Join us in urging CDC’s Director to ensure that CDC and HICPAC recognize aerosol transmission science and protect health care workers and patients from infectious diseases!

Make your voice heard

Dear Dr. Cohen,

Ensuring that our health care facilities are safe for all who seek or provide care is of the utmost importance. The CDC plays a pivotal role in setting guidance that shapes infection control and prevention practices in hospitals, nursing homes, and other health care settings across the nation and around the world.

I commend the CDC for adding important perspectives to the Healthcare Infection Control Practices Advisory Committee’s (HICPAC) Isolation Precautions Guideline Workgroup, including those representing frontline nurses and other health care workers. These perspectives are essential to developing robust, implementable, science-based guidance.

I urge CDC, HICPAC, and the Isolation Precautions Guideline Workgroup to ensure the following elements are upheld in updates to infection control guidance in health care settings:

1. Fully recognize aerosol transmission of SARS-CoV-2 and other respiratory pathogens.

Recognizing the science on infectious disease transmission is essential to formulating effective controls. The World Health Organization (WHO) recently issued a global technical consultation report, which involved many experts from a wide variety of disciplines to find consensus on terminology to describe transmission of pathogens through the air. HICPAC and CDC should examine this report closely and update HICPAC’s draft to better recognize the science on transmission through the air.

HICPAC and the CDC should ensure that updated guidance includes the use of multiple control measures that have been shown to effectively prevent transmission of respiratory pathogens, including SARS-CoV-2 and others, including:

• Ventilation to remove aerosolized viral particles and other pathogens, including the use of negative pressure isolation and other engineering controls.

• Respiratory and eye protection for health care workers providing care to patients with suspected or confirmed respiratory infections.

• Safe staffing is essential to effective infection control and prevention. Updated CDC/HICPAC guidance must recognize this and must not make allowances for health care employers to circumvent measures necessary to protect worker and patient health due to staffing concerns.

2. Maintain and strengthen respiratory protection and other protections for health care workers caring for patients with suspected or confirmed respiratory infections.

N95 filtering facepiece respirators represent the minimum level of respiratory protection available and are essential to protecting health care workers from respiratory infections. HICPAC and CDC should clearly and explicitly incorporate elastomeric and powered air-purifying respirators (PAPRs) into any updated guidance on health care infection control. PAPRs and elastomeric respirators can provide a higher level and more reliable protection than N95s, be more comfortable to wear, and more cost-effective for employers to implement.

3. The CDC must maintain an approach in any updated infection control guidance that is clear and explicit on the precautions that are needed in situations where infectious pathogens are present or may be present in health care settings; don’t adopt a crisis standards approach.

Action Needed:

CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) has been working to update foundational infection control guidance for health care settings. HICPAC’s process has been non-transparent, lacking in public input, and has ignored essential science on aerosol transmission and respiratory protection.

But after months of advocacy by nurses, other health care workers, and patient advocates, the CDC returned HICPAC’s draft for more work to address some of our core concerns—a major win! And just recently, the CDC added important perspectives to HICPAC’s Isolation Precautions Workgroup, including a union industrial hygienist and other experts in fields addition to infection control—another important win!

But HICPAC’s Workgroup has not reached consensus regarding the use of N95 respirators vs surgical masks to protect health care workers and patients from pathogens that transmit through the air. Based on meeting summaries acquired via NNU’s information requests, multiple members of the Workgroup remain focused on maintaining and even expanding the use of surgical masks as protective equipment for health care workers and patients exposed to infectious diseases.

Join us in urging CDC’s Director, Mandy Cohen, to ensure that CDC and HICPAC recognize the important science on aerosol transmission and craft guidance that protects health care workers and patients from infectious diseases!

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