The CDC/HICPAC voted before giving the public ample time to review the draft guidance or seeking input from frontline health care workers, patients

National Nurses United (NNU) condemns today’s unanimous vote by the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) to finalize a draft of infection control guidelines before giving the public ample time to review the draft or before seeking input from health care workers and patients whose health and safety will be directly impacted by this guidance.

The draft Isolation Precautions Guideline, which was only released to the public yesterday, Nov. 2, is an extremely influential document that directs infection control practices for health care facilities in the United States. This guidance, which has not been updated in 16 years, will be referenced by U.S. employers and government agencies across the country and also by health agencies around the world.

Despite the critical importance of this infection control guidance, the CDC/HICPAC is only accepting written public comment on the draft until 11:59 p.m. on Monday, Nov. 6, giving the public a mere five days to review the 24-page document and 162 pages of supporting documentation and provide feedback. 

HICPAC’s draft guidance is aimed at frontline nurses and other health care workers, rather than health care employers, inappropriately shifting responsibility and risk to individual workers to protect corporate profits. The focus of HICPAC’s draft is almost exclusively on personal protective equipment, and it fails to make strong recommendations on other essential measures, such as ventilation and patient screening and isolation.

“HICPAC’s draft is permissive and weak and seeks not just to maintain existing practice — which has been shown to be inadequately protective — but even rolls back the use of some important measures, such as airborne infection isolation rooms,” said NNU President Zenei Triunfo-Cortez, RN. “This draft guidance will only further degrade the already dangerous working conditions of nurses and other health care workers and further contribute to high rates of moral distress, which will only serve to drive more nurses away from the bedside and further deepen the staffing crisis in health care.”

During the oral public comment section of the CDC/HICPAC meeting yesterday, Triunfo-Cortez urged the committee members to delay their vote until they have incorporated input from nurses, other health care workers, their unions, patients, and other public health experts. “HICPAC is missing the perspective of frontline nurses, other health care workers, our unions,” said Triunfo-Cortez. “As nurses, we carry out many essential pieces of infection prevention. We have insights and expertise that are essential to crafting protective guidance.

“During the Covid pandemic, nurses saw too many patients and colleagues become infected, get sick, and even die because of inadequate infection prevention. Too many continue to experience the impacts of long Covid. And now, extensive research has documented what nurses have advocated for since the beginning of the Covid pandemic — we need a multiple measures approach that combines ventilation, PPE including respiratory protection any time we are exposed to an aerosol transmissible disease like Covid, screening and isolation, exposure notification, and other measures,” Triunfo-Cortez added.

NNU urges the CDC to reject HICPAC’s draft and to actively engage the input of frontline nurses, other health care workers, their unions, patients, and public health experts, in addition to infection preventionists, in the development of a new draft of the updated guidance. NNU urges CDC to hold public meetings, similar to the meetings held in 1992 during the development of the multidrug-resistant tuberculosis infection control guidelines for health care, as soon as possible and, based on this input, to significantly amend HICPAC’s draft to better protect health care workers and patients.

In July, NNU sent a letter to the CDC asking to meet to discuss the union’s concerns about the guidance. In August, NNU delivered a petition signed by nearly 11,000 individuals and organizations urging the CDC to fully recognize aerosol transmission of SARS-CoV-2 and other respiratory pathogens and to strengthen the agency’s Isolation Precautions guidance. In September, nearly 2,000 experts in public health, infectious disease, and industrial hygiene and concerned individuals sent a follow-up letter to CDC Director Mandy Cohen urging the CDC “to involve key experts and all stakeholders in the development process” and hold public meetings. