements of the Order at this website.

Masks

When choosing a mask, look at how well it fits. Gaps can let air with respiratory droplets leak in and out around the edges of the mask. Gaps can be caused by choosing the wrong size or type of mask and when a mask is worn with facial hair.

It is important to check that it fits snugly over your nose, mouth, and chin.

• Check for gaps by cupping your hands around the outside edges of the mask.
• Make sure no air is flowing from the area near your eyes or from the sides of the mask.
• If the mask has a good fit, you will feel warm air come through the front of the mask and may be able to see the mask material move in and out with each breath.

Cloth Masks

Cloth Masks can be made from a variety of fabrics and many types of cloth masks are available.

Wear cloth masks with

• A proper fit over your nose, mouth, and chin to prevent leaks
• Multiple layers of tightly woven, breathable fabric
• Nose wire
• Fabric that blocks light when held up to bright light source

Do NOT wear cloth masks with

• Gaps around the sides of the face or nose
• Exhalation valves, vents, or other openings (see example)
• Single-layer fabric or those made of thin fabric that don’t block light
• Wet or dirty material.
  
  

  Procedure Masks

  Disposable procedure masks are widely available. They are sometimes referred to as surgical masks or medical procedure masks.

  Wear procedure masks with

  • A proper fit over your nose, mouth, and chin to prevent leaks
  • Multiple layers of non-woven material
  • A nose wire

  

  Do NOT wear procedure masks with

  • Gaps around the sides of the face or nose (see example)
  • Wet or dirty material.."
    Face masks 

COVID-19 Reported Patient Impact and Hospital Capacity by Facility

"The following dataset provides facility-level data for hospital utilization aggregated on a weekly basis (Friday to Thursday). These are derived from reports with facility-level granularity across two main sources: (1) HHS TeleTracking, and (2) reporting provided directly to HHS Protect by state/territorial health departments on behalf of their healthcare facilities.

The hospital population includes all hospitals registered with Centers for Medicare & Medicaid Services (CMS) as of June 1, 2020. It includes non-CMS hospitals that have reported since July 15, 2020. It does not include psychiatric, rehabilitation, Indian Health Service (IHS) facilities, U.S. Department of Veterans Affairs (VA) facilities, Defense Health Agency (DHA) facilities, and religious non-medical facilities.

For a given entry, the term “collection_week” signifies the start of the period that is aggregated. For example, a “collection_week” of 2020-11-20 means the average/sum/coverage of the elements captured from that given facility starting and including Friday, November 20, 2020, and ending and including reports for Thursday, November 26, 2020..."
Patient and hospital capacity 

Interim Public Health Recommendations for Fully Vaccinated People

"Summary of Recent Changes

• Updated information for fully vaccinated people given new evidence on the B.1.617.2 (Delta) variant currently circulating in the United States.
• Added a recommendation for fully vaccinated people to wear a mask in public indoor settings in areas of substantial or high transmission.
• Added information that fully vaccinated people might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19, or if they have someone in their household who is immunocompromised, at increased risk of severe disease or not fully vaccinated.
• Added a recommendation for fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.
• CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

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View Previous Updates

Key Points

The following recommendations apply to non-healthcare settings. For related information for healthcare settings, visit Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.

Fully vaccinated people can:

• Participate in many of the activities that they did before the pandemic; for some of these activities, they may choose to wear a mask.
• Resume domestic travel and refrain from testing before or after travel and from self-quarantine after travel.
• Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States.
• Refrain from routine screening testing if feasible.

Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. However, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others. To reduce their risk of becoming infected with the Delta variant and potentially spreading it to others: CDC recommends that fully vaccinated people:

• Wear a mask in public indoor settings if they are in an area of substantial or high transmission.
  • Fully vaccinated people might choose to mask regardless of the level of transmission, particularly if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is unvaccinated. People who are at increased risk for severe disease include older adults and those who have certain medical conditions, such as diabetes, overweight or obesity, and heart conditions.
• Get tested if experiencing COVID-19 symptoms.
• Get tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until a negative test result.
• Isolate if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms.
• Follow any applicable federal, state, local, tribal, or territorial laws, rules, and regulations.

