Important First Steps

Exciting news (and guidance) for individuals who are fully vaccinated and for those with loved ones in nursing homes

This week (as we celebrate the one-year anniversary of WHO declaring a pandemic) CDC released new guidance allowing fully vaccinated individuals to gather with each other in small groups and with unvaccinated family members at low risk of severe illness. And CMS released new/updated guidance allowing families to visit their loved ones in nursing homes.

These are important first steps.

But — they are just that. First Steps…

While both sets of guidance (which are discussed below) move us closer to our prepandemic lives, my experience as a mom & epidemiologist tells me that I need to set realistic expectations about when things will really return to normal. Simply put — we cannot rush to the end of the pandemic; we need to take slow, small steps.

When our daughter was about a year old, she took a couple of steps. However, she didn’t really walk for another eight months. She took her time finding her footing and spent most of the year between her first and second birthdays scooting around on her knees. I was constantly saying “she’ll be walking soon,” but she just didn’t. I found myself frustrated, worried, and fearful about her not walking. Her walking timeline was completely out of my control. I finally stopped saying “she’ll be walking soon,” and I bought her a pair of kneepads. And eventually, she did walk.

There is a clear period of time between first steps and walking.

And so it is with COVID.

This week we take a few cautious steps toward a future that does not revolve around the pandemic. We should expect to proceed cautiously. The goal is to move forward. We do not want to rush reopening and have to take a step(s) backward.

Finally… a few weeks before turning two, my daughter decided to actually walk. This picture reminds me that the pandemic will end (my kid did eventually walk), but it is not over yet. We are in the period/space between first steps & walking. Frustration, worry, and fear will not bring the pandemic to an end. We must commit to masking, physical distance, avoiding crowds, handwashing, and getting a vaccine.

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Updated guidance from CDC — This guidance allows for individuals who are fully vaccinated¹ to:

• Gather indoors or outdoors with other fully vaccinated individuals (without masks or physical distancing);

• Gather indoors (no masks or distancing) with another household that is not fully vaccinated as long as those who are unvaccinated are at low risk for severe disease caused by COVID - in other words, grandkids can hug and hang out with vaccinated grandparents (!!!);

• Refrain from quarantine and COVID testing after being exposed to the SARS-CoV-2 virus through a close contact (so longs as they do not have symptoms).

In public, individuals who are fully vaccinated are required to continue to mask, maintain physical distance, and avoid crowds. These requirements are necessary to protect individuals in our communities (including all of our children) who are not vaccinated. While preliminary evidence suggests that fully vaccinated individuals pose little risk of transmitting the SARS-CoV-2 virus to unvaccinated individuals, there is still some level of risk/transmission, and we are still in the middle of the pandemic. We MUST continue to wear our masks in public for the foreseeable future.

Updated guidance from CMS — This guidance allows for visitation in nursing homes. Citing the “psychological, emotional, and physical toll of prolonged isolation and separation from family,” CMS states that visiting family in nursing homes can take place. The guidance notes that outdoor visitation is optimal, but if conditions do not permit an outdoor visit, families can gather indoors as long as masking and physical distance are maintained. CMS includes a long list of suggestions for nursing homes regarding scheduling visits, limiting the number of family members per visit, and pre-visit health screens/COVID testing. As nursing homes begin to allow visitors, communicating with individual facilities about their procedures will be necessary.

In the coming weeks, months, and years -- guidance will change. Expect it.

And please note -- changes are NOT flip-flops. We are adjusting what is allowed/required as we learn more about the virus, variants, and vaccines. Our goal has NOT CHANGED. We want to prevent the spread of the SARS-CoV-2 virus and reduce the number of cases and deaths caused by COVID-19.

1. Fully vaccinated = individuals who have received both doses of either the Pfizer or Moderna vaccine and are at least 14 days post-second dose; or individuals who have received the J&J vaccine and are at least 14 days post-vaccination. NOTE: CDC has gotten rid of the “and within 90 days of the final dose” from its guidance, as immunity lasts at least 6 months after one is fully vaccinated.