Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning

Updated COVID-19 testing language in coordination with updates to COVID-19 Testing: What You Need to Know Replaces COVID-19 Community Levels with COVID-19 hospital admission levels to guide prevention decisions. See the following for details on the reasons for this change. MMWR: COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration ― United States, May 11, 2023 MMWR: Correlations and Timeliness of COVID-19 Surveillance Data Sources and Indicators ― United States, October 1, 2020–March 22, 2023 View Previous Updates On This Page Introduction Strategies for Everyday Operations COVID-19 Hospital Admission Levels and Associated Prevention Strategies Considerations for Prioritizing Strategies Introduction Schools and early care and education (ECE) programs are an important part of the infrastructure of communities as they provide safe, supportive learning environments for students and children and enable parents and caregivers to be at work. Schools and ECE programs like Head Start also provide critical services that help to mitigate health disparities, such as school lunch programs, and social, physical, behavioral, and mental health services. This guidance can help K-12 schools and ECE programs remain open and help their administrators support safe, in-person learning while reducing the spread of COVID-19. Based on COVID-19 hospital admission levels, this guidance provides flexibility so schools and ECE programs can adapt to changing local situations, including periods of increased community health impacts from COVID-19.

Isolation and Precautions for People with COVID-19

If you were exposed to COVID-19, you should start taking precautions. Isolation and Exposure Calculator A tool to help you determine if you need to isolate or take other steps to prevent spreading COVID-19. If you have COVID-19, you can spread the virus to others. There are precautions you can take to prevent spreading it to others: isolation, masking, and avoiding contact with people who are at high risk of getting very sick. Isolation is used to separate people with confirmed or suspected COVID-19 from those without COVID-19. These recommendations do not change based on COVID-19 hospital admission levels. If you have COVID-19, also see additional information on treatments that may be available to you. This information is intended for a general audience. Healthcare professionals should see Ending Isolation and Precautions for People with COVID-19. This CDC guidance is meant to supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations.

Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic

The recommendations in this guidance continue to apply after the expiration of the federal COVID-19 Public Health Emergency. For healthcare personnel, see Isolation and work restriction guidance. For strategies to mitigate healthcare personnel staffing shortages, see Contingency and crisis management. For healthcare professionals advising people in non-healthcare settings about isolation for laboratory-confirmed COVID-19, see Ending Isolation and Precautions for People with COVID-19. Summary of Recent Changes Updated recommendations for universal source control and admission testing in nursing homes Added Appendix to assist facilities with how and when to implement broader use of source control, including examples of potential metrics Table of Contents Introduction 1. Recommended routine infection prevention and control (IPC) practices during the COVID-19 pandemic 2. Recommended infection prevention and control (IPC) practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection 3. Setting-specific considerations Appendix Definitions Infection Control FAQ Key Points This guidance applies to all U.S. settings where healthcare is delivered, including nursing homes and home health. Introduction This interim guidance has been updated based on currently available information about COVID-19 and the current situation in the United States. Updates were made to reflect the high levels of vaccine-and infection-induced immunity and the availability of effective treatments and prevention tools. This guidance provides a framework for facilities to implement select infection prevention and control practices (e.g., universal source control) based on their individual circumstances (e.g., levels of respiratory virus transmission in the community). This guidance is applicable to all U.S. settings where healthcare is delivered (including nursing homes and home health). This guidance is not intended for non-healthcare settings (e.g., restaurants) and not for persons outside of healthcare settings. CDC's main landing page for COVID-19 content will help readers navigate to information regarding modes of transmission, clinical management, laboratory settings, COVID-19 vaccines and CDC guidance on other COVID-19-related topics. Employers should be aware that other local, territorial, tribal, state, and federal requirements may apply, including those promulgated by the Occupational Safety and Health Administration (OSHA).

