United States: CDC advisors have recommended that healthcare providers wear masks when attending to patients suspected of having contagious diseases. The type of mask, whether a loose-fitting surgical mask or a snugly fitting N95 mask, was not specifically specified in the recommendation.
Guidelines from HICPAC Spark Controversy
The CDC’s advice suggests using N95 masks when dealing with patients suffering from diseases for which there are no available treatments or vaccines. These masks are also suggested for cases where the infection can spread through the air, such as with measles.
A newly proposed set of guidelines from the Healthcare Infection Control Practices Advisory Committee (HICPAC) indicates that wearing masks is not mandatory. This has led to mixed reactions in the healthcare community.
Concerns Raised by National Nurses United
Zenei Triunfo-Cortez, the president of the National Nurses United, expressed concerns about the HICPAC draft, describing it as permissive and weak. She criticized it for not maintaining existing protective measures and, in some cases, even rolling back critical precautions like airborne infection isolation rooms. Triunfo-Cortez believes that such guidance could worsen working conditions for healthcare workers and contribute to moral distress, potentially driving more nurses away from the bedside and deepening staffing challenges.
She also stressed the importance of involving frontline healthcare workers in crafting protective guidelines, as they have unique insights and expertise in infection prevention. Nurses, in particular, played a vital role during the COVID-19 pandemic and witnessed the consequences of inadequate infection prevention.
Physician Mortality Study Raises Questions
A recent study conducted by researchers at Stanford and the University of Southern California in Los Angeles revealed that between 2020 and the end of 2021, approximately 4,500 physicians lost their lives in the United States, which was 600 more than expected.
Critique of Guidelines by Dr. David Michaels
Dr. David Michaels, an epidemiologist and professor at the George Washington University School of Public Health, criticized the guidelines, stating that they appear to be regressive. He believes that the committee members may have had preconceived notions about infection control and that their perspectives were influenced by a hospital-based view that has not evolved in decades. Michaels also noted that the committee lacks members with expertise in worker protection and aerosol science.
Debate Over Universal Masking
It’s worth mentioning that the committee’s views on universal masking in healthcare settings have been a subject of debate. Some committee members argued against universal masking to combat the spread of COVID-19.
Reevaluation of Masking Policies
An editorial published in the Annals of Internal Medicine highlighted the significant progress made in preventing and managing SARS-CoV-2 since its identification in 2019. The editorial suggested that it might be time to reconsider policies like universal masking in healthcare settings, especially when the expected benefits are low, as the virus becomes endemic.
CDC’s Approval and Timeline
The committee’s vote on the guidelines will be sent to the CDC for approval. According to reports, it will take approximately 60 days for the revised guidelines to be finalized, and they are not expected to be in place before 2024.