COVID-19 and Patient Safety in the Medical and Dental Office

In May 2023, the federal Public Health Emergency declaration for SARS‑CoV‑2 officially ended. Nevertheless, as we enter our seventh year of living with the evolution of COVID‑19 in the U.S., measurable impacts of the virus continue to span all sectors of healthcare. Recent national surveillance data indicates that COVID‑19 activity, while significantly lower than early‑pandemic peaks, continues. As of the week ending April 11, 2026, CDC surveillance reported a 1.7 percent test positivity rate, with 0.2 percent of emergency department visits attributed to COVID‑19 and a hospitalization rate of 0.4 percent per 100,000 population. As of the week ending in April 4, 2026, COVID‑19 accounted for 0.3 percent of all U.S. deaths. Globally, SARS‑CoV‑2 circulation remains low but stable. Considering ongoing viral activity, medical and dental practices must maintain vigilance by monitoring emerging variants, fluctuating infection rates, evolving vaccine recommendations, clinical protocols, and the availability of local public health resources.

According to the CDC’s “Variants and Genomic Surveillance,” “SARS-CoV-2, the virus that causes COVID-19, is constantly accumulating mutations in its genetic sequence over time. These mutations can result in new variants with different traits. New variants of SARS-CoV-2 are expected to continue to emerge. Some variants will emerge and disappear, while others will emerge and continue to spread and may replace previous variants.” As new variants manifest, the rate of hospital admissions rises and falls in different regions. The potential always exists for community transmission to surge and for hospital beds to be in short supply once again. As of spring 2026, the CDC’s data does not indicate increased transmission or severity compared to earlier pandemic strains. For currently circulating variants, see “What COVID Is Going Around Right Now: Variants & Symptoms” and “Early Detection and Surveillance of the SARS-CoV-2 Variant BA.3.2.”

Practices should continue to protect patients and staff members by consistently adhering to CDC “Infection Control Guidance: SARS-CoV-2.” They should remain mindful that three circulating respiratory viruses—SARS-CoV-2, RSV, and the flu—may be seen within their office settings concurrently. Understanding the differences between the three viruses will help ensure a precise differential diagnosis. See our article “Flu, RSV, or COVID-19? Reducing Diagnostic Errors” for additional strategies.

As communities around the country continually face COVID-19 infections, what are the latest considerations for safety within medical and dental office settings? Consider the strategies presented in this guide.

Mask Requirements

The CDC lifted its recommendation for mandatory universal masking in all healthcare settings in September 2022. Except in rare circumstances, medical and dental practices followed suit. With the recent rise of highly mutated COVID-19 variants, some facilities have reinstated mandatory masking based on local transmission rates. (Check the CDC’s “Surveillance and Data Analytics” for the status of variant metrics in the United States.) Given the potential for newer variants to lead to a significant wave of COVID-19 over the next year, medical and dental practices should remain attentive to infection rates within their local jurisdictions.

If masking is required in your community or clinical setting, practice staff members who make in-office patient appointments will need to communicate expectations to patients that they follow established infection-control protocols prior to patients’ arrival in the office. It is also important to post signage on the entrance door and on the practice’s website.

For patients who are sick, immunocompromised, and in close proximity to one another, wearing masks continues to be clinically prudent. Have masks available for these patients.

Vaccination Trends and Considerations

According to the CDC’s "COVIDVaxView," vaccination rates across the U.S. have declined significantly over the past two years as restrictions have been lifted. The “Weekly COVID-19 Vaccination Dashboard” for April 15, 2026, reports that among adults 18 years and older, “As of February 22, 2026, 17.5% (95% Confidence Interval: 17.1%–18.0%) of adults reported having received the 2025–26 COVID-19 vaccine.” According to the CDC’s “National Immunization Survey—Fall Respiratory Module,” 8.6 percent of adults reported that they “definitely” will get a vaccine. (Vaccination coverage varied by age, disability status, health insurance status, poverty status, race and ethnicity, sex, sexual orientation, urbanicity, and jurisdiction.)