Guidance on Management of COVID-19 in Homeless Service Sites and in Correctional and Detention Facilities

Replaces COVID-19 Community Levels with COVID-19 hospital admission levels to guide prevention decisions. Changes based on: MMWR: COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration ― United States, May 11, 2023 MMWR: Correlations and Timeliness of COVID-19 Surveillance Data Sources and Indicators ― United States, October 1, 2020–March 22, 2023 Recommends intake testing in correctional and detention facilities be considered an Enhanced Prevention Strategy. Previous versions of this guidance document recommended intake testing as a Strategy for Everyday Operations. Provides information about changes to CDC's Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, which should still be used by healthcare personnel in dedicated patient areas within homeless service sites and correctional and detention facilities. Because of the congregate living arrangements in homeless shelters and correctional and detention facilities, the risk of COVID-19 transmission is higher in these settings compared with the general population. In addition, there is a high prevalence of certain medical conditions associated with severe COVID-19 among people experiencing homelessness and among people who are incarcerated, increasing the risk for severe outcomes from COVID-19 in these populations. This guidance can be used to inform COVID-19 prevention actions in homeless service sites and correctional and detention facilities and replaces previous CDC guidance documents for these settings.

Considerations for SARS-CoV-2 Antigen Testing for Healthcare Providers Testing Individuals in the Community

Updates on guidelines for repeat antigen testing Updates to guidelines for reporting test results View Previous Updates Key Points This guidance is intended for healthcare providers who order antigen tests, receive antigen test results, or perform point-of-care antigen testing for SARS-CoV-2. It is also intended for laboratory and testing professionals and public health practitioners who perform antigen testing and reporting for SARS-CoV-2 in a laboratory setting or at the point of care. The guidance supports effective clinical use of antigen tests for different testing situations. This guidance focuses on the use of antigen tests to diagnose new infections. Guidance for performing antigen self-tests (also known as at-home tests) can be found on CDC's Self-Testing webpage. On This Page General Guidance Performance of Antigen Tests for SARS-CoV-2 Interpreting the Results of Antigen Testing for SARS-CoV-2 Confirmatory Testing When Using Antigen Tests for SARS-CoV-2 Processing of Antigen Tests for SARS-CoV-2 Reporting Antigen Test Results for SARS-CoV-2 Regulatory Requirements for Using Antigen Tests for SARS-CoV-2

Additional Information for Community Congregate Living Settings (e.g., Group Homes, Assisted Living)

What You Need to Know Facilities that serve unrelated people who live in close proximity and share at least one common room (e.g., group or personal care homes and assisted living facilities) should apply prevention strategies based on COVID-19 hospital admission levels for their general operations. Healthcare services delivered in these settings should be informed by CDC's Infection Prevention and Control Recommendations. Facilities can also assess the unique risks of their setting and the populations they serve and use enhanced COVID-19 prevention strategies, described below, to help reduce the impact of COVID-19. Facility operators should balance the need for COVID-19 prevention with the impact from reducing access to daily services and programming. Facilities may not be able to apply all enhanced COVID-19 prevention strategies due to local resources, facility and population characteristics, and/or other factors. Therefore, they can add combinations of these enhanced prevention strategies as feasible for a layered approach to increase the level of protection.

Effectiveness of a Second COVID-19 Vaccine Booster in Chinese Adults

Guidance for Healthcare Workers about COVID-19 (SARS-CoV-2) Testing

Testing Overview ;Summary of considerations and current CDC recommendations regarding COVID-19 testing strategies. ;;;COVID-19 Antibody Testing ;Learn about COVID-19 antibodies and CDC recommendations for using COVID-19 antibody tests. ;;Performing Broad-Based Testing ;Prepare for broad-based viral testing in facilities after known or suspected SARS-CoV-2 exposure or when there is moderate to substantial transmission in the community. ;;Testing in Healthcare Settings ;Nursing Homes ;Performing Facility-Wide Testing in Nursing Homes ;Other Testing Resources ;Pooled Procedures for Testing ;Laboratory Resources ;Testing Guidance for the Public ;Search All COVID-19 Guidance for Healthcare Workers ;Testing in Communities, Schools and Workplaces ;Schools ;Non-Healthcare Workplaces ;Homeless Shelters ;Correctional and Detention Facilities ;Testing Animals ;Pets, Livestock, and Other Animals

