CDC Issues New COVID-19 Guidance for Congregate Settings

The Centers for Disease Control and Prevention (CDC) has issued combined COVID-19 guidance documents for sites serving persons experiencing homelessness, correctional and detention facilities, and other congregate community living settings, with updated content reflecting the most recent CDC recommendations. Because “assisted living, group homes, and other residential care settings (excluding nursing homes), have different contexts and needs than homeless shelters and correctional facilities,” the guidance release includes a specific set of considerations for COVID-19 prevention in these settings.

This specific guidance indicates that “facility operators should balance the need for COVID-19 prevention with the impact from reducing access to daily services and programming,” and acknowledges that local resources, facility and population characteristics, and other factors may make it impossible to apply all enhanced COVID-19 prevention strategies. The guidance offers recommendations specific to “facilities that serve unrelated people who live in close proximity and share at least one common room (e.g., group or personal care homes and assisted living facilities)” for assessing and mitigating COVID-19 risk.

Assessing risk

In addition to monitoring their COVID-19 Community Levels, CDC suggests facilities can consider factors that would indicate heightened risk, including the following:

*            A substantial portion of people in the facility who are more likely to get very sick from COVID-19, for example, due to underlying health conditions (including immunocompromise), older age, having certain disabilities, or poor access to care.

*            Facility structural and operational characteristics that might accelerate spread, such as a high volume of outside visitors, poor ventilation, areas where many people sleep close together, or resident population’s ability to adhere to COVID prevention strategies.

*            Active COVID-19 spread occurring in the facility.

Mitigating risk

CDC suggests that congregate settings can consider adopting any of the following enhanced prevention strategies, in addition to implementing the generally recommended prevention steps at each COVID-19 Community Level:

*            Increase and improve ventilation as much as possible and consider moving activities outdoors, when possible.

*            Consult with the health department about testing strategies, including whether to implement routine screening testing.

*            Expand use of masks and respirators.

*            Add enhanced cleaning and disinfection protocols.

*            Create physical distance in congregate areas where possible and/or reduce movement and contact between different parts of the facility and between the facility and the community, as appropriate. FMI: The guidance specific to setting like group homes can be found at <> . An additional guidance document with FAQs is available at: <