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CDC’s recommendations for implementation of

mitigation strategies for Massachusetts, based on 

current situation with COVID-19 transmission

On March 10, 2020, the Governor of Massachusetts declared a State of Emergency to Respond 

to COVID-19. This coincided with the implementation of many interventions aimed at 

community mitigation included in the CDC guidance (https://www.cdc.gov/coronavirus/2019-

ncov/community/index.html). The Governor announced guidance for Executive Branch 

employees in order to prevent and mitigate the spread of COVID-19. 

 

The most recent recommendations from Massachusetts can be found at: 

https://www.mass.gov/resource/information-on-the-outbreak-of-coronavirus-disease-2019-

covid-19

The following describes CDC recommendations for community interventions in Massachusetts. 

Bottom Line Up Front:

At this time, the majority of the cases of COVID-19 are related to a single cluster associated 

with a conference at a hotel in Boston, MA. However, because of the extent of national and 

international travel related to Universities and technological companies in Massachusetts, 

the risk of additional travel-related introductions, and community transmission within large 

local meetings/conferences, of COVID-19 is increased. Due to the current level of COVID-19 

transmission already in Massachusetts, and the likelihood of additional spread, CDC 

recommends certain community mitigation activities to help slow the spread of COVID-19 into the 

community and to protect vulnerable members of the community. CDC recommends the following 

interventions be implemented at this time (Table). These recommendations may be updated, if 

necessary, based on any changes in the current local situation. 

The goals for using mitigation strategies for Massachusetts are to reduce the spread of COVID-19 in the 

community and to protect:

• Individuals at increased risk for severe illness, including older adults and persons of any age with 

underlying health conditions (See Appendix A). 

• The healthcare workforce and critical infrastructure workforces

These approaches are used to minimize morbidity and mortality caused by COVID-19 and minimize 

social and economic impacts of COVID-19. Individuals, communities, businesses, and healthcare 

organizations are all part of a community mitigation strategy. 

Implementation emphasizes:

• Emphasizing individual responsibility for implementation of recommended personal-level actions, 
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• Empowering businesses, schools, and community organizations to implement recommended actions,

particularly in ways that protect persons at risk of severe illness such as older adults and persons with

serious underlying health conditions (e.g., Dialysis patients, congestive heart failure, emphysema)

• Focusing on settings that provide critical services to implement recommended actions to protect

critical infrastructure and individuals at risk of severe disease

• Minimizing disruptions to daily life to the extent possible

For Every Individual 

and Families at Home

• Monitor local information about COVID-19 in your community.

• Know the signs and symptoms of COVID-19 and what to do if you become

symptomatic.

• Practice personal protective measures (e.g., hand washing).

• Create a household plan of action (https://www.cdc.gov/coronavirus/2019-

ncov/downloads/community-mitigation-strategy.pdf)

• Know about emergency operations plans for schools/workplaces of household

members.

• Individuals at risk of severe illness should considering staying at home and avoiding

gatherings or other situations of potential exposures, including travel, church

attendance, social events with 10 or more people.

For Every 

School/Childcare

Facility 

• Monitor local information about COVID-19 in your community.

• Know the signs and symptoms of COVID-19 and what to do if students or staff become

symptomatic at school/childcare site.

• Review and update emergency operations plan (including implementation of social

distancing measures) or develop plan if one is not available.

• Students at increased risk of severe illness should consider implementing individual

plans for distance learning (e-learning).

• Short-term dismissals for school and extracurricular activities as needed (e.g., if cases

in staff/students) for cleaning and contact tracing.

For Every Assisted 

Living Facility, Senior 

Living Facility, and 

Adult Day Programs 

• Know the signs and symptoms of COVID-19 and what to do if clients/residents or staff

become symptomatic.

• Review and update emergency operations plan (including implementation of social

distancing measures) or develop a plan if one is not available.

• Encourage personal protective measures among staff, residents and clients who live

elsewhere (e.g., stay home or in residences when sick, handwashing, respiratory

etiquette).

• Clean frequently touched surfaces daily.

• Ensure hand hygiene supplies are readily available in all buildings.

• Consider temperature and respiratory symptom screening of attendees, staff, and

visitors.

• Consider restricting visitors to long-term care facilities.

Table. Community mitigation strategies for Massachusetts

Community Mitigation strategies
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Every Workplace • Use extensive telework and use of e-meetings to conduct business.