Several factors have contributed to the recent decline in COVID-19 vaccination rates. These include concerns about potential vaccine complications—particularly myocarditis—reduced community transmission, skepticism about the vaccine’s effectiveness, individual health status and age, the perceived lower severity of current variants, political and religious affiliation, and a broader distrust of the federal government.

Should a surge in community transmission rates occur, vaccination rates may increase. Depending on the medical or dental specialty and patient type, patient visits may increase or decrease accordingly, and practices should consider returning to policies that were in effect before vaccinations became available. These include the use of telehealth, curbside visits, preexamination questions and screening, masking by patients and staff members, physical distancing, and disinfecting patient care areas frequently. An additional option is designating one exam room to be used exclusively for the treatment of COVID-19 patients by clinicians wearing personal protective equipment (PPE), while maintaining rigorous screening for patients entering the facility.

Vaccine Administration

The following recommendations will assist in vaccine administration and management:

• Updated Vaccines: In August 2025, the FDA updated COVID-19 vaccines to target the LP.8.1 strain and the JN.1 Omicron subvariant, which is closely related to the prevalent XFG (Stratus) variant, with continued emphasis on boosters for high-risk populations. (See the CDC’s “Variants and Genomic Surveillance” for the latest variant guidance.) For vaccine-specific information, including dosing, see the CDC’s “Coronavirus Disease 2019 (COVID-19) Vaccine Safety“ and “Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States.”
• Informed Decision Making: On October 6, 2025, the CDC adopted individual-based decision making for COVID-19 vaccines, with recommendations for the provision of informed consent discussions. In addition, some local pharmacies in some states now require a prescription for COVID-19 vaccine administration. See the CDC’s “2025–2026 COVID-19 Vaccination Guidance” and the American Academy of Pediatrics COVID-19 website. Medical and dental practices should implement plans to educate patients and guide them to an informed decision about the vaccines available within their community. Vaccine fact sheets for recipients and caregivers are available through the Immunize.org “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.” The CDC also provides easy-to-understand information for patients on its website: “Benefits of Getting Vaccinated.”
• Vaccine Administration: If your practice administers COVID-19 vaccines, establish policies and procedures for storage and inventory, patient screening and scheduling, patient education, documentation, patient follow-up, and managing medication errors and emergencies. The CDC provides guidance on vaccine administration, vaccine storage and handling, and COVID-19 vaccination training programs and reference materials for healthcare professionals, as does the World Health Organization (WHO) through its online training.

Ongoing Screening and Management

The following recommendations will assist in ongoing screening and management of suspected COVID-19 patients in your practice:

