Advisers at the U.S. Centers for Disease Control and Prevention (CDC) are expected to approve new draft guidelines for infection control in hospitals this week, marking the first update since 2007. However, healthcare workers are concerned that the guidelines, which suggest that surgical masks are as effective as N-95 masks in preventing the spread of respiratory infections during routine care, prioritize hospital finances over worker health, CNN reported.
The Healthcare Infection Control Practices Advisory Committee plans to conclude a two-day meeting on the proposed updates on Friday. While the new guidelines are not mandatory, they are often adopted, and agencies like the Occupational Safety and Health Administration (OSHA) tend to base worker safety standards on them.
“What they are working on will impact patients and healthcare workers in many different places. It’s going to determine whether some of them live or die, quite honestly,” Jane Thomason, senior industrial hygienist at National Nurses United, told CNN. Thomason is concerned that the guidelines will reduce protections for healthcare workers, despite lessons learned during the pandemic.
A recent study by researchers at Stanford and the University of Southern California in Los Angeles found that more than 4,500 physicians died between early 2020 and December 2021, which was 600 more than expected. “This is a setback,” Dr. David Michaels, an epidemiologist and professor at the George Washington University School of Public Health, told CNN, noting that the guidelines could have benefited from pandemic-era knowledge about respiratory infection transmission.
The CDC committee’s evidence, which suggests that surgical masks are as effective as N95s, is troubling to some experts. “I think what has happened here is that the members of this committee came to us with a bias about how infection control should be applied,” said Michaels, who was part of a group of experts who approached the committee with their concerns in October. “This committee has no members with expertise in worker protection or aerosol science,” said Michaels, who is also the former head of OSHA. “Their view of infection control is hospital-based and hasn’t changed in decades.”
Among the committee members are three individuals who published an editorial in June arguing against universal masking in healthcare settings to prevent the spread of COVID-19. “We have made significant progress in the prevention and management of SARS-CoV-2 since the pathogen was initially identified in 2019,” the editorial in Annals of Internal Medicine stated. “In recognition of these achievements, the time has come to overturn policies that are not appropriate for an endemic pathogen when the expected benefits of such policies are low. Universal masking in healthcare is a policy whose time has come and gone … for now.”
Thomason and National Nurses United have since filed an open records request for summaries of the committee’s work meetings, CNN reported. “From the first meeting, there’s been an orientation toward flexibility and feasibility, focusing on the cost to employers to protect healthcare workers and patients,” Thomason said.
The updated draft guidance states that personal protective equipment is a “critical component in healthcare settings,” but the committee found “no difference” in laboratory-confirmed seasonal respiratory viral infections in workers wearing surgical masks versus N95s. The committee’s vote will be sent to the CDC for approval, although the agency could request additional review. The guidance may be revised again after a 60-day comment period, with the final guidelines expected to be available in 2024.
‘Critics question updated infection control recommendations for hospitals’, CE Noticias Financieras: English (online), 3 Nov 2023 ‹https://infoweb-newsbank-com.ezproxy.sl.nsw.gov.au/apps/news/document-view?p=AWGLNB&docref=news/19516C3FFB901BA0›