Recently Updated COVID-19 Information/Guidance

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes … Version 21 is the latest version, updated in April 2021.   It Includes recent information and guidance on vaccinations to prevent infection with influenza virus, pneumococcus, and SARS-CoV-2, the virus that causes COVID-19.


Unanswered Questions: Improving Technology, Communications, and Reporting in Long-Term Care Facilities During the Pandemic is an interesting 11-page read.  “This special report evaluates how well the State of Delaware prepared long-term care facilities (LTCFs) for the pandemic and how well it responded to facilities’ needs once the pandemic began.”   Kathleen K. McGuiness, Delaware’s State Auditor, and her team “reviewed federal and state guidance provided to LTCFs at the beginning of the pandemic and six months later. We also conducted two statewide surveys of LTCF directors to evaluate their views on the guidance that came from the state and federal governments regarding COVID-19 best practices. Once we received the survey data and analyzed it, we also interviewed several LTCF directors for their direct feedback on what our analysis showed. We also reviewed federal and state data reports to determine whether the number of COVID cases and deaths at LTCFs were being consistently reported. This special report is meant to help state health officials see specific areas related to long-term care facilities so they can improve their communication, guidance and data reporting to provide an accurate picture of how these facilities’ residents and staff are being affected.”

Recommendations are found on page 10 of the report with a subtitle of “Make COVID-19 lessons learned improvements a priority.”   I have no doubt that other states experienced the same issues.  We need data like this in order to learn how to do better going forward.  I encourage you to review Ms. McGuiness’ and her team’s findings. 


Scientific Brief: SARS-CoV-2 Transmission was updated by CDC on May 7, 2021.  

SARS-CoV-2 is transmitted by exposure to infectious respiratory fluids.

The principal mode by which people are infected with SARS-CoV-2 (the virus that causes COVID-19) is through exposure to respiratory fluids carrying infectious virus. Exposure occurs in three principal ways: (1) inhalation of very fine respiratory droplets and aerosol particles, (2) deposition of respiratory droplets and particles on exposed mucous membranes in the mouth, nose, or eye by direct splashes and sprays, and (3) touching mucous membranes with hands that have been soiled either directly by virus-containing respiratory fluids or indirectly by touching surfaces with virus on them.

People release respiratory fluids during exhalation (e.g., quiet breathing, speaking, singing, exercise, coughing, sneezing) in the form of droplets across a spectrum of sizes. These droplets carry virus and transmit infection.

  • The largest droplets settle out of the air rapidly, within seconds to minutes.
  • The smallest very fine droplets, and aerosol particles formed when these fine droplets rapidly dry, are small enough that they can remain suspended in the air for minutes to hours.

Infectious exposures to respiratory fluids carrying SARS-CoV-2 occur in three principal ways (not mutually exclusive):

  1. Inhalation of air carrying very small fine droplets and aerosol particles that contain infectious virus. Risk of transmission is greatest within three to six feet of an infectious source where the concentration of these very fine droplets and particles is greatest.
  2. Deposition of virus carried in exhaled droplets and particles onto exposed mucous membranes (i.e., “splashes and sprays”, such as being coughed on). Risk of transmission is likewise greatest close to an infectious source where the concentration of these exhaled droplets and particles is greatest.
  3. Touching mucous membranes with hands soiled by exhaled respiratory fluids containing virus or from touching inanimate surfaces contaminated with virus.

CMS would like to make you aware that the federally supported website that makes it easier for individuals to access COVID-19 vaccines is now live. Vaccines.gov – powered by the trusted VaccineFinder brand – is available in English and Spanish, with high accessibility standard, and will help connect Americans with locations offering vaccines near them. In addition to the website, people in the U.S. are also now able to utilize a text message service, available in both English and Spanish. People can text their ZIP code to 438829 (GETVAX) and 822862 (VACUNA) to find three locations nearby that have vaccines available.

Vaccines.gov is meant to complement the number of state and pharmacy websites that have been successfully connecting many Americans with vaccinations, by providing a unified federal resource for Americans to use no matter where they are. 

In addition to the website and text messaging service, the National COVID-19 Vaccination Assistance Hotline is now available to help those who prefer to get information by phone on where to get a vaccine. Call 1-800-232-0233 to find a location near you.