• Legislation and Guidance: Consult the CDC, your state licensing board, and professional societies, as well as federal, state, and local authorities for public health guidance and new legislation. Monitor for outbreaks of COVID-19 cases within your community. Stay on top of current trends to protect your patients and your practice.
• Infection Control Protocols for the Office Setting: The CDC’s updated “Infection Control Guidance: SARS-CoV-2” provides specific instructions for healthcare settings (medical and dental).
• Screening Criteria: Follow a screening process for those entering your office setting. Assess visitors to your facility for symptoms and contact exposure and direct them to remain outside if COVID-19 infection is suspected.
• Differentiating Between the Flu, RSV, and COVID-19: The flu, RSV, and COVID-19 are all respiratory illnesses that can present with similar symptoms. For further guidance, see our article “Flu, RSV, or COVID-19? Reducing Diagnostic Errors.” Check the CDC’s “Respiratory Illnesses Data Channel” to view community trends for these three viruses.
• Accepting Patients: It is strongly recommended that practices not turn away patients who are not fully vaccinated or simply because a patient calls with acute respiratory symptoms. Triage all patients over the phone or via telemedicine and manage them according to CDC recommendations. Refusing assessment/care may lead to concerns of patient abandonment.
• Telehealth Triage: Should we experience a return to COVID-19 variants with very high transmission rates and severity of infection, the CDC may again recommend alternatives to face-to-face triage and visits, particularly for high-risk patients, if screening can take place over the phone, via telemedicine, through patient portals or online self-assessment tools, or through a designated external triage station. Licensed staff members should be trained in triage protocol to assess which patients can be managed safely at home versus those who need to be seen at the office or at a designated community facility. The Doctors Company offers resources on telehealth. For a list of telehealth COVID-19 rules by state, see the Federation of State Medical Boards (FSMB) document, “U.S. States and Territories Modifying Requirements for Telehealth in Response to COVID-19.”
• Designated Triage Location: To limit exposure in your facility should transmission levels become very high, check with your local public health authorities for locations designated to triage patients with suspected COVID-19 infections. Community emergency preparedness plans would be activated so that parties are coordinating efforts to deliver effective public health interventions.
• Patient Testing: Medical and dental practitioners should determine which patients require testing based on presenting symptoms, history, contact exposure, and community transmission of disease, factoring in special considerations for settings such as schools and nursing homes. See the CDC’s “Testing for COVID-19.” Reporting COVID-19 cases is no longer mandatory in most locations except under certain circumstances, such as work-related transmission under the Occupational Safety and Health Administration (OSHA). Check with your local health department and the CDC website for current requirements.
• Elective Services: If cases of COVID-19 trend significantly upward within your community, check with regional health authorities on the provision of nonessential and elective healthcare visits and group-related activities. States and counties vary in their guidelines depending on the number of cases, availability of PPE, and availability of hospital beds. Some states may reinstate restrictions on the provision of nonurgent, elective surgeries and procedures. (See the FSMB’s “COVID-related Legislation.”) In some states, violations may result in fines or complaints to the medical or dental board. Check with state and local regulatory agencies for any related mandates.
• Office Messaging: If local transmission rates become high, screen patients prior to visits using screening questionnaires via texts and/or emails. For those exhibiting symptoms of COVID-19, consider scheduling a telehealth visit. Post entry-door signage requiring patients and visitors who are exhibiting COVID-19 symptoms or who have had recent contact exposure to immediately notify facility personnel by telephone for instructions on accessing care. (See the CDC’s “Symptoms of COVID-19.”) Include information on the practice website regarding office policies for appointments, telephone assessment / telemedicine, and visitors. Also, post COVID-19 resources for patients with a reminder to maintain physical distance, wear a face mask if exhibiting symptoms of cough, and follow local orders to lessen community spread.
• Physical Distancing: The CDC continues to recommend physical distancing to lessen the transmission of respiratory viruses. Encourage patients and staff members to sit at least six feet or more apart and reconfigure seating as needed.
• Limit Exposure: Limit staff exposure to suspected COVID-19 patients by keeping the exam room door closed. Ideally, the designated exam room should be at the back of the office, away from other staff members and patients. Appropriate PPE should be worn.
• Surface Disinfection: Disinfect surfaces once the patient exits the room. Ensure that participating staff members continue to wear PPE. For information about cleaning agents, see the Environmental Protection Agency’s “About List N: Disinfectants for Coronavirus (COVID-19).”
• Dental Office Considerations: The CDC’s latest recommendations apply to all healthcare settings, including dentistry. When transmission rates are high, screen patients for coronavirus symptoms and postpone nonurgent dental care if the patient has tested positive at home or is symptomatic for COVID-19. Urgent febrile patients may be seen if the fever is suspected to be due to a dental condition, but the dentist should make this determination. Continue to follow the most current PPE guidelines, as defined by the CDC and OSHA’s directions for protecting workers. Periodically review state health department COVID-19 guidance and county infection rates. Devices such as ultrasonic scalers, high-speed dental handpieces, and air/water syringes produce aerosols during use, creating additional exposure risk for clinicians. The CDC recommends additional precautions, such as four-handed dentistry, high-evacuation suction, and the use of dental dams during these procedures to reduce the risk of droplets. Participating staff members should wear NIOSH-approved N95 masks or higher-level respirators in areas with high rates of coronavirus transmission. Review the CDC’s “Best Practices in Dental Infection Prevention and Control.”
• Patient Education: Refer to CDC resources for providing suspected COVID-19 patients and their close contacts with up-to-date information about the virus. Provide information about how to follow infection-control practices at home, such as in-home isolation and quarantine, hand hygiene, cough etiquette, waste disposal, and the use of masks. Remind patients and their families to access information about the virus through reputable sources such as the CDC, not through social media.
• Provider/Staff Exposure and Vaccination: Discuss vaccination with office staff and screen for symptoms/contacts relevant to COVID-19. Any unprotected occupational exposure by staff members should be assessed, monitored, and documented in administrative files. Per OSHA, COVID-19 can be a recordable workplace illness if an employee is infected because of performing work-related duties. See also the CDC’s “Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2.” Per the CDC, “In general, asymptomatic healthcare personnel (HCP) who have had a higher-risk exposure do not require work restriction, regardless of vaccination status, if they do not develop symptoms or test positive for SARS-CoV-2.”
• Staff Training: Assess the need for additional staff training to review screening and triage protocols, patient management, use of PPE, patient communications, and any revision in policies and procedures that have been made to adapt to the evolution of the virus. Document all training provided to staff and maintain records in administrative files.
• Team Briefs: Conduct daily staff briefs/huddles and end-of-day debriefs. These provide all staff members with opportunities to discuss issues anticipated or encountered during the day and identify concerns, pre- and post-clinic, including COVID-19 updates. (See the Agency for Healthcare Research and Quality’s TeamSTEPPS® tools.)

