The Compliance Divas Podcast
Our podcast covers current topics such as infection prevention and control, OSHA and HIPAA compliance for dentistry. We discuss the latest regulatory information, answer frequently asked questions and give suggestions for dental practices to make compliance easy and sustainable. The Compliance Divas are a trusted source for consistent, accurate information based upon current guidelines, standards, science, and recommendations.
The Compliance Divas Podcast
#177 Are You in the Know About the Latest CDC Guidance for COVID-19?
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Keeping up with the CDC's many changes to its guidance for COVID-19 has been challenging at best. And we have yet another update as of June 2024. In this episode the Divas discuss this update, the current status of COVID-19 occurrence as well as other respiratory viruses. Join us for a lively discussion about protecting patients and the dental team from respiratory infections.
Resources:
- CDC Infection Control Guidance SARS-CoV-2 (6/24/24) https://www.cdc.gov/covid/hcp/infection-control/index.html
- Subscribe to CDC Updates https://tools.cdc.gov/campaignproxyservice/subscriptions.aspx
Welcome. I'm Leslie Cannon. I'm Mary Gavoni.
SPEAKER_01I'm Linda Harvey. I'm Olivia Wan. And together we are the Compliance Divas.
SPEAKER_00Welcome to the Compliance Divas Podcast. We bring clarity and simplicity to compliance by navigating regulatory compliance to keep you on course. My name is Leslie Cannem, and I'm the moderator of this podcast. We encourage you to subscribe to the Compliance Divas Podcast through your favorite podcast channel or on our website, thecompliancedivas.com. Today's podcast resources that we mentioned can be found on the compliancedivas.com through the episodes. Click on the episodes and go to the show notes, and you will find any of the resources that we mentioned. We also encourage you to send your questions to support at thecompliancedivas.com. The public health emergency ended in May of 2023 for COVID-19. So why is CDC still updating the COVID-19 recommendations? It's a perfect time to talk about infection control and CDC. As you know, this month is DICAMP. We are dental infection control awareness month. And this is the last week of that month of September 2024. And it's a great idea to talk about what we need to know as dental professionals, where we get our information and how we can have resource material to back up the information that we share with our teams and with our patients. So with CDC changing guidelines for the COVID-19, I would like everyone to know that while the emergency, the public health emergency ended, this did not, however, mean that it's the end of COVID-19 transmission. And CDC emphasizes that healthcare facilities should continue to follow the poor infection control recommendations. Again, because Dell professionals are responsible for infection control, every clinical team member should be well acquainted with CDC guidelines for COVID and CDC guidelines for infection control. I'd like to just call on our diva, Linda, if you could tell our listeners uh when was the COVID-19 public health emergency first announced? And when did uh CDC respond to that announcement?
SPEAKER_03Well, thank you, Leslie. We it kind of takes us back a little bit to when the Secretary of the Department of Health and Human Services issued a COVID-19, a public health emergency on January 31st, 2020. That was the famous year, 2020. But it wasn't until March 11th of 2020 that the World Health Organization characterized the outbreak as a pandemic. And it was about that timeframe that state by state everybody started shutting down to, as you remember, flatten the curve and only remain open for emergency care situations. So that left a lot of dental practices, Leslie, scrambling about how to close down for several weeks. What do you do with delineated waterline bottles? What do we do with our autoclaves? How do we shut down the whole unit and the whole practice rather? And then how did we have to reopen? So there was a lot of things going on during that time period. The CDC responded throughout the entire public health emergency. And they continue to respond now, Leslie, because as you mentioned, COVID-19 is not going anywhere. We're still going to have cases of COVID-19. It's endemic in our society. And I would like to just remind our listeners, for those that are new to our podcast, the divas came together because of COVID-19. We came together to share best practices and to analyze and understand what the CDC guidance was that was being published every so often. So then we could turn around and disseminate that to all the dental professionals. From the beginning of the pandemic and early 2020 until 2023, the CDC regularly updated their interim infection control guidelines. And every time that happened, every two, three, six months, whatever the interim was, the Divas brought updates to our dental professionals. And it was important that the CDC provided that because the updates were evolving as the scientific understanding of the virus evolved, information about its transmission, as well as the best practices for protecting healthcare workers and the general public. So Leslie, ultimately, the Department of Health and Human Services declared the end of the public health emergency on May 11, 2023. And that created some confusion. And you think, well, why would that create confusion? Can't we go back to our old ways? You know, the pandemic's over. Let's forget those last couple of years. They weren't too much fun. Let's move on. Well, actually, there were some things that we needed to be taking away and learn from that time period. We implemented many enhanced safety measures. And those were important, such as air purifiers, high velocity evacuation frigental hygienists, and just an awareness of aerosol transmitted diseases in general, to name a few things. But then when the public health emergency was over, it's like we just threw everything out, like we took out the garbage, so to speak. We just threw all those good practices away and we went back to our old habits and our old ways. And I'm dismayed, and I talk about this to every practice that I do training with, Leslie, is how we're all wearing our mask under our chins again. That's such a very sanitary sight. So please, if you're listening, double check yourselves and your team members for that. But we went back to the old habits, and by that I meant we're we just aren't following the enhanced protocols anymore. Maybe we stopped using air purifiers, the hygienist said, Oh, I don't want to use uh HVE any longer, I don't like the way it fits, I don't like this, or it was too bulky. When we think about just the environmental health and safety and dental practice and all the other illnesses that are aerosol-transmitted diseases, it's important that we keep that in mind. Because I don't think we really did so well before the pandemic, Leslie. And I'd like to refer our listeners back to the podcast that we did with Dr. John Molinari just the beginning of this month, episode number 174. So please, if you didn't listen to that one, I would encourage you to go back and listen to it. And if you did, it's worth listening to again because John really does a good job of laying out all the different diseases and why it's so important that we still have this vigilance at the top of mind and not drop back our protocols to the what I call BC, the before COVID days. Back to you, Leslie.