Interim Guidelines for COVID-19 Antibody Testing

Added introduction to antibodies and COVID-19. ;Moved “Development of Antibodies and Immunity” section. ;Key Points: ;Antibody tests have public health value for monitoring and evaluating population levels of immunity, as well as clinical utility for patients. ;;Antibody tests that have received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) may be used for both public health and clinical purposes. Individual performance characteristics for each test can be found in the test’s instructions for use (IFU). ;Antibody testing should not be used to determine whether someone is currently infected with SARS-CoV-2. Viral tests detect current infection. ;Antibody testing is not currently recommended to assess for immunity to SARS-CoV-2 following COVID-19 vaccination or to assess the need for vaccination in an unvaccinated person. ;On This Page ;Introduction to COVID-19 Antibodies ;Recommendations for Use of Antibody Tests ;Antibody Testing in the United States ;Development of Antibodies and Immunity

Information for Pediatric Healthcare Providers

This content provides clinicians and public health professionals with key information and evidence for clinical considerations when diagnosing and managing pediatric patients infected with SARS-CoV-2, the virus that causes COVID-19. For evidence-based treatment recommendations for COVID-19, visit the National Institutes of Health (NIH) COVID-19 Treatment Guidelines prepared by the COVID-19 Treatment Guidelines Panel. Also see the American Academy of Pediatrics (AAP) Critical Updates on COVID-19 and the Centers for Disease Control and Prevention’s (CDC’s) Variants of the Virus and Vaccines for COVID-19. ;;Summary of Recent Changes ;;Revisions were made on October 17, 2022, to include new information about COVID-19 relevant for pediatric healthcare providers. ;View Previous Updates ;;On This Page ;Incidence ;Incubation Period and Clinical Presentation ;Severity and Underlying Medical Conditions ;Testing, Diagnosis, and Recommendations for Isolation ;Laboratory and Radiographic Findings ;Management of Illness ;Multisystem Inflammatory Syndrome in Children (MIS-C) ;Post-COVID Conditions (PCCs) ;Considerations for Routine Pediatric Care During the COVID-19 Pandemic ;References

Diagnosis: Clinical considerations for care of children and adults with confirmed COVID-19

What You Need to Know ;When testing for current COVID-19, the CDC recommends that clinicians use viral tests that detect SARS-CoV-2, not a serologic test, which detects antibodies. ;Testing is important to identify and help reduce the spread of COVID-19 (see diagnostic tests for COVID-19). Viral tests, including NAAT and antigen tests, are used to diagnose COVID-19. Antibody tests (serology) are not indicated to diagnose a current infection. NAATs that use reverse transcription-polymerase chain reaction (RT-PCR) technology to detect SARS-CoV-2 ribonucleic acid (RNA) are highly sensitive and specific and detect SARS-CoV-2 RNA in respiratory specimens. Clinical RT-PCR tests for SARS-CoV-2 that determine the cycle threshold (Ct) value are not validated to estimate viral load, and the NIH recommends that Ct values may be considered only in consultation with an infectious disease expert. ;;SARS-CoV-2 antigen tests typically provide rapid results and are less expensive than NAATs, but they are generally less sensitive than NAATs. Antigen tests for SARS-CoV-2 use immunoassays to detect the presence of a specific viral antigen in respiratory specimens, and include point-of-care, laboratory-based, and self-tests. A negative antigen test in persons with signs or symptoms of COVID-19 should be confirmed by NAAT. For more information, see the Antigen Test Algorithm. ;;Specific recommendations on testing strategies in various clinical situations and information on SARS-CoV-2 molecular and antigen assays (including COVID-19 self-tests) that have received U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) are available, see: FDA’s COVID-19 In Vitro Diagnostics EUAs, CDC’s Overview of Testing for SARS-CoV-2, CDC’s Interim Guidance for Antigen Testing for SARS-CoV-2, and the NIH’s Testing for SARS-CoV-2 Infection which describes testing recommendations, including guidance on the use of Ct values.

