Despite recent debates, the Centers for Disease Control and Prevention (CDC) forges ahead with updating its guidelines hospitals use to govern the containment of infectious diseases. A contentious decision was made by experts, including the Healthcare Infection Control Practices Advisory Committee (HICPAC), advising healthcare providers to don masks during routine care for patients suspected to be infectious.
The controversy emerges due to the lack of specifics about the type of masks to be used, with neither surgical masks nor N95 respirators singled out. Advocates for frontline health care workers and immunocompromised patients urged for a strong endorsement for N95 respirators in all patient care situations. However, HICPAC recommended N95 masks only in specific cases such as the spread of new or emerging pathogens without a corresponding vaccine or treatment pathway, or diseases like measles known for their airborne transmission capabilities.
Jane Thomason, a lead industrial hygienist for the largest nursing union in the US, National Nurses United (NNU), criticized the draft recommendations, stating that they disregard the scientific facts about aerosol transmission of diseases and the required respiratory protection. The debate around healthcare mask usage is only one of many discussed during the meeting, where various other draft recommendations were scrutinized. The next steps involve the CDC granting their approval, followed by these updated draft recommendations going on public comment for 60 days before HICPAC reviews them again for potential modifications. The finalized guidelines are expected by 2024. They are not mandatory, but widely followed by many hospitals and are used as a foundation for standards by agencies like the Occupational Safety and Health Administration.
This update to infection control guidelines is the first since 2007. HICPAC has faced several critiques related to updated guidelines with worries about the rollback of some existing infection control measures, and lack of focus on airborne germs spread efficiently via air, and adequate ventilation or indoor air purification methods. The advisory committee’s next steps involve transparency and public engagement, allowing the public to comment on the guidelines. The CDC expressed that the draft recommendations are not legally binding, but a stage of a broader process that includes an extensive public comment period.