SPEAKER_00Thank you, Linda. And it brings to mind how many times that CDC guidelines, the interim guidelines for healthcare settings had changed. And back in the beginning, we had an exclusive set of guidelines just for our dental uh settings. And then eventually that was merged into all healthcare settings. I'd like to speak with Mary. If you can give us some information about the changes that occurred, we had September 2022, we had May 2023, and then March of 2024, along with a lot of other changes that popped up just intermittently. And sometimes I was surprised to see, oh my goodness, there's a new change on the CDC recommendations for us. So, Mary, can you talk a little bit about those changes that occurred over the uh four years that we've been dealing with this uh pandemic?
SPEAKER_02Thanks, Leslie. And Linda, I'm so glad that you gave us the historical perspective of the pandemic when we closed down, when we adopted the practices that we needed to flatten the curve. I think that's just so very important. And the other thing that we need to keep in mind, and it's one of the things that our friend John Molinari talked about in his podcast, is we have to remember that just because the public health emergency was declared over in um 2023, it doesn't mean that COVID is gone. It just means that it is not circulating at such a high level. So the risks are still there, just maybe not in so many numbers. Now, I know that when you say updated CDC guidance, we some people's eyes just gloss over because um we had so many, and many of them were contradictory. We were told maybe one week to do one thing and then another week to do something else. And that is not the result of the CDC not being able to make up their minds. It was the benefit, if you will, of us gaining more knowledge about COVID, how it spreads, what kind of precautions work, what doesn't work. So the latest in a series of um guidance that we got from the CDC started in September of 2022. And this really didn't change a lot in terms of what we did during um the COVID-19 um pandemic because we still had a fair amount of disease higher than now, still circulating. And so it talks that those particular guidelines, and Olivia is going to talk a little bit more about them in a bit. They talked about um what do healthcare workers need to do if they have a high-risk exposure? What do they need to do if they test positive for um COVID-19 and so forth? And then infection control protocols that we need to follow. And truly, the infection control protocols have not changed, even though we have a very recent um set of guidance now that's no longer called interim guidance. It's now infection control for SARS-CoV-2. So in May of 2023, there was a little more guidance updated from the CDC, more to do with what do workers do if they test positive for COVID-19. And some of you will remember in some of the early days that even if you had a high-risk exposure, not even symptoms, but you had a high-risk exposure to COVID-19, meaning you were exposed to someone who had COVID for 15 minutes or more over a 24-hour period at less than six feet of distance without wearing respiratory protection, then you needed to be away from work for a period of time. It started out at 14 days and then it eventually came down to 10 and then came down to seven days. And now, if you have a high-risk exposure, but you don't have symptoms and you don't test positive, you do not need to be restricted from work. But many people misunderstand that, don't know what it means. Many people think that there's no work restriction at all, even if you have symptoms or test positive for COVID. So um, Olivia is going to enlighten us on what the most recent recommendations are. Now, the really confusing information, I think, came out in March of 2018, or 2018, March 18th of 2024. And that guidance had more to do with public settings, not healthcare settings. And the interesting timing on this was it was just before spring breaks started. And in this guidance, the CDC said that if you tested positive for COVID or you had symptoms, but your symptoms were decreasing or improving, and you did not have a fever for at least 24 hours without taking any fever reducing medications like Tylenol or ibuprofen, something like that, that you could go about your business. So, meaning you still were quite possibly infectious, but you could go out into public if you were getting better. Many people in dentistry interpreted that as it applies everywhere. And right in that set of guidelines, it specifically says this does not apply to healthcare settings. So I would urge all of our listeners to make sure if you're looking at any guidance from CDC on respiratory infections or SARS-CoV-2, COVID-19, or any public health issues, that you always read through that document and make sure that you understand what applies to the general public and what applies to healthcare settings. And dentistry is categorized as an ambulatory healthcare setting. So we need to be able to differentiate between those two.
