November 2024 CDC HICPAC Public Comment
CDC aims to roll back infection control, public comments on masking in healthcare and strengthening infection control still open until Fri. Nov. 22
Last week, I had the opportunity to give oral public comment at the CDC’s Healthcare Infection Control Practices Advisory Committee meeting on Nov. 14. My comment continues to support universal masking in healthcare and broad use of N95 respirators. There is still time make your written comment to HICPAC by Nov. 22 at HICPAC@cdc.gov.
Despite years of advocacy for strengthening infection control from National Nurses United, along with other groups and many individual advocates, the committee concluded this meeting with votes that continued their denial of the physics of aerosol transmission. The committee continues to perpetuate the dangerous claim that surgical masks (rather than respirators) are adequate protection for certain aerosol-transmitted pathogens under the proposed “Routine Air Precautions” category, based on a flawed analysis of the scientific evidence. Despite public comments overwhelmingly in favor of broadly enhancing infection control, including using N95 respirators for all aerosol-transmitted pathogens and recommending universal masking in healthcare year-round, the committee voted to continue on their path toward weakening infection control in their forthcoming update to the Isolation Precautions Guideline.
The committee also voted to shorten quarantine for healthcare workers exposed to COVID and isolation for healthcare workers who test positive for COVID, with rollback of isolation to a minimum of 3 days, shortened drastically from the previous recommendation of 10 days. This rollback in isolation will undoubtedly be used to push COVID-positive healthcare workers back to work while they are still contagious, putting fellow healthcare workers and patients at risk. Healthcare workers need strong isolation guidelines and paid sick leave to isolate, rest, and recover.
There is still time to submit comments to demand universal masking, broad use of N95 respirators, and a multilayered approach to stronger infection control. You can use People’s CDC’s template letter or talking points to make your comment to HICPAC by Nov. 22 at HICPAC@cdc.gov.
The text of my oral comment, also submitted in writing, is below. Video recordings for each day of the meeting can be found as follows: Thursday Nov. 14 (public comment begins at about 9:14:14, with my comment at about 9:31:45) and Friday Nov 15 (public comment begins at about 3:09:16).
My name is Kaitlin Sundling, and I am an MD-PhD physician-scientist and pathologist in Wisconsin. I have no conflicts to disclose. I am a volunteer with People’s CDC and Wisconsin Community Health Action, although I am not speaking on behalf of any group. I am commenting in support of universal masking and strengthening infection control policies.
Infection control begins with the basic assumption that infections are worth preventing. Healthcare workers need strong guidelines from the CDC to ensure best practices are followed. I hope we can all agree that it should not be up to individual healthcare workers to decide whether handwashing is needed, whether exam rooms should be clean, or whether gloves should be worn during procedures. Masking is no different.
This committee needs to decide: is aerosol transmission a personal belief or a scientific fact? All healthcare settings pose risks of aerosol-transmitted infectious diseases, such as tuberculosis, COVID, seasonal influenza, avian influenza, measles, and so on.
Many healthcare settings have implemented fall-winter universal masking, without adverse impacts to operations. COVID spreads year-round, and year-round universal masking as a standard precaution is the only sensible solution to prevent healthcare acquired infections. Masking should not only be a reactive approach that comes after preventable exposures have already occurred.
Mask bans have been enacted in multiple locations, creating a dangerous situation for our communities. Meanwhile, healthcare crisis standards enacted during PPE shortages risk becoming permanent policies. This committee must formally address the very real instances where healthcare workers and patients have not been allowed to wear respirators, and where healthcare policies have been used to deny patient requests for staff to wear respirators.
As the foremost authority on infection control, you have the opportunity to combat stigma and misinformation about masking by recognizing the need for universal masking in healthcare and that respirators, at minimum N95, are the ONLY appropriate respiratory protection against aerosol-transmitted pathogens.
Regarding the Healthcare Personnel guidelines, shortening COVID isolation for healthcare workers would put both patients and workers at risk. In May 2024, the People’s CDC submitted a letter to the CDC with over 400 expert signatures supporting that COVID positive workers must isolate at home for at least 7-10 days and should test negative before returning in-person.
Universal masking in healthcare with broad use of N95 respirators is necessary for safe patient care and workforce protection. Please use your authority to strengthen infection control using a multilayered precautionary approach.
Thank you.