People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) regardless of their vaccination status to protect themselves against COVID-19 until advised otherwise by their healthcare provider..."
Fully vaccinated people 

Federal Deficits, Growing Debt, and the Economy in the Wake of COVID-19

"The Coronavirus Disease 2019 (COVID-19) pandemic caused a swift and deep economic downturn from which the country has yet to fully recover. In response to COVID-19, the federal government enacted expansionary fiscal policy to provide relief and stimulus to the economy. Several bills were enacted in FY2020, including the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136). The FY2020 federal budget deficit totaled $3.1 trillion, more than triple its FY2019 value, and the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) project the bills enacted in FY2020 to increase FY2020-FY2030 deficits by $2.6 trillion.

Additional relief and stimulus was enacted in FY2021 in the Consolidated Appropriations Act, 2021 (P.L. 116-260), which CBO and JCT estimate would increase deficits by $1 trillion over the 2021-2031 period, $868 billion of which comes from COVID-19 related provisions. This was followed by the American Rescue Plan Act of 2021 (P.L. 117-2), enacted on March 11, 2021, which CBO and JCT estimate will increase deficits by nearly $2 trillion over the 2021-2031 period.Before P.L. 117-2 was enacted, CBO projected the FY2021 deficit to be 10.3% of gross domestic product (GDP).

To finance these deficits, the government needs to borrow money. The federal debt-to-GDP ratio rose significantly in FY2020, reaching slightly above 100%. CBO projects that deficits and debt will trend upwards in the coming decades, with the debt-to-GDP ratio surpassing 200% by 2051 under current policy. The current and projected size of deficits and the rising debt-to-GDP ratio are a topic of concern for many economists and policymakers given that FY2020 deficits and debt as a share of GDP were the largest on record since World War II. Some of the possible consequences of persistent deficit spending include the crowding out of private investment, which can in turn stunt long-term growth; increasingly large portions of the federal budget being directed toward interest payments on debt, which can crowd out other policy priorities; and an unsustainable level of debt, which can lead to a fiscal crisis..."
Federal Deficits 

The Digital Divide: What Is It, Where Is It, and Federal Assistance Programs

"As the Coronavirus Disease 2019 (COVID-19) pandemic began to unfold, many federal, local, and state governments, in addition to large and small businesses, implemented remote working or distance learning options to help abate the spread of the virus. As these decisions were made, some of the population had the option and the capability to shift activities online, while others did not. The digital divide has been used to characterize a gap between those Americans who have access to telecommunications and information technologies and those who do not. One subset of the digital divide debate concerns access to high-speed internet, also known as broadband. Broadband is provided by a variety of technologies (e.g., cable, telephone wire, fiber, satellite, and mobile and fixed wireless) that give users the ability to send and receive data at volumes and speeds that support a wide range of applications, including voice communications, entertainment, telemedicine, distance education, telework, ecommerce, civic engagement, public safety, and energy conservation.

Broadband technologies are currently being deployed, primarily by the private sector, throughout the United States. While the number of new broadband subscribers continues to grow, in general, rural areas—and tribal areas in particular—tend to lag behind urban and suburban areas in broadband deployment and the speed of service offered. Some policymakers, believing that disparities in broadband access across American society could have adverse economic and social consequences on those left behind, assert that the federal government should play a more active role to address the “digital divide” in broadband access, particularly in light of the COVID-19 pandemic, which further revealed discrepancies in broadband availability and accessibility.

Federal support for broadband infrastructure occurs mainly through the Universal Service Fund (USF) programs under the Federal Communications Commission (FCC), the broadband and telecommunications programs at the Rural Utilities Service (RUS) of the U.S. Department of Agriculture (USDA), and newly established broadband programs within the Consolidated Appropriations Act, 2021 (P.L. 116-260) at the National Telecommunications and Information Administration (NTIA). The USF, which was originally designed to ensure rural, high-cost areas have access to voice service, is undergoing a major transition, which is targeted to the deployment, adoption, and utilization of both fixed and mobile broadband.As currently designed, the USF consists of four programs: the High Cost/Connect America Fund Program; the Schools and Libraries Program; the Rural Health Care Program; and the Low Income (Lifeline) Program. While the overall purpose of each program is to help ensure the universal availability of telecommunications and broadband services, each program addresses specific aspects of that goal to fulfill the universal service mandate and help to close the digital divide. The USDA, through its Rural Utilities Service, administers five programs that provide loans and grants to increase access to broadband service in rural areas.These programs include the Community Connect Program, the ReConnect Program, the Rural Broadband Access Program, the Telecommunications Infrastructure Program, and the Distance Learning and Telemedicine Program. Three new broadband programs are to be administered by the NTIA—a pilot program to connect minority communities, a grant program to support broadband connectivity on tribal lands throughout the country, and a grant programto support broadband infrastructure deployment to areas lacking broadband..."
Digital Divide 