SPEAKER_00Thanks, Mary. That's a great explanation and good historical background. Now, moving forward, I'd like to turn this over to Olivia to give us a summary of the most current uh CDC COVID uh, I guess you could say, recommendations that were published on June 24th of this year, which is our most current update.
SPEAKER_01Olivia? Sure, Leslie. The guidance now focuses on how we should adapt to local conditions and being flexible in looking at you know what is going on in our community so that we could take a more personalized risk-based approach to our infection control. For example, whether to wear an N95 for aerosol generating procedures. You know, if COVID is high in our area, that's what's recommended. So it is a more personalized approach. Also, we should continue to create a process for anyone entering the dental office to be aware of recommended actions. And I still continue to see, which is great, where dental offices are sending out a text inquiring of this criteria, which includes, you know, have you had a positive viral test for SARS-CoV-2, symptoms of COVID-19, close contact with someone that had it, and so forth. So we still should continue to do that, even though we've come out of this pandemic. And also it highlighted that we still should be using source control. Um, we do have flexible options. We could choose an N95. Now, although the KN95 is not appropriate for use for respiratory protection, if we still have a bunch of those laying around, we could use them for source control or even just a well-fitting face mask. And so uh this June version discusses PPE use, as I mentioned, for the aerosol generating procedure. So I hope people don't forget about that, you know, because we see people going back to just wearing a level three, and we want to highlight how important it is to have the appropriate respiratory protection in choosing our PPE. So also the June version stresses not performing testing on individuals who recovered from SARS-CoV-2 within the past 30 days. So, you know, it has maybe solidified our guidance rather than being interim or temporary provisional. Now we have more solid guidance in moving forward. And I do suggest that folks maybe keep this earmarked on their uh computer internet so that they can refer back to it. Because now that we're not using it day to day as frequently, it may become more fuzzy and cloudy in our minds, and we need to refer to it regularly. So that's probably some of the key things to look at, Leslie.
SPEAKER_00Well, I'm so glad that we have this updated. It brings up a lot of memories of uh many people being frustrated as to not knowing what to do and not knowing when the guidelines were updated, and just feeling like they they were doing their best, but maybe could be doing better. CDC updated infection prevention and control recommendations for healthcare personnel during the uh COVID pandemic multiple times. And again, we want to make sure that we are always on top of those changes. Because being responsible for patient safety and infection control, we need to know that we're doing everything we can to not only protect our patients, but protect ourselves and protect the reputation of the practice. There's a tip I can leave with our listeners about subscribing to CDC, where there's a section of the CDC website you can subscribe to called CDC News and Updates. And we have a link that we'll include in our show notes that will give you access to that. And uh, when you want to receive any information from CDC, you put in your email address and then you can select from a list of the different subscriptions. You check the inbox for uh your inbox for a confirmation email from CDC, and then you'll be on their subscription, the subscriber list. So you can get the information delivered right to your inbox. Now, another set of guidelines that were updated in 2003, we had our CDC guidelines for best practices in dental health care settings. And a companion to that came along in 2016. It did not eliminate the 2003 guidelines. And if you have not printed out those guidelines from 2003 and the 2016 summary of infection prevention of practices in dental health care settings for safe care, please do that. Again, we're responsible for patient safety. We should be well acquainted with all of the CDC guidelines that help protect us and our practice and our patients. And I hope we still have something from Mary. Mary, did you want to chime in?
SPEAKER_02Yes, Leslie, and this is a question for you. Has California updated any of their information recently on the airborne transmissible diseases standard in terms of wearing N95s? Is that still in place?
SPEAKER_00At this time, Mary, there's a statement in the CDC or in the California regulations that the employer has to conduct a hazard assessment to determine the risk of COVID-19 transmission. There's still an aerosol transmissible disease standard, but uh the current orders at this time really do, as Olivia said, uh, indicate that N95 respirators are best for aerosol treasuring procedures, but it is again up to the employer, as it always is, to determine the best PPE for the task at hand. With that, I'd like to close our podcast. We at the Compliance Demons like to bring clarity and simplicity to compliance by navigating regulations to keep you on course. Submit your questions to support at the compliancedeemas.com and look at our show notes for the resources that we mentioned today. Also, we'd love it if you scroll all the way down to your favorite podcast channel uh site and leave us a quick review. Thanks so much, and we'll see you next time.