'Profits over protection': Critics fret over draft CDC masking guidance

Healthcare workers and other experts are expressing concern over the CDC's draft masking guidelines, saying that, if finalized, the guidance would incentivize hospitals to prioritize profits over protection, NBC News reported March 18.

Critics fear that the final guidelines will not clearly state a need for N95 masks, meaning hospitals will not adequately stockpile them, which could lead to shortages in future health emergencies. They also worry the guidelines won't emphasize ventilation and air filtration, meaning health systems won't invest in upgrades.

In November, the agency sent an initial draft of recommendations to the Healthcare Infection Control Practices Advisory Committee, a federal advisory committee, for its consideration, which was approved by the committee. The CDC has since requested clarification on masking guidance in healthcare facilities from the committee — specifically whether N95 masks should be required and under what circumstances.

Newly released survey findings from National Nurses United indicate a significant proportion of hospital nurses do not have regular access to N95s or other types of respirators, a situation the nation's largest union of registered nurses claims could worsen if the CDC moves forward with draft guidelines that don't make firm recommendations on the use of respirators to prevent the spread of common pathogens like flu and COVID-19. 

Although critics said they are glad to see the draft reconsidered, they remained concerned. 

"The CDC needs to make sure that this guidance doesn't give employers leeway to prioritize profits over protection," Jane Thomason, the lead industrial hygienist at the union National Nurses United, told NBC.

One of the key points of contention in the guidance are the recommendations of different approaches for airborne viruses that "spread predominantly over short distances" versus those that "spread efficiently over long distances." The logic allowed employers in 2020 to withhold protective gear from some workers, according to the report.

For example, medical assistants at Sacramento, Calif.-based Sutter Health weren't given N95 masks when they accompanied patients who appeared to have COVID-19. The system received a citation from the state's occupational safety and health agency, but Sutter appealed by pointing to the CDC's statement on virus spread over short distances, NBC reported.

Distinctions based on distance reflect a lack of scientific understanding, Don Milton, MD, DrPH, a University of Maryland researcher who specializes in the aerobiology of respiratory viruses, told NBC. What matters is the route that most often infects people, the concentration of virus-laden droplets and the chance of becoming sick after exposure.

"By focusing on distance, the CDC will obscure what is known and make bad decisions," Dr. Milton said in the report.

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