When You’ve Been Fully Vaccinated

"COVID-19 vaccines are effective at protecting you from getting sick. Based on what we know about COVID-19 vaccines, people who have been fully vaccinated can start to do some things that they had stopped doing because of the pandemic.

We’re still learning how vaccines will affect the spread of COVID-19. After you’ve been fully vaccinated against COVID-19, you should keep taking precautions in public places like wearing a mask, staying 6 feet apart from others, and avoiding crowds and poorly ventilated spaces until we know more.

What’s Changed

If you’ve been fully vaccinated:

• You can gather indoors with fully vaccinated people without wearing a mask.
• You can gather indoors with unvaccinated people from one other household (for example, visiting with relatives who all live together) without masks, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19.
• If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.
  • However, if you live in a group setting (like a correctional or detention facility or group home) and are around someone who has COVID-19, you should still stay away from others for 14 days and get tested, even if you don’t have symptoms..."
    COVID-19 vaccine 

Global Handwashing Day

"The COVID-19 pandemic provides an important reminder that one of the most effective ways to stop the spread of germs and stay healthy is also one of the simplest — handwashing with soap and water. Keeping hands clean can prevent 1 in 3 diarrheal illnesses and 1 in 5 respiratory infections, such as a cold or the flu.

Each year on October 15, Global Handwashing Day highlights the importance of handwashing with soap and water at home, in the community, and around the world.

Global Handwashing Dayexternal icon serves as a yearly reminder that handwashing with soap and water is one of the best steps we can take to avoid getting sick and spreading germs to others. The observance was established by the Global Handwashing Partnership in 2008. This year’s theme, “Hand Hygiene for All,” seeks to raise awareness of making soap and water available globally, especially in public places, schools, and health care facilities. It also calls for institutions and individuals to improve hand hygiene efforts in the COVID-19 response that can outlast the pandemic and ensure continued access to clean water and soap.

Many germs that can make people sick are spread when we don’t wash our hands with soap and clean, running water. That is why handwashing is so important, especially at key times such as after using the bathroom, when preparing food, before eating, and after coughing, sneezing, or blowing your nose..."
Hand washing 

Legal Issues in COVID-19 Vaccine Development

"Private companies, universities, and governmental entities are working to develop a vaccine for coronavirus disease 2019 (COVID-19). Vaccines are biological products regulated under the Public Health Service Act (PHSA) and the Federal Food, Drug, and Cosmetic Act (FD&C Act). New vaccines must generally be licensed by the U.S. Food & Drug Administration (FDA) before they can be marketed and used in the United States. To obtain licensure, the vaccine must be tested in human subjects through clinical trials. The clinical trials inform the dosing schedule and labeling that will be used for the approved vaccine. Sponsors use the data from clinical trials, along with other information, to prepare a biologics license application (BLA) to submit to FDA. FDA approves the BLA if it determines that the vaccine is safe, potent, and pure.

Because the development and review process can be lengthy, the FD&C Act provides several avenues to accelerate this process for pharmaceutical products intended to treat or prevent serious diseases or conditions. FDA may grant fast track product and breakthrough-therapy designation at the sponsor’s request for products that are intended to fill an unmet need or improve on existing therapies. Both designations entitle the sponsor to increased communication with FDA regarding the clinical trial design and data collected, as well as rolling review of the BLA. Products may also qualify for accelerated approval based on intermediate or surrogate endpoints likely to predict a clinical benefit. In addition, FDA may designate products for priority review..."
COVID-19 Development