National Nurses United

10 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 3 NEWS BRIEFS I n december, the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee voted unanimously to approve its draft infection control guidance and send it to the CDC for review. This extremely influential document, which was last updated 16 years ago, will be referenced by hospitals and other health care facilities to set their infection control policies. How- ever, the draft only offers minimal recommendations to the CDC, and, even worse, incorrectly treats surgical masks as respiratory protection. This unscientific guidance puts the United States in an even weaker position than we had with Covid, to battle future pandemics. Surgical masks do not offer respiratory protection, especially against aerosol parti- cles — yet HICPAC's draft acts as if they do. This dangerous claim will result in inade- quate protection for nurses and other health care workers. The FDA, OSHA, NIOSH, and even the CDC have said that surgical masks do not offer respiratory pro- tection. These masks are loose-fitting and do not filter the air breathed in by the wearer. HICPAC's "flexible" guidance will result in inadequate protection for health- care workers. Nurses are scientists. We follow the pre- cautionary principle, which means we do not wait for proof of harm before taking action to protect people's health. In other words, use the highest level of protections when confronted with a novel virus. Numer- ous studies show that Covid is spread primarily via aerosol transmission. We know that surgical masks are inade- quate protection against airborne pathogens. So it is maddening and uncon- scionable that HICPAC would ignore scientific evidence in its draft infection con- trol guidance. But there are no frontline health care workers, unions, or patients on the committee. We are not protected. We feel betrayed by the institutions that are supposed to safe- guard our health. HICPAC's vote lets us know that nurses and health care workers are expendable to our employers—despite the staffing crisis. The message to us: We are not heroes. We are disposable. "We're following CDC guidance" was the answer many registered nurses got in 2020 when we were given a surgical mask instead of an N95 respirator or told to reuse single- use disposable N95s, forcing nurses to risk their lives to care for patients. In April 2020, RNs at Providence Saint John's Med- ical Center in Santa Monica, Calif. were suspended when they refused to go into Covid patient rooms without an N95. That same month, Celia Yap-Banago, an RN in the cardiac telemetry unit at Research Med- ical Center in Kansas City, Mo., died because she contracted Covid at work after her employer failed to screen a patient with active Covid symptoms and did not give her an N95. She had previously raised concerns about the lack of personal protective equip- ment (PPE) at her hospital. Her employer had moved PPE from all units to one floor of the hospital so it was not available on her unit, which was not "supposed to" have Covid patients. Back then, the CDC gave health care employers "flexibility" to conduct their own risk assessment. Employers were following the CDC's crisis and contingency standards that said a surgical mask was acceptable. The result was an enormous number of avoidable Covid infections and tragic deaths among health care workers at a time when their care was so desperately needed. The committee's new recommendations propose to give employers the same kind of "flexibility" that led to Celia's death. The draft guidance lets employers decide whether to implement the recommenda- tions based on their own risk assessment. If the CDC approves the draft, it will lead to unnecessary infections, deaths, and long- term health consequences from a wide range of pathogens, including Covid, influenza, and RSV. After nearly four years of living with the Covid pandemic, we have all learned hard lessons about PPE and how health care employers focus on the bottom line rather than protecting health care workers and patients. We know that health care workers need more protections and employers need clear and specific guidance, not "flexibility" on infection control. It is past time to do the right thing and follow the science in the update to the infec- tion control guidance. We urge the CDC to reject HICPAC's draft guidelines and create a new draft with input from frontline nurses and other health care workers who will be implementing the infection control guid- ance and their unions, as well as experts in infection prevention, ventilation engineer- ing, respiratory protection, and industrial hygienists who have been excluded and ignored in HICPAC's process. —Jean Ross, RN and Jane Thomason CDC's HICPAC betrays nurses and patients

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