In the face of intense scrutiny and protest, the US Centers for Disease Control and Prevention (CDC) is persevering with its procedure to revise the guidelines that hospitals use to regulate the spread of infectious diseases. The Healthcare Infection Control Practices Advisory Committee (HICPAC), the expert body advising the CDC on hospital infection control guidelines, has voted in favor of recommending healthcare providers to wear masks during routine patient care if the patients are believed to be contagious.
This draft recommendation does not dictate the type of mask to be worn. It has, however, sparked displeasure among frontline health care workers and immune-compromised patient advocates who were hopeful of a strong endorsement for using N95s in all patient-care situations. The HICPAC did, on the other hand, recommend the use of N95s for patients infected with new or emerging pathogens without available vaccines and treatments, and for diseases that spread efficiently over long distances.
The largest nursing union in the US, National Nurses United (NNU), criticized the draft for treating surgical and medical masks as personal protective equipment. They believe these types of masks do not offer protection against infectious aerosols and have urged the CDC to consider the scientific evidence on aerosol transmission of infectious diseases while forming infection prevention guidance.
The controversial mask recommendation is part of a suite of draft recommendations for controlling infections in healthcare settings. But these are still drafts; they will proceed to the CDC for approval next. After receiving CDC’s approval, they will be published in the Federal Register for public comment. The final version of the guidelines, which are potentially to be used by hospitals and agencies like the Occupational Safety and Health Administration, isn’t expected until 2024.
The pressures of the Covid-19 pandemic, reality of long covid, and fears for future pandemics have brought this revision under the microscope. Some critics have raised concerns over the draft guidelines’ sparse mention of ventilation or strategies to clean indoor air, while the NNU President Zenei Triunfo-Cortez labelled the draft as ‘weak’ and feared it could exacerbate the challenging conditions for health care workers.
The advisory committee is striving to refine and simplify the previous document by incorporating findings from new reviews of medical literature conducted by the CDC. Despite the overwhelming encouragement to delay the vote to hear from vulnerable patients and experts, all nine voting members of the committee approved the recommendations at this meeting. There is still hope though, with the CDC assured the public they will have a chance to comment on the guidelines in the coming months.