Box Preventive measures against SARS-CoV-2 for immunocompromised persons, their family members, and close contacts in light of the currently circulating omicron sublineage – United States, January 2023
Because Evusheld is not currently licensed in the United States for pre-exposure prophylaxis against SARS-CoV-2 infection, it is important for people with moderate to severe immunodeficiency, who have had an inadequate immune response to the Covid-19 vaccine, and those who are not. Be careful with contraindications to receiving Covid-19 vaccines and be aware of the need for additional preventive measures to protect themselves from SARS-CoV-2 infection. Immunocompromised people, their family members and close contacts can use the following measures and precautions to prevent SARS-CoV-2 infection and, if they do contract, Covid-19.
Get up-to-date information on Covid-19 vaccines, booster doses*
- Covid-19 vaccines remain the best way to protect against severe COVID-19. Covid-19 vaccines help the body develop immunity against SARS-CoV-2 infection. Although vaccinated people sometimes become infected with SARS-CoV-2, staying up-to-date with their Covid-19 vaccinations can significantly reduce the risk of serious illness, hospitalization or death from Covid-19.
- CDC advises all eligible individuals, especially those with compromised immune systems or immunocompromised† Get updated (bivalent) booster doses and stay up-to-date with Covid-19 vaccines.
Personal covid-19 action plan§
- People need to think about how to protect themselves and others if they get sick with Covid-19 or if the level of transmission of Covid-19 changes. The plan should include:
- Ways to protect yourself and others should be considered during illness, such as finding an isolation room
- Actions to be taken when exposure or disease symptoms occur
- What to do if a positive SARS-CoV-2 test result is received
- People should share their COVID-19 plan with their family, friends, and health care providers so they can support prevention and preparedness measures. The CDC suggests that people consider how others can help them if they get sick. It is important to adhere to treatment plans, keep regular health care appointments and make sure prescriptions are filled. People should make alternative plans for work, childcare, and other responsibilities that can cause stress if they get sick.
Masks or respirators¶
- Masks are designed to contain droplets and particles that people inhale, cough or sneeze. Various masks are available. Some masks provide more protection than others. Wearing a mask properly and comfortably will provide the best protection.**
- Respirators (such as the N95 and NIOSH-approved KN95) provide more protection than masks.†† Respirators are designed to protect people by fitting closely to their faces to filter out particles, including SARS-CoV-2. They can also block droplets and particles that a person breathes, coughs, or sneezes and can pass them on to others. NIOSH approves many types of filtering facepiece respirators. The most commonly available are N95 respirators, but other types (N99, N100, P95, P99, P100, R95, R99, and R100) provide the same or better protection as an N95 respirator.
Physical distance
- Small particles that people breathe out can contain virus particles. The closer a person is to other people, the higher the risk of exposure to SARS-CoV-2. People can reduce their risk of exposure by avoiding crowded areas in the home or by keeping a distance of ≥6 feet (1.8 m) from others. Such actions must be balanced against the risks of avoiding such activities.
Ventilation§§
- Opening windows and doors to bring as much fresh air into the home as possible (weather permitting) improves ventilation.
- Portable high efficiency air cleaners are useful if a home is not equipped with an HVAC system.
- Exhaust fans and other fans can improve airflow.
- In homes where HVAC fan operation may be thermostatically controlled, the fan should be set to the “auto” position when others are visiting. This allows the fan to run continuously, even if the heater or air conditioner is not turned on, while the HVAC system provides continuous air flow and filtration.
Time outside
- Spending time outdoors, rather than indoors when possible, can help reduce transmission. Virus particles spread more easily between people than outdoors.
Hand washing
- Frequent hand washing with soap and water, preferably or using a hand sanitizer containing ≥60% alcohol, can reduce the risk of many diseases, including COVID-19.
Testing for SARS-CoV-2¶¶
- People should be tested if they have symptoms of Covid-19. Viral tests are used for the diagnosis of SARS-CoV-2. There are two types of virus tests, rapid tests and laboratory tests. These tests may use nasal, throat, or saliva samples. If people are aware of SARS-CoV-2 infection, they can take steps to reduce further transmission.
- Free in-home trials *** available. People should check with their health insurance, Medicaid or Medicare to find out what tests are available.††† People with disabilities can get help from the Disability Information and Access Line.§§§ To access the test or to identify an accessible test area.
- People should be aware of free or low-cost testing sites¶¶¶ Those near their homes.
Treatment for covid19****
- People should contact their health care provider, health department or community health center†††† Learn about treatment options. Treatment should be started within 5-7 days after symptoms appear to be effective.
- Community trial to treat areas§§§§ People can find their health care providers if they can’t or don’t have one. These sites provide diagnoses and prescriptions from a health care provider (on-site or telehealth) and dispense medications.
- Antiviral treatments are available for people with mild to moderate symptoms of Covid-19 and who are at increased risk of severe disease, hospitalization and death. If people are sick, they are more susceptible to the disease
- They are aged ≥50 years.
- have a chronic medical condition;¶¶¶ Especially moderate and severe immunity
- They are unvaccinated
- People who are immunocompromised should discuss a treatment plan with their doctor and determine which Covid-19 treatment is best for them. Some people who have a weakened immune system or are receiving immunosuppressive therapy for Covid-19 may benefit from plasma therapy.**
- CDC recommends that people who are immunocompromised with COVID-19 isolate for ≥10 days and consult their health care provider before ending isolation.†††††
Abbreviations: HVAC = Heating, Ventilation and Air Conditioning; NIOSH = National Institute for Occupational Safety and Health.
** People who are deaf or hard of hearing may request a clear mask to help them read lips or see facial expressions. People with sensory or mental and developmental disabilities cannot wear masks and should consider face shields.
†† People with severe respiratory problems (such as mild shortness of breath or supplemental oxygen use) should consult with a healthcare professional about using an N95 respirator. Some N95 respirators may contain latex. People with natural rubber latex allergies should consult the manufacturer’s website for information on specific models.
§§ https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/Improving-Ventilation-Home.html;