MDS Alert

Question: I keep seeing some phrases bandied about in guidelines surrounding COVID-19, but I’m not sure what they mean. What does “close contact” mean, when my context of close contact, as a nursing home employee, can involve toileting or bathing?

Rhode Island Subscriber

Answer: The realities of providing direct care or otherwise interacting with many people in sometimes intimate ways definitely skews perception of “close contact”! The Centers for Disease Control and Prevention (CDC) defines close contact rather liberally: being within 6 feet of a person with COVID-19 for at least 15 minutes, cumulatively, over 24 hours.

Here are some definitions for other phrases used in official COVID-19 guidance:

A person is “fully vaccinated” after two weeks after their second dose in a two-dose COVID-19 vaccine series or two weeks after the initial dose for a single-dose vaccine. An “unvaccinated” person is anyone who does not meet the aforementioned standards, or whose vaccination status is unknown — basically, if you’re not sure the person you’re interacting with is fully vaccinated, take all possible precautions to protect yourself and to protect them.

“Facility staff” includes employees paid directly by your facility or organization, as well as “consultants, contractors, volunteers, and caregivers who provide care and services to residents on behalf of the facility, and students in the facility’s nurse aide training programs or from affiliated academic institutions,” the Centers for Medicare & Medicaid Services (CMS) say.

The CDC defines “higher-risk exposure” as a greater intensity of exposure of material potentially containing the virus particles of SARS-CoV-2 to a person’s eyes, nose, or mouth, such as attending an aerosol-generating procedure. Higher-risk exposure is especially likely in situations where people are interacting without sufficient personal protective equipment (PPE).

Lastly, the “level of community transmission” refers to the level of transmission in the county of a particular facility. CMS says this metric uses two indicators: 1) Total number of new cases per 100,000 people in the last seven days, and 2) the percentage of positive diagnostic and screening nucleic acid amplification tests (NAAT) in the last 7 days. You can find more information (and information specific to your county) on the CDC’s website here, https://covid.cdc.gov/covid-data-tracker/#county-view.