Get Medicine for COVID-19

There is medicine you can take if you get very sick from COVID-19. ;Taking medicine can help you stay out of the hospital. ;Call your doctor right away if you get sick with COVID-19. ;It is important to take the medicine right away. ;;Who Should Take Medicine for COVID-19? ;A woman is covering her nose with a tissue and checking her temperature on a thermometer. ;Most people with COVID-19 have mild symptoms. ;You can buy medicines from the drug store if you feel bad. ;These medicines include Tylenol, Motrin, and Advil. ;;Some people may get very sick from COVID-19. ;Medicines from the drug store are not enough. ;A doctor can prescribe COVID-19 medicine for these people. ;Medicine helps keep these people from going to the hospital. ;These medicines include Paxlovid and Lagevrio. ;;Who May Get Very Sick from COVID-19? ;A group of people are shown who have different reasons they may get very sick from COVID-19. The people who are older, group includes people with disabilities, people who have weak immune systems, people who have serious health problems, people who are pregnant, and people who have not gotten the COVID-19 shot. ;People who are 50 years old or older may get very sick. ;People with disabilities may get very sick. ;People with weak immune systems may get very sick. ;People with serious health problems may get very sick. ;Pregnant people may get very sick. ;People who have not gotten a COVID-19 shot may get very sick. ;If this sounds like you and you get COVID-19, call your doctor right away. ;;How Can I Get Medicine? ;A woman is at her doctor’s office wearing a mask and is talking to her doctor who is also masked. The woman is holding a brochure about COVID-19 medicine. ;If you test positive for COVID-19, ask your doctor about medicine. ;Tell your doctor if you are taking any other medicines. ;Your doctor will help decide if COVID-19 medicine is right for you. ;;You can also visit a “Test to Treat” location. ;These locations offer testing and medicine all in one place. ;If treatment is right for you, you can get medicine right then. ;Call 1-800-232-0233 (TTY 888-720-7489) to find a location near you. ;;When Should I Get Medicine? ;A woman is at home and calling her doctor over the phone. ;Call your doctor right away if you get sick with COVID-19. ;Start the medicine within a few days of getting sick. ;The medicine works best if you start it right away.

Operational Considerations for Routine Immunization Services during the COVID-19 pandemic in non-US Settings Focusing on Low- and Middle-Income Countries

Added COVID-19 vaccination for eligible populations. ;Updated Quarantine and Isolation Guidelines link. ;Added disclaimer regarding the CDC quarantine, isolation, and testing guidance. ; ;;View Previous Updates ;;Key Points ;Adapt immunization strategies to the vaccine-preventable disease risks and COVID-19 situation in your country. ;Engage with communities and implement communication strategies to make people aware that routine vaccines are available. ;Use the immunization information systems in your country to monitor who missed routine vaccines and to inform your catch-up vaccination strategies. ;On This Page ;Background ;Implementation of routine immunization services during COVID-19 ;Background ;Routine immunization services have been disrupted significantly during the COVID-19 pandemic, threatening achievements in the fight against major vaccine-preventable diseases (VPDs) like polio, yellow fever, and measles. According to new data, 60 lifesaving immunization campaigns are currently postponed in 50 countries, putting around 228 million people – mostly children – at risk for preventable infectious diseases. Over half of the 50 countries affected by these interruptions are in Africa, highlighting protracted inequities in access to critical immunization services [1]. ;;Routine immunization is the sustainable, reliable, and timely interaction between the vaccine, those who deliver it, and those who receive it to ensure every person is fully immunized against VPDs. Examples of routine immunizations are childhood vaccination against diphtheria, measles, polio, tetanus, meningitis, pertussis, and adulthood vaccination against flu and tetanus. ;;In many countries, routine immunization services have been disrupted due to: ;;Unavailability of healthcare workers because of their deployment to the COVID-19 response. ;Lack of personal protective equipment (PPE) to conduct immunization activities. ;Healthcare workers’ fear about contracting COVID-19. ;Interrupted supply of vaccines due to COVID-19 related closure of country borders. ;Unwillingness or inability of parents to leave their homes due to fear of COVID-19. ;The following guidance is meant to supplement but not replace any local health and safety laws, rules, and regulations. It is intended for CDC country offices, immunization program managers, and staff from partner immunization programs.