Administrative Recordkeeping

Document administrative records of community transmission rates, current protocols, and updated policies followed by your office. Content may include records of PPE supplies/shortages, cleaning protocols followed, communications with patients, case incidence, and available medical and dental resources within your community. Documentation that you have taken steps to follow recommended infection-control protocols may be your best defense if litigation related to COVID-19 should occur in the future.

Managing Legal Risks

According to the WHO, the influx of variants in the U.S. will continue to present unique challenges. Government authorities in some states may mandate additional restrictions of public activities, while other states will likely maintain unrestricted business operations. Medical and dental offices will continue to face challenges as they provide “catch-up” care for patients who postponed care because of fear and as they implement ongoing CDC recommendations for practice operations, vaccinations, and managing sick employees.

Liability becomes a concern for healthcare practitioners if treatment of patients without COVID-19 is delayed due to hospital and emergency room conditions. Invariably, the question becomes, “Did the hospital comply with community standards regarding access and delivery of services?” Following an adverse event—when plaintiff’s counsel would attempt to prove that the facility failed to follow what other similarly situated medical centers did in the same or similar situations—much would depend on whether the hospital complied with CDC guidelines and executive orders then in effect.

The bottom line: Even with the availability of the vaccine and lower transmission rates, medical and dental practices must not become complacent or be less vigilant. Because the virus continues to be a moving target, all healthcare practitioners and facilities must remain well-informed and current on public health guidance for screening protocols and patient management, as well as regulatory requirements affecting their practices. Continued careful screening of respiratory illness with a bias for suspicion that a patient might have COVID-19 will serve healthcare practitioners well. We emphasize that the key to future litigation defense is keeping office policies and procedures current while following recommended guidelines and documenting adherence (in both administrative files and medical and dental records).

The dynamics surrounding the virus will continue to evolve, particularly with the spread of variants and as the population’s vaccination status fluctuates. What does not change is that healthcare practitioners and care teams must remain watchful and adapt their practices accordingly. Remain exceptionally proactive in asking the right questions, documenting interactions, rigorously following protocols, and keeping abreast of emerging insights and data as they become available from the CDC.

Additional Guidance

If you need help or have additional questions, contact Patient Safety and Risk Management at (800) 421-2368 or by email.