By Noah Weiland
WASHINGTON — The Biden administration published revised guidelines Wednesday for nursing home visits during the coronavirus pandemic, allowing guests to go inside to see residents regardless of whether they or the residents have been vaccinated.
The recommendations, released by the Centers for Medicare and Medicaid Services with comment from the Centers for Disease Control and Prevention, are the first revision to the federal government’s nursing home guidance since September. And they arrived as more than 3 million vaccine doses had been administered in nursing homes, the agency said.
Federal officials said in the new guidance that outdoor visits were still preferable because of a lower risk of transmission, even when residents and guests have been fully vaccinated.
The guidance was also the latest indication that the pandemic in the United States was easing, with coronavirus cases continuing to decrease across the nation, though the seven-day average remains at more than 58,000. The CDC released long-awaited guidance Monday for Americans who have been fully vaccinated, telling them that it was safe to gather in small groups at home without masks or social distancing.
About 62.5 million people have received at least one dose of a COVID-19 vaccine, including about 32.9 million people who have been fully vaccinated by Johnson & Johnson’s single-dose vaccine or the two-dose series made by Pfizer-BioNTech and Moderna.
In a statement laying out the reasons for updating the recommendations, Dr. Lee A. Fleisher, the chief medical officer at the Centers for Medicare and Medicaid Services, cited the millions of vaccines administered to nursing home residents and staff and a decline in coronavirus cases in nursing homes.
“CMS recognizes the psychological, emotional and physical toll that prolonged isolation and separation from family have taken on nursing home residents and their families,” he said.
Earlier in the pandemic, the coronavirus raced through tens of thousands of long-term care facilities in the United States, killing more than 150,000 residents and employees and accounting for more than a third of all virus deaths since late spring. But since the arrival of vaccines, new cases and deaths in nursing homes have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data.
The eight pages of recommendations, which are not legally binding, did come with suggested limits, saying that “responsible indoor visitation” should be allowed at all times unless a guest is visiting an unvaccinated resident in a county where the COVID-19 positivity rate is higher than 10% and less than 70% of residents in the nursing home have been fully vaccinated. The guidance also says to limit visits if residents have COVID-19 or are in quarantine.
So-called compassionate care visits — when a resident’s health has severely deteriorated — should be allowed regardless of vaccination status or the county’s positivity rate, the guidance said.
When a positive case is identified in a nursing home, visits should be halted and residents and staff tested, the guidance said. Visits can resume in other parts of the facility if there are no positive tests there, but if cases are discovered in other areas, nursing homes should suspend all visits.
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