Guidance on Management of COVID-19 in Homeless Service Sites and in Correctional and Detention Facilities

Combines and replaces previous CDC guidance documents for COVID-19 in homeless service sites and correctional and detention facilities. ;Describes tailored everyday and enhanced COVID-19 prevention strategies. ;Recommends adding enhanced COVID-19 prevention strategies when the COVID-19 Community Levels are high (previously medium) or when there are facility-specific risks. ;No longer routinely recommends quarantine after someone is exposed to a person with COVID-19. Continues to provide considerations for facilities that prefer to continue implementing quarantine protocols. ;Includes an option to end isolation for people with COVID-19 after 7 days with a negative viral test. ;Emphasizes the importance of maximizing access to in-person visitation to promote correctional and detention facility residents’ mental health and well-being. ;Because of the congregate living arrangements in homeless shelters and correctional and detention facilities, the risk of COVID-19 transmission is higher in these settings compared with the general population. In addition, there is a high prevalence of certain medical conditions associated with severe COVID-19 among people experiencing homelessness and among people who are incarcerated, increasing the risk for severe outcomes from COVID-19 in these populations. ;;This guidance can be used to inform COVID-19 prevention actions in homeless service sites and correctional and detention facilities and replaces previous CDC guidance documents for these settings. ;; For Healthcare Professionals: This guidance does not apply to dedicated patient care areas within these settings. Any healthcare workers who provide care in these settings should follow Infection Control Recommendations for Healthcare Personnel. ;;On This Page ;Assessing a Facility's Risk ;COVID-19 Prevention Strategies ;Quarantine ;Personal Protective Equipment and Source Control ;Identifying Exposures ;Additional Considerations ;Assessing a Facility’s Risk ;CDC recommends that homeless service sites and correctional and detention facilities use a combination of COVID-19 Community Levels and facility-specific risks to guide decisions about when to apply specific COVID-19 prevention actions. Assessing the following factors can help decide if additional layers of protection are needed because of facility-specific risks: ;;Facility structural and operational characteristics: Assess whether facility characteristics or operations contribute to COVID-19 spread. For example, facilities may have a higher risk of transmission if they have frequent resident or staff turnover, a high volume of outside visitors, poor ventilation, or areas where many people sleep close together. ;Risk of severe health outcomes: Assess what portion of people in the facility are more likely to get very sick from COVID-19, for example, due to underlying health conditions, older age, pregnancy, or poor access to medical care. ;COVID-19 transmission in the facility: Assess the extent to which transmission is occurring within the facility. Transmission can be assessed through diagnostic testing of people with COVID-19 symptoms and their close contacts, through routine screening testing (not routinely recommended, but some facilities might use it in consultation with their health department to facilitate early identification of infections in populations with especially high risk for severe illness from COVID-19), or other surveillance testing that the facility uses (such as wastewater testing). Results of testing at intake are not recommended as an indicator of transmission inside the facility, since infections identified at intake most likely occurred elsewhere.

Additional Information for Community Congregate Living Settings (e.g., Group Homes, Assisted Living)

What You Need to Know ;Facilities that serve unrelated people who live in close proximity and share at least one common room (e.g., group or personal care homes and assisted living facilities) should apply prevention strategies based on COVID-19 Community Levels for their general operations. ;Healthcare services delivered in these settings should be informed by CDC’s Infection Prevention and Control Recommendations. ;Facilities can also assess the unique risks of their setting and the populations they serve and use enhanced COVID-19 prevention strategies, described below, to help reduce the impact of COVID-19. ;Facility operators should balance the need for COVID-19 prevention with the impact from reducing access to daily services and programming. Facilities may not be able to apply all enhanced COVID-19 prevention strategies due to local resources, facility and population characteristics, and/or other factors. Therefore, they can add combinations of these enhanced prevention strategies as feasible for a layered approach to increase the level of protection.

Diagnosis: Clinical considerations for care of children and adults with confirmed COVID-19

