CDC asks for clarification on hospital masking draft guidance

The CDC has requested clarification on masking guidance in healthcare facilities from the Healthcare Infection Control Practices Advisory Committee — specifically whether N95 masks should be required and under what circumstances.

In November, the agency sent an initial draft of recommendations to HICPAC for its consideration, which was approved by the committee. The CDC is requesting this additional clarification on a few key aspects before moving the guideline into the Federal Register for public comment.

Among the key asks the CDC is making of the HICPAC are additional guidance to clarify if regular masks are effective enough against respiratory pathogens or if N95 masks should be used instead, as well as if masks should be used at all times in a hospital setting, not just for protection during an outbreak.

While things are still in the draft stage, nothing will change quite yet inside hospitals, but it is important epidemiological progress to clarify what masks to use when and how and where, according to Tom Talbot, MD, chief hospital epidemiologist, at Vanderbilt University Medical Center in Nashville, Tenn., and president of the Society for Healthcare Epidemiology of America. 

The CDC seeking this clarity —  literally down to the size of respiratory droplets and the best ways to prevent their transmission — is the agency's attempt to become more aligned with "up-to-date scientific view of how respiratory infections are transmitted," the agency stated in its Jan. 23 update. 

Trying to determine the best way to protect patients and hospital employees both now and ahead of a future pandemic is necessary, particularly related to masks, since respiratory viruses may be the cause of the next COVID-scale event. 

"We're pleased with the comprehensiveness of what we've learned so far. Infection prevention is not a stagnant process," Dr. Talbot told Becker's. "There will always be an evolution as science develops. I don't know what those future changes will be, but it's important that it is an evolving process."

Additional masking in hospital settings is something several healthcare groups have called for since COVID-19. 

In August, the NNU sent a petition signed by 11,000 healthcare workers and organizations to the CDC and HICPAC calling for an update to the CDC's Isolation Precautions that includes masking related to respiratory viruses. After HICPAC's review and approval of the CDC's initial draft, the NNU did not believe recommendations were strong enough and sent a subsequent, second petition to CDC Director Mandy Cohen, MD, in December, urging her to reject the recent draft and revise it to include detailed masking protocols. 

"We are gratified that the CDC is asking HICPAC to resolve some of our core concerns, including the use of N95 respirators versus surgical masks to protect health care workers from pathogens that transmit through the air," NNU President Jean Ross, RN, said in a statement shared with Becker's. "As nurses, we always want to follow the science, and we know that surgical masks do not provide the same level of protection as an N95 respirator."

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