Hot Topics in Infection Prevention: CDC Mask Confusion, and a New Doggone Coronavirus

Saskia v. Popescu, PhD, MPH, MA, CIC
Saskia v. Popescu, PhD, MPH, MA, CIC

SASKIA V. POPESCU, PHD, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist. During her work as an infection preventionist, she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She holds a doctorate in biodefense from George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in infection control and has worked in both pediatric and adult acute care facilities.

The new CDC mask guidance came down so quickly that it just didn’t give people time to prepare, and it also ignores that we still have a majority of the population not fully vaccinated.

Dos and Don’ts of the CDC Mask Update

Last week was a bit … intense. The Centers for Disease Control and Prevention (CDC) released a new update that fully vaccinated individuals can resume normal activities without wearing a mask, except where there are mandates. Per the CDC “You can resume activities that you did prior to the pandemic. You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.”

As we’ve all likely read a lot about what this means, the bigger questions are about what how this will manifest itself in our communities. The CDC clarified for schools and reiterated that masks and social distancing should still be occurring in schools. Right now, though, the ramifications for this are pretty significant. First, many states and counties were caught entirely off guard – really, we all were. This left many scrambling to adjust their existing policies or decide how they wanted to proceed. In addition to the challenges of state policies, the bigger hurdle is for businesses and employers.

First, it’s important to note that this guidance is scientifically sound in that those who are vaccinated are protected against severe disease, but also significantly protected against infection in general. This represents confidence in the vaccines to protect people, but also that even for those breakthrough infections, level of infectiousness is thought to be much lower, meaning it poses less of a risk to those around the person (something we’re still learning more about). The problem though is that this new guidance occurred so quickly it just didn’t give people time to prepare, and it also ignores that we still have a majority of the population not fully vaccinated: 38.5% of the United States is fully vaccinated currently and we are still struggling against stagnating vaccinated rates and inequity in distribution.

For those businesses and employers, now the decision becomes tough, and they are often left with only three routes – uphold masking requirements, utilize an honor system in which there’s no real vaccination for vaccination status, or implement a view/verify process that allows vaccinated people to unmask and those unvaccinated are required to still mask. The communication of this has been particularly challenging as it’s been mixed regarding the reasoning as trying to improve vaccination rates, etc. Regardless of the strategy, the onus is now on local leaders, businesses, and employers to determine how they’ll respond to the new CDC guidance.

Novel Coronavirus: Look What the Dog Dragged In

Emerging coronaviruses aren’t particularly surprising, nor is it that they often emerge in animals and are spread to humans. An article on National Public Radio (NPR) shed some light on a novel coronavirus that was detected by a hospital epidemiologist who began asking some bigger questions. “The samples came from patients at a hospital in Sarawak, Malaysia, taken by a collaborator in 2017 and 2018,” the NPR article states. Gregory Gray, MD, MPH, an infectious disease epidemiologist at Duke University's Global Health Institute, tells NPR that “these were deep nasal swabs, like doctors collect with the COVID-19 patients.”

The patients had what looked like regular pneumonia. But in eight out of 301 samples tested, or 2.7%, Gray and Leshan Xiu, a graduate student in his lab, found that the patients' upper respiratory tracts were infected with a new canine coronavirus, i.e., a dog virus.” This is a great read and one that is a helpful reminder of the importance of hospital epidemiology and one health work.