CDC advisers support masks in update to hospital infection guidelines

Experts who advise the US Centers for Disease Control and Prevention on its hospital infection control guidelines have voted to recommend that health care providers wear masks during routine care for patients who are thought to be contagious, including for patients with endemic, or regularly occurring, respiratory infections.

This draft recommendation does not specify what kind of mask to wear — either looser-fitting surgical masks or more fitted and tightly woven N95 respirators. The decision frustrated some advocates for frontline health care workers and immune-compromised patients who wanted to see a strong recommendation for the use of N95s in all patient-care situations.

The CDC’s Healthcare Infection Control Practices Advisory Committee, known as HICPAC, did recommend the use of N95s in cases where patients are infected with new or emerging pathogens for which vaccines and treatments are not available. N95s were also recommended for situations where patients may have infections that are known to spread efficiently through the air over long distances, such as measles.

Jane Thomason, lead industrial hygienist for National Nurses United, the largest nursing union in the US, said the draft inappropriately treats surgical and medical masks as personal protective equipment, or PPE, and respiratory protection.

“A surgical or medical mask does not provide protection against inhalation of infectious aerosols,” Thomason wrote in a statement to CNN on HICPAC’s draft recommendations. “NNU urges CDC to fully recognize the science on aerosol transmission of infectious diseases and respiratory protection (including N95s, powered air purifying respirators, and elastomeric respirators) in creating infection prevention guidance,” Thomason wrote.

Guidelines aren’t yet final

The masking recommendation is just one of a suite of draft recommendations for the control of infections in health care settings that was voted on at the meeting, but it is one of the most contentious.

That recommendations are not final. They will next go to the CDC for its sign-off. Once the CDC approves, the draft recommendation will be published in the Federal Register and members of the public have 60 days to comment. After the comment period ends, HICPAC will review the comments and may tweak its draft guidelines and vote on them again. Final versions of the guidelines aren’t expected until 2024.