While the world still has a long way to go to reach herd immunity, certain aspects of life are slowly beginning to feel more familiar for people who have been vaccinated—including being able to spend time with friends and family again.
Under new guidance from the Centers for Medicare and Medicaid Services (CMS), people with loved ones living in nursing homes can resume in-person visits, with some precautions still in place, once they have been fully vaccinated.
The Updated Guidance
The recently revised guidance applies to people who have been fully vaccinated against COVID-19.
The most notable change to the guidelines pertains to indoor visits, which are now allowable at all times and for all residents—regardless of vaccination status. There are exceptions to the updates, however. For example, if there is a COVID outbreak in the county or if the resident has a confirmed case of COVID-19.
Two weeks after the second dose of the Pfizer-BioNtech or Moderna vaccines Two weeks after the single-dose Johnson & Johnson vaccine
How Facilities Are Adapting
The American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) seem optimistic about the new guidelines. A recent fact sheet from the organizations revealed that roughly 77% of assisted living residents and 37% of staff had received their first dose.
While vaccination makes it safer for residents and visitors to be together, it’s still not without risk. A representative from the AHCA and NCAL says that safety precautions—such as wearing masks, social distancing, and handwashing—should remain the same even with a higher concentration of vaccinated visitors.
According to the representative, the organizations “support the CMS guidance and encourage outdoor activities for residents when possible. Staff recognizes that meaningful and engaging activities are critical for our residents’ health and wellbeing, so they have also been working hard to adapt activities to adhere to infection control best practices—whether indoors or outdoors.”
Precautions Still Needed After Vaccination
Immunologist Robert Quigley, MD, DPhil, FACS, senior vice president and global medical director of International SOS, tells Verywell that while vaccination is a solid first step, it has its limitations.
Vaccines Help, But Risk Remains
“It comes down to risk appetite,” Quigley says. “The guidelines are laid out by the authorities in the very specific context of vaccination of both parties, visitors, and residents themselves. But no matter which vaccine you receive, the vaccines don’t provide sterilizing immunity.”
What the available vaccines do offer is effective immunity—meaning that while you could still contract the virus, you’re less likely to get seriously sick if you do.
However, Quigley says that where there is a possibility of contraction, there is also a possibility of transmission. That means that a person could get infected and become an asymptomatic carrier within one of the country’s most vulnerable populations.
Concerns About Variants
New COVID variants are another concern: According to the CDC, the B.1.1.7 variant (also known as the UK variant) has become the most prevalent strain because of its higher transmission rate.
The COVID-19 vaccines that are currently available were not developed with new variants in mind. Quigley says that there are still too many unknowns to make any safety assumptions. However, research has shown that the vaccines do appear to be effective at reducing the risk of severe illness from the virus.
Wear a Mask and Spread Apart
Quigley says that for now, if you plan to meet with loved ones inside, the best approach is to keep taking the precautions you have been.
“If you are going to visit, apply the principles that we know work, which is wearing a mask, social distancing, and making sure there’s adequate ventilation,” Quigley says. “We don’t want to forget the psychological impact that the pandemic has had on these kinds of relationships. Our loved ones who are sitting in these long-term care facilities are alone, and that’s devastating.”
A Look Inside a Nursing Home
To mitigate the devastating effects of the pandemic, administrators at some facilities in the U.S. have shifted to accommodate the new allowances.
KJ Page, Administrator RN-BC, LNHA, an administrator for Chaparral House, a 49-bed not-for-profit skilled nursing community in Berkeley, California, tells Verywell that since all of its residents have been vaccinated, Chaparral House has allowed visits inside with precautions since mid-March.
“Inside visits with fully vaccinated visitors are unrestricted,” Page says. “They can hug and eat with the residents and hold hands. If the visitor is unvaccinated, they must keep their mask on, with no food or drink, no hugs, and they must maintain social distance.”
Most visits are in communal spaces with tables spaced six feet apart. Small group activities with fewer than eight people have also started up again, with physical distancing enforced.
Once the county’s transmission rate was less than 5%, group visits have been subject to review from the Chaparral House medical director and the City of Berkley Public Health Department.
The facility checks visitors for vaccine cards and places them on a vaccinated safe visitor list, but per the CMS updated guidelines, even unvaccinated visitors can now visit. If neither the resident nor the visitor is vaccinated, the visitor must wear an N95 mask, which the facility provides.
Since it resumed allowing inside visits in mid-March, there have been no known cases of COVID-19 in staff or residents at Chaparral House.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
There are no limits for compassionate care visits, although you will still need to follow safety precautions.
Before you go, talk to your loved one’s facility about what they will allow, as the guidance is dependent on your local area’s risk tier at the time you’d like to visit.