What You Need to Know ;When testing for current COVID-19, the CDC recommends that clinicians use viral tests that detect SARS-CoV-2, not a serologic test, which detects antibodies. ;Testing is important to identify and help reduce the spread of COVID-19 (see diagnostic tests for COVID-19). Viral tests, including NAAT and antigen tests, are used to diagnose COVID-19. Antibody tests (serology) are not indicated to diagnose a current infection. NAATs that use reverse transcription-polymerase chain reaction (RT-PCR) technology to detect SARS-CoV-2 ribonucleic acid (RNA) are highly sensitive and specific and detect SARS-CoV-2 RNA in respiratory specimens. Clinical RT-PCR tests for SARS-CoV-2 that determine the cycle threshold (Ct) value are not validated to estimate viral load, and the NIH recommends that Ct values may be considered only in consultation with an infectious disease expert. ;;SARS-CoV-2 antigen tests typically provide rapid results and are less expensive than NAATs, but they are generally less sensitive than NAATs. Antigen tests for SARS-CoV-2 use immunoassays to detect the presence of a specific viral antigen in respiratory specimens, and include point-of-care, laboratory-based, and self-tests. A negative antigen test in persons with signs or symptoms of COVID-19 should be confirmed by NAAT. For more information, see the Antigen Test Algorithm. ;;Specific recommendations on testing strategies in various clinical situations and information on SARS-CoV-2 molecular and antigen assays (including COVID-19 self-tests) that have received U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) are available, see: FDA’s COVID-19 In Vitro Diagnostics EUAs, CDC’s Overview of Testing for SARS-CoV-2, CDC’s Interim Guidance for Antigen Testing for SARS-CoV-2, and the NIH’s Testing for SARS-CoV-2 Infection which describes testing recommendations, including guidance on the use of Ct values.

Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination

Summary of recent changes (last updated September 2, 2022) Updated guidance for observation periods following COVID-19 vaccination Key Points Anaphylaxis, an acute and potentially life-threatening allergic reaction, has been reported rarely following COVID-19 vaccination. Under the Emergency Use Authorizations for COVID-19 vaccines, appropriate medical treatment for severe allergic reactions must be immediately available at any site administering the vaccine in the event that an acute anaphylactic reaction occurs following administration of a COVID-19 vaccine. These interim considerations provide information on preparing for the initial assessment and potential management of anaphylaxis following COVID-19 vaccination. On This Page Personnel, medications, and supplies for assessing and managing anaphylaxis Post-vaccination observation periods Early recognition of anaphylaxis Management of anaphylaxis at a COVID-19 vaccination location Considerations for anaphylaxis management in special populations Patient counseling Reporting anaphylaxis Additional resources References Appendix Previous Updates Overview Anaphylaxis, an acute and potentially life-threatening allergic reaction, has been reported rarely following COVID-19 vaccination. These interim considerations provide recommendations on assessment and potential management of anaphylaxis following COVID-19 vaccination. Detailed information on CDC recommendations for vaccination, including contraindications and precautions to vaccination, can be found in the Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Patients should be screened prior to receipt of each vaccine dose, and those with a contraindication should not be vaccinated. A COVID-19 prevaccination questionnaire [6 pages] is available to assist with screening.

Ending Isolation and Precautions for People with COVID-19: Interim Guidance

CDC’s COVID-19 Community Levels recommendations do not apply in healthcare settings, such as hospitals and nursing homes. Instead, healthcare settings should continue to use community transmission rates and continue to follow CDC’s infection prevention and control recommendations for healthcare settings. This page is intended for use by healthcare professionals who are caring for people in the community setting under isolation with COVID-19. For more information for the general population in the community, please see Isolation and Precautions for People with COVID-19. These recommendations do not apply to healthcare personnel in the healthcare setting, and do not supersede state, local, tribal, or territorial laws, rules, and regulations. For healthcare settings, please see Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 and Interim Infection Prevention and Control Recommendations for Healthcare Personnel. For more details, including details on certain non-healthcare settings, please review Setting-Specific Guidance. Summary of Recent Changes Updated guidance reflects new recommendations for isolation and precautions for people with COVID-19. Removed Assessment for Duration of Isolation and Key Findings From Transmission Literature sections so page provides most current information. View Previous Updates Key Points People who are infected but asymptomatic or people with mild COVID-19 should isolate through at least day 5 (day 0 is the day symptoms appeared or the date the specimen was collected for the positive test for people who are asymptomatic). They should wear a mask through day 10. A test-based strategy may be used to remove a mask sooner. People with moderate or severe COVID-19 should isolate through at least day 10. Those with severe COVID-19 may remain infectious beyond 10 days and may need to extend isolation for up to 20 days. People who are moderately or severely immunocompromised should isolate through at least day 20. Use of serial testing and consultation with an infectious disease specialist is recommended in these patients prior to ending isolation.

