CDC no Longer Recommends Universal Masking in Health Facilities

The Hill | By Nathaniel Weixel

The Centers for Disease Control and Prevention no longer recommends universal masking in health care settings, unless the facilities are in areas of high COVID-19 transmission.

The agency quietly issued the updates as part of an overhaul to its infection control guidance for health workers published late Friday afternoon [09/23/22]. It marks a major departure from the agency’s previous recommendation for universal masking.

“Updates were made to reflect the high levels of vaccine-and infection-induced immunity and the availability of effective treatments and prevention tools,” the CDC’s new guidance says.

Now, the CDC says facilities in regions without high transmission can “choose not to require” all doctors, patients, and visitors to mask. Transmission is different from the community levels CDC uses to guide non-health care settings.

Community transmission refers to measures of the presence and spread of SARS-CoV-2, CDC said.

“It is the metric currently recommended to guide select practices in healthcare settings to allow for earlier intervention, before there is strain on the healthcare system and to better protect the individuals seeking care in these settings,” CDC said.

Right now, about 73 percent of the US is experiencing “high”rates of transmission. 

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 said. 

Only 7 percent of counties are considered high risk, while nearly 62 percent of counties are considered low.

In addition, the new guidance includes a list of exceptions when people might choose to mask, compared to the previous guidance that included a list of exceptions when masking was not recommended. 

Even if masking is not universally required, if a provider works in a part of the facility experiencing a COVID-19 outbreak, or if they care for immunocompromised patients, they should wear a mask. 

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Colorado Economic Forecast

Last week, the Joint Budget Committee heard the September Economic Forecast from Legislative Council Staff (LCS) and the Office of State Planning and Budgeting (OSPB).

Under the presented forecasts, the economy is in a transitional period from rapid post-recession recovery to a trend of slower growth. A recession is still not forecasted for Colorado, despite national trends. However, unemployment has risen slightly in the state and inflationary pressures continue. Inflation now outpaces wage gains as real wages decline.

In the current fiscal year, revenue collections broke records but the state does not expect much additional growth. Both LCS and OSPB expect revenue projections to increase for all fiscal years relative to the June forecast. This means TABOR refunds are also expected throughout the forecast.

Looking forward to the FY 2023-24 budget, General Fund revenue is expected to exceed current collections and the Referendum C cap (which constrains the state to inflation) will incorporate the current inflation rate at 8.2%.

The General Assembly is projected to have $1.08 billion (+5.6%) to spend or save in FY 2022-23. However, once you account for caseload growth, costs in K-12 education, increases in compensation and provider rates consistent with those in the last fiscal year and costs for capital construction, the projected surplus is much lower at $85.1 million (+0.4%).

Attached is a copy of the full forecast presentation slides.
 

Five Reasons Biden Might be Wrong About the Pandemic Being Over

The Hill | By Joseph Choi

President Biden boldly claimed in an interview over the weekend that the pandemic is over, but public health experts — and U.S. statistics — put those remarks in serious doubt.

Coronavirus cases and deaths in the U.S. have been on a steady decline in recent weeks following a slight rise due to the BA.5 omicron subvariant.

However, tens of thousands of new cases are still being recorded daily, hundreds of Americans are still dying of the virus every day and enthusiasm for immunization has all but stagnated. 

In his “60 Minutes” interview, Biden acknowledged the U.S. still has “a problem with COVID,” but pointed to the fact that people were not wearing masks at the event he was attending as evidence that the pandemic phase of COVID-19 is over.

He sought to walk back the remarks on Tuesday, saying the pandemic is “not where it was.”

But he has maintained the core of his argument: COVID-19 has reached a new, less severe phase. 

Many have been waiting for the pandemic to become endemic.

For a virus to be considered endemic, it would still exist within communities, but it would not severely impact medical providers and health systems. 

Available information paints a picture of a country that, while making strides in combating the outbreak, is far from being in the clear. 

Cases 

While cases are declining, they are still far from being the lowest they have ever been throughout the pandemic. 

Case rates for COVID-19 currently stand at a seven-day moving average of about 55,000 cases per day, a marked decline from the hundreds of thousands of infections that were seen at the start of this year when the omicron wave peaked. 

This rate is still more than twice what the U.S. saw in April before BA.5 rose in dominance.

Since the start of the pandemic, case rates reached their lowest in June 2021 when they dipped below 12,000 per day for a few weeks. 

Half of all U.S. counties are currently considered to have low COVID-19 community levels, according to the Centers for Disease Control and Prevention (CDC). Another 36 percent of counties have medium COVID-19 community levels, and 13 percent have high community levels.  

This leaves half the communities in the country in a place where mask wearing is still recommended by the CDC in some situations, particularly for those at high risk for severe illness. 

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HHS Rolls Out First National Family Caregiver Strategy

McKnight’s Home Care | By Diane Eastabrook

The Department of Health and Human Services unveiled its first national strategy to support family caregivers on Wednesday. Among the list of actions HHS recommended is the creation of a job classification for direct care workers and standardized training and accreditation across states.

“Supporting family caregivers is an urgent public health issue, exacerbated by the long-term effects of the COVID-19 pandemic,” HHS Secretary Xavier Becerra said in a statement. “This national strategy recognizes the critical role family caregivers play in a loved one’s life. I know the importance of this first-hand, as someone who cared for my late father and navigated the challenges associated with caregiving.” 

The national strategy lists 350 actions the federal government will take to help family caregivers over the next year and 150 actions that can be adopted by state and local governments, as well as the private sector to build a safety net for family caregivers. They include:

  • Increased funding to state, tribal and local health departments to embed family caregiving into public health infrastructure and planning
  • Incentives for healthcare systems to incorporate family caregivers into healthcare decision-making
  • Expansions to Medicare benefits, including respite care, adult day services and meals
  • Financial support for caregiving initiatives through federal funding opportunities, including expansion of Older Americans Act and the Elder Justice Act funding opportunities
  • Federal passage of family leave and expansion of FMLA to include smaller employers

The strategy is the result of the RAISE Family Caregivers Act, signed into law in 2018, which required HHS to come up with an action plan to aid family caregivers within 18 months of its passage. It was developed jointly through advisory councils and included input from family caregivers.

An estimated 53 million Americans provide informal, and typically unpaid, care to older adults and disabled people, according to the National Alliance for Caregiving and AARP. A 2015 study by AARP estimated family caregivers provide approximately $470 billion in unpaid care annually. 

A poll released last week found one-third of family caregivers surveyed worried about juggling work and caregiving duties, while nearly half said using paid caregiving would reduce their emotional and physical stress.
 

APTA Advocacy Roundup: What's Been Passed in Congress, What's Still on the Table

Here's the status of APTA-supported legislation on the fee schedule, telehealth, prior authorization, the PTA differential, and more.

As much as you might hear about gridlock on Capitol Hill these days, the 117th U.S. Congress has taken action on a number of pieces of legislation relevant to physical therapy — with more in the works.

We know how hard it can be to keep up. So here's an overview of what's happening — the APTA-supported legislation that's been enacted and bills under consideration.

(Want to keep up in the future? That's easy, too: Sign up for the APTA Advocacy Network, a free member benefit that puts you on the fast-track to the latest legislative information and calls to action.)

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