Public Comment to CDC Infection Control: Universal Masking Must Become a Routine Standard in Healthcare
N95 respirators are a well-proven standard to prevent transmission of infections in healthcare
A version of this comment was delivered via Zoom at CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) meeting on June 8, 2023.
The written text of my comment is included below.
Many others from
and other groups voiced their support of improved infection control protections for airborne pathogens. Watch the recording of the public comments from the meeting below.Please also refer to my public comment to Medicare for references and additional actions. (Public comment to Medicare is due today, Friday June 9, by 11:59 Eastern time - so don’t wait!).
I am Kaitlin Sundling, an MD-PhD physician scientist, pathologist, and assistant professor in Madison, WI. I’m a volunteer with the People’s CDC.
I have not been able to safely work in a hospital environment due to the loss of universal masking in non-patient care areas over a year ago. Now patient care masking has been dropped as well. I have multiple high risk and immunocompromised family members, and they are not able to safely access care. Members of our community, find that they must beg their healthcare providers to mask, and even then they are moving through crowded waiting areas and other shared spaces with no masking requirements in order to get necessary care.
Airborne is airborne - there is no physical basis for variable distances of airborne transmission for different pathogens. COVID is airborne and can be transmitted by patients and healthcare workers who are asymptomatic (without any symptoms). Healthcare facilities must require universal masking, and ideally N95 respirators, for everyone in these settings.
The proposal for 3 different levels of “air precautions” is inappropriate and dangerous. It is shocking to suggest that we need more studies to know whether N95 respirators are effective against an airborne pathogen. The science of N95 respirators is well-established and based on physical properties, engineered filter materials, and our scientific understanding of how airborne transmission works—it’s not based on clinical trials. N95 respirators have a great advantage in both providing respiratory protection to the wearer as well as providing excellent source control. Fit testing should be provided for all workers in the healthcare setting. We do not need to put patients and workers at risk in order to gather more data. We need a precautionary approach that protects people with the best available protection for airborne pathogens. We do not need additional research.
We have been doing universal masking for 3 years, and we just need to continue doing it. This is something that should have been part of basic infection control prior to the pandemic, and now that we understand this can reduce the risk of transmission of infectious diseases within healthcare settings, we need to add this to our arsenal of routine universal standard precautions.
Now is the time to provide education for all healthcare workers so that everyone knows why and how to protect themselves for COVID and other airborne pathogens. Many healthcare workers do not understand how to protect themselves or that repeated COVID infection poses increased risks of organ system damage and long COVID.
Universal masking is an integral part of a multilayered approach to reducing the risk of airborne pathogens including COVID. Patients being admitted for outpatient procedures should be tested for COVID, which may impact their post-procedure risks. Patients who test positive for COVID and other airborne pathogens must be isolated appropriately with ventilation controls.
We must not allow crisis standards that arose during times of severe PPE shortages and reduced oversight and regulation to become a new, lower standards of care that put patients and workers at risk. We at the People’s CDC, as healthcare workers, patients, and others who are dedicated to improving public health, need your help, the CDC HICPAC, to implement universal masking and other protections to build safer healthcare for all of us. Thank you.