Interim Guidelines for Collecting and Handling of Clinical Specimens for COVID-19 Testing

Added new language on ordering swabs and media, assessing specimens obtained through self-collection, and transporting specimens through pneumatic tube systems. View Previous Updates Key Points The type of specimen collected when testing for current or past infection with SARS-CoV-2 is based on the test being performed and its manufacturer’s instructions. Some of the specimen types listed below will not be appropriate for all tests. For initial diagnostic testing for current SARS-CoV-2 infections, CDC recommends collecting and testing an upper respiratory specimen. This guidance is intended for healthcare providers or health department staff who are collecting specimens from others in a healthcare setting or at the point-of-care. Guidance for self-collection of specimens can be found here. CDC has guidance for who should be tested, but decisions about who should be tested are at the discretion of State, Tribal, Local, and Territorial (STLT) health departments and/or healthcare providers. Testing for other pathogens by the provider should be done as part of the initial evaluation, as indicated, but should not delay testing for SARS-CoV-2, the virus that causes COVID-19. On This Page Collecting and Handling Specimens Safely Respiratory Specimen Collection Assessing Validity of Specimens Obtained Through Self-Collection Handling Bulk-Packaged Sterile Swabs Properly for Upper Respiratory Specimen Collection Storing and Shipping Respiratory Specimens Capillary Fingerstick Specimen Collection Additional Resources Collecting and Handling Specimens Safely For healthcare providers collecting specimens or working within 6 feet of patients suspected to be infected with SARS-CoV-2, maintain proper infection control and use recommended personal protective equipment (PPE), which includes an N95 or higher-level respirator (or face mask if a respirator is not available), eye protection, gloves, and a gown. For healthcare providers who are handling specimens, but are not directly involved in collection (e.g. handling self-collected specimens) and not working within 6 feet of the patient, follow Standard Precautions. Healthcare providers should wear a form of source control (face mask) at all times while in the healthcare facility. Healthcare providers can minimize PPE use if patients collect their own specimens while maintaining at least 6 feet of separation. For example, the provider should wear a face mask, gloves, and a gown.

CDC COVID-19 Response Health Equity Strategy: Accelerating Progress Towards Reducing COVID-19 Disparities and Achieving Health Equity

Guiding Principles Reduce health disparities. Use data-driven approaches. Foster meaningful engagement with community institutions and diverse leaders. Lead culturally responsive outreach. Reduce stigma, including stigma associated with race and ethnicity. Vision All people have the opportunity to attain the highest level of health possible. Charge To reduce the disproportionate burden of COVID-19 among populations at increased risk for infection, severe illness, and death. To broadly address health disparities and inequities related to COVID-19 with a holistic, all-of-response approach. To develop a strategic plan to help us realize these goals. Overview Achieving health equity requires valuing everyone equally with focused and ongoing efforts to address avoidable inequities, historical and contemporary injustices, and the elimination of health and healthcare disparities. The population health impact of COVID-19 has exposed longstanding inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19. Persistent health disparities combined with historic housing patterns, work circumstances, and other factors have put members of some racial and ethnic minority populations at higher risk for COVID-19 infection, severe illness, and death. As we continue to learn more about the impact of COVID-19 on the health of different populations, immediate action is critical to reduce growing COVID-19 disparities among the populations known to be at disproportionate risk. CDC’s COVID-19 Response Health Equity Strategy broadly seeks to improve the health outcomes of populations disproportionately affected by focusing on four priorities: Expanding the evidence base. Expanding programs and practices for testing, contact tracing, isolation, healthcare, and recovery from the impact of unintended negative consequences of mitigation strategies in order to reach populations that have been put at increased risk. Examples of potential unintended negative consequences include loss of health insurance;food, housing, and income insecurity;mental health concerns;substance use;and violence resulting from factors like social isolation, financial stress, and anxiety. Expanding program and practice activities to support essential and frontline workers to prevent transmission of COVID-19. Examples of essential and frontline workers include healthcare, food industry, and correctional facility workers. Expanding an inclusive workforce equipped to assess and address the needs of an increasingly diverse U.S. population.