Expected CDC guidance on N95 masks outrages healthcare workers

His assertion is supported by California’s workplace safety agency, Cal/OSHA, whose rules on protecting at-risk workers from infections could conflict with those of the CDC if the proposals are adopted. “The CDC must not undermine respiratory protection regulations by falsely and misleadingly claiming that there is no difference in protection” between N95 masks and surgical masks, commented Deborah Gold, an industrial hygienist at Cal/ OSHA, at the August meeting.

Researchers and workplace safety experts were also perplexed by how the committee categorized airborne pathogens. A surgical mask, rather than an N95, was suggested as protection for a category they created for “common and endemic” viruses that spread over short distances, and “against which individuals and communities should have a certain immunity. Three committee representatives, researchers Hilary Babcock, Erica Shenoy and Sharon Wright, were among the authors of a June editorial arguing that hospitals should no longer require all health care workers, patients and visitors to wear masks in the hospital. “Now is the time to implement policies that are inappropriate for an endemic pathogen,” they wrote.

However, in a call with KFF Health News, Kallen clarified that the committee puts coronaviruses that cause colds in that category, but not yet the coronavirus causing Covid.

The committee’s next tier was viruses in the “pandemic phase,” when the pathogen is new and there is little immunity through infection or vaccination. He recommended health workers wear an N95 mask when treating patients infected with microbes in this category. Its third, highest level of protection was reserved for pathogens like those that cause measles and tuberculosis, which they said can spread further than lower-level threats and require an N95.

Virologists said the committee’s categories carry little weight, biologically speaking. How a pathogen spreads is not affected by its frequency; common viruses can still harm vulnerable populations; and many viruses, including SARS-CoV-2, can travel significant distances on microscopic airborne droplets.

“Large COVID outbreaks in prisons and long-term care facilities have demonstrated that the behavior of infectious aerosols is not easy to classify, and that these aerosols are not easily contained,” wrote the deputy chief of Cal Health/OSHA Eric Berg in a letter of concern to the CDC committee, obtained by KFF Health News.

An N95 protective mask hangs next to a hand sanitizer dispenser on the reception desk of a clinic in Lansing, Michigan, October 18, 2020.Emily Elconin/Bloomberg via Getty Images file

The committee weighed its assessment of N95 masks against their drawbacks. His project cites a Singapore study in which nearly a third of healthcare workers, mostly nurses, said wearing such masks negatively affected their work, causing acne and other problems exacerbated by poor conditions. hot, humid conditions and long shifts. Rather than throwing away masks, the authors of this study recommend better-fitting masks and rest breaks.

Noha Aboelata, a physician and CEO of Roots Community Health Center in Oakland, California, agrees. “There are other strategies to implement, like improved mask design and better testing,” she said, “if we decide it is unacceptable to give Covid to a patient when they go to the hospital.”

Aboelata was among hundreds of doctors, researchers and others who signed a letter to CDC Director Mandy Cohen in July expressing concern that the CDC committee would weaken protections in hospitals. They also warned that the reduction in N95 masks could impact emergency supplies, leaving doctors and nurses as vulnerable as they were in 2020, when mask shortages fueled infections. More than 3,600 health care workers died in the first year of the pandemic in the United States, according to a joint investigation by KFF Health News and The Guardian.

Concerned clinicians hope the committee will reconsider its report in light of additional studies and insights before November. Referring to the project, Rocelyn de Leon-Minch, industrial hygienist for National Nurses United, said: “If they end up codifying these standards of care, it will have a disastrous impact on patient safety and will impact our capacity to address future health problems. crises. »

KFF Health Newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues and is one of the major operating programs of KFF — the independent source for health policy research, polling and journalism.Follow BNC HEALTH on Twitter & Facebook.


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