A CDC advisory committee has been working to update an influential set of infection control guidelines since August 2023. Over the past year, the agency has faced growing pressure from clinicians, who have criticized early versions of the updated guidance for putting surgical masks on par with N95s.
The CDC's Isolation Precautions Guidance — which informs infection control and prevention practices within hospitals and nursing homes worldwide — was last updated in 2007. The agency's Healthcare Infection Control Practices Advisory Committee, or HICPAC, has been meeting for over a year to discuss revisions.
Here's what to know about the proposed mask guidance and ongoing revision process:
- Last November, HICPAC voted to finalize an updated draft of the guidance that recommends healthcare workers wear masks during routine care to prevent the spread of common endemic respiratory infections, such as flu and COVID-19. The proposed guidelines suggest N95s and other higher-level respirators for "special air precautions," or when caring for patients with a new or emerging respiratory pathogen for which no vaccines and treatments are available.
- National Nurses United, the nation's largest nursing union, has strongly opposed the draft, saying it inappropriately treats surgical and medical masks as personal protective equipment and respiratory protection. The draft guidance states healthcare personnel may "choose voluntarily" to wear an N95 for routine air precautions, but critics have argued this shifts responsibility and risk onto individual workers.
- In January, NNU released survey findings that showed a significant portion of hospital nurses don't have regular access to N95s or other types of respirators. Clinicians claim this situation could worsen if the updated guidance doesn't end up making a firm recommendation on the use of respirators to prevent the spread of common pathogens like flu and COVID.
- The CDC, in response to criticism of the draft guidance at the time, told Becker's the "process has been misunderstood," reiterating that recommendations are not final. "The advisory committee has not introduced any binding recommendations, but is instead kicking off a process that includes a transparent, lengthy public comment period."
- In January, the agency requested HICPAC to clarify components of the draft guidance, including whether N95s should be required and under what specific circumstances. NNU later commended the move, and urged the CDC to ensure frontline healthcare workers and infectious disease experts were represented on the advisory committee. In May, Jane Thomason, NNU's lead industrial hygienist, and Lisa Baum, lead occupational safety and health representative at the New York State Nurses Association, were invited to join the committee.
- The committee is currently in Stage 3 of a six-stage process to update the guidance. While initial timelines aimed for finalization in 2024, the process will likely continue through at least the first half of 2025. Once the CDC reviews and approves of the revised guidance, the proposal will be published in the Federal Register for a 60-day public comment period. Based on this feedback, the guidance could undergo further revisions before being finalized, according to the CDC.