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COVID-19: Community Levels Framework; Accessibility Plan

The Centers for Disease Control and Prevention (CDC) on Feb. 25 announced a new COVID-19 community levels framework to measure the risk a community faces from COVID-19 and provide corresponding mitigation strategies.

Previously, CDC guidance stratified infection prevention and control measures using community transmission risk, a metric calculated by the number of new cases per 100,000 people in the past seven days, as well as the percentage of positive nucleic acid amplification tests during the last seven days.

The new community levels consider a combination of three metrics:

  • new COVID-19 hospitalizations per 100,000 people in the past seven days;
  • a seven-day average percentage of staffed inpatient beds occupied by COVID-19 patients; and
  • new COVID-19 cases per 100,000 people in the past seven days.

The agency will publish community-level data every weekday on its county tracker.

The low community level indicates limited effect on the health care system and less occurrence of severe disease in the community. At this level, CDC directs individuals to stay up-to-date on vaccines against COVID-19 and get tested if they are sick. At the medium level, CDC recommends high-risk individuals, including those who are immunocompromised, should talk to their health care provider about taking additional precautions and may choose to wear a mask. At the high level, which indicates high rates of severe disease and significant strain on the health care system, CDC recommends everyone wear a mask indoors and in public, including in schools.

With this guidance, the agency also withdraws its previous guidance for universal masking in schools and now requires masking only in jurisdictions at the high community level. The agency is in the process of updating its guidance for COVID-19 prevention in K–12 schools.

As of Feb. 25:

  • 23 percent of counties are at low;
  • 39.6 percent of counties are at medium; and
  • 37.3 percent of counties were at high levels.

The agency urges communities to use these metrics in combination with their own local metrics, such as wastewater surveillance, emergency department visits, and workforce capacity, to shape their local policies and ensure equity and prevention efforts.

Notably, community levels do not apply in health care settings, including hospitals and nursing homes. These facilities should continue to follow CDC’s infection prevention and control recommendations for health care settings, which still use community transmission levels to shape infection control and prevention measures.

Biden Administration COVID-19 Mitigation Plan for Individuals with Disabilities

The Biden administration on Feb. 24 announced new plans to improve access to COVID-19 testing, masks, and other mitigation strategies for people with disabilities. These initiatives include:

  • working with the Department of Education and CDC to develop strategies for safe, in-person education and provide resources through local regional parent training and information centers;
  • using the Department of Health and Human Services Administration for Community Living’s Disability Information and Access Line to support people with disabilities who face difficulty using or cannot use a self-test;
  • issuing new COVID-19 testing guidance in American Sign Language and reviewing existing COVID-19 guidance to ensure accessibility;
  • working with the National Institutes of Health’s RADx program to develop more accessible at-home COVID-19 tests;
  • publishing a request for information asking COVID-19 test manufacturers to prioritize the accessibility of at-home tests for people who are blind or visually impaired; those with physical, cognitive, or other disabilities; and individuals who need non–English language or literacy support;
  • requesting that all test developers who received Food and Drug Administration emergency use authorization for a COVID-19 test provide accessible, Americans with Disabilities Act–compliant instructions; and
  • encouraging states and jurisdictions to distribute masks through organizations serving individuals with disabilities.

FDA List of Over-The-Counter COVID-19 Tests

The Food and Drug Administration (FDA) on Feb. 22 published a list of authorized over-the-counter COVID-19 tests. The list includes the manufacturer and test name and type, as well as symptoms and ages for which each test is authorized. To date, FDA has authorized 17 tests for at-home use.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the pandemic.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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