Update: NNU invited to join CDC’s HICPAC workgroup on infection prevention

In May 2024, CDC invited NNU’s lead industrial hygienist to join the workgroup and NYSNA’s lead health and safety representative to join HICPAC — a major victory for frontline nurses, other health care workers, and patients!

New workgroup meeting summaries were added for July 8, 2024 – September 9, 2024.

The U.S. Centers for Disease Control and Prevention (CDC) initiated work to update foundational infection control guidance for health care settings in 2022. The CDC’s advisory committee, the Healthcare Infection Control Practices Advisory Committee (HICPAC), has formed a workgroup to formulate draft updates. In January 2024, the CDC returned HICPAC’s proposed updates for more work and requested that HICPAC expand the scope of technical expertise represented on its workgroup.

Documents acquired by NNU in response to information requests under federal law indicate that the CDC has reconstituted the workgroup and resumed meeting to address the CDC’s questions. Here is what we have found in our analysis of these documents, which are posted below in the format in which they were received from the CDC:

• Seven new members have been added to the workgroup. Two have infection prevention expertise, similar to the ten existing workgroup members. Three are physicians with expertise in occupational medicine or aerosol research. Two are certified industrial hygienists with expertise in worker protections like respirators, ventilation, and other measures. 
• The updated roster has expanded perspectives, which is a significant improvement, but the workgroup still represents a majority of infection prevention and manager perspectives. There are still no patient advocates, ventilation engineers, or other public health experts included. 
• The workgroup began to meet again in February 2024 with new members to address the questions raised by the CDC when it returned the draft to HICPAC for further work. NNU’s industrial hygienist was added in May 2024.
• The group has not reached consensus regarding the use of N95 respirators vs surgical masks to protect health care workers from pathogens that transmit through the air. Multiple members of the group remain focused on maintaining and even expanding the use of surgical masks as protective equipment for health care workers exposed to infectious diseases.
• The group has not reached consensus on adding explicitly a recommendation for voluntary use of NIOSH-approved N95 (or higher-level) respirators in health care facilities. Andrew Levinson, Director of OSHA Directorate of Standards and Guidance, attended as a guest to discuss current regulations. Mr. Levinson shared that OSHA saw health care employers prohibiting respiratory protection because they were afraid it could scare patients. He also shared that health care employers felt that voluntary use by one health care worker when not required could make other health care workers nervous and question the determination of the employer that a respirator was not required.
• Workgroup members continued reviewing a list of interest statements to help guide discussions and answer questions from the CDC. The group is debating whether “meeting OSHA regulations” should be included on the list given the impact on worker health and safety. Some of the workgroup members argued that it was unnecessary to include OSHA regulations in CDC guidance.
• The group has not reached consensus on whether the language in the current source control draft recommendations should be strengthened. Some of the workgroup members remained focused on recommending source control during periods of higher levels of community respiratory virus transmission and in higher-risk areas of health care facilities based on facility risk assessment.
• Some members of the workgroup expressed that the current draft contains insufficient information about ventilation.
• Some members of the workgroup continue to rely on findings from flawed and narrowly selected randomized controlled trials that concluded there is no difference between N95 respirators and surgical masks instead of looking at an entire body of literature that shows the efficacy of N95 respirators.