• Cancel work-sponsored conferences, tradeshows, etc.

• Review possible alternative work assignments for employees who are at high 

risk for severe disease (see appendix A)

• Review, update, or develop workplace plans to include liberal leave and telework 

policies. 

o Consider 7-day leave policies for people with COVID-19 symptoms

o Consider alternate team approaches for work schedules.

o Encourage staff to telework (when feasible), particularly individuals at 

increased risk of severe disease.

• Work with all local employers to ensure all workers have the financial support to stay 

home with any respiratory symptoms

• Encourage personal protective measures among staff (e.g., stay home when sick, 

handwashing, respiratory etiquette).

• Clean and disinfect frequently touched surfaces daily. 

• Ensure hand hygiene supplies are readily available in building.

• Limit large work-related gatherings (e.g., staff meetings, after-work functions).

• Cancel non-essential work travel. 

Every Community and 

Faith-Based 

Organization

• Enforce limited numbers of persons on public transportation trains and buses.

• Encourage persons who have underlying conditions or are older to use alternatives 

to public transportation if feasible.

• Cancel large gatherings (e.g., >250 people), and smaller gatherings that may bring 

persons together from multiple parts of the country.

• For gatherings that are smaller and not cancelled, conduct screening of persons 

attending.

• Monitor local information about COVID-19 in your community.

• Know the signs and symptoms of COVID-19 and what to do if organization 

members/staff become symptomatic.

• Determine ways to continue providing support services to individuals at increased risk 

of severe disease (services, meals, checking in) while limiting group settings and 

exposures. 

• For organizations that serve high-risk populations, consider cancelling gatherings of 

more than 10 people.

• Encourage staff and members to stay home and notify organization administrators of 

illness when sick. 

• Encourage personal protective measures among organization/members and staff (e.g., 

stay home when sick, handwashing, respiratory etiquette).

• Clean frequently touched surfaces at organization gathering points daily. 

• Ensure hand hygiene supplies are readily available in building.
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Healthcare Settings 

and Healthcare 

Providers (Including

Outpatient, Nursing 

Homes/Long-Term 

Care Facilities, 

Inpatient, Telehealth) 

• Promote telemedicine practices to support rural communities.

• Consider reducing schedule of elective procedures.

• Implement triage before entering facilities (e.g. parking lot triage, front door); phone 

triage and telemedicine; limit unnecessary healthcare visits

• Encourage HCP to stay home and notify healthcare facility administrators when sick. 

• Actively monitor HCP absenteeism and respiratory illness among HCP and patients. 

• Consider implementing temperature/symptom checks for staff, visitors, limit visitor 

movement in the facility. 

• Actively monitor PPE supplies

• Establish processes to evaluate and test large numbers of patients and HCP with 

respiratory symptoms (e.g. designated clinics for people with fever, surge tent for 

overflow triage, offsite testing locations) 

• Cross train HCP for working in other units to support staffing shortages

Appendix A: Underlying medical conditions that may increase the risk of serious COVID-19 for 

individuals of any age. 

• Blood disorders (e.g., sickle cell disease or on blood thinners)

• Chronic kidney disease as defined by your doctor. Patient has been told 

to avoid or reduce the dose of medications because kidney disease, or is 

under treatment for kidney disease, including receiving dialysis

• Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic 

hepatitis) Patient has been told to avoid or reduce the dose of 

medications because liver disease or is under treatment for liver 

disease. 

• Compromised immune system (immunosuppression) (e.g., seeing a 

doctor for cancer and treatment such as chemotherapy or radiation, 

received an organ or bone marrow transplant, taking high doses of 

corticosteroids or other immunosuppressant medications, HIV or AIDS) 

• Current or recent pregnancy in the last two weeks 

• Endocrine disorders (e.g., diabetes mellitus) 

• Metabolic disorders (such as inherited metabolic disorders and 

mitochondrial disorders)

• Heart disease (such as congenital heart disease, congestive heart failure 

and coronary artery disease)

• Lung disease including asthma or chronic obstructive pulmonary 

disease (chronic bronchitis or emphysema) or other chronic conditions 

associated with impaired lung function or that require home oxygen
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• Neurological and neurologic and neurodevelopment 

conditions [including disorders of the brain, spinal cord, peripheral 

nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), 

stroke, intellectual disability, moderate to severe developmental delay, 

muscular dystrophy, or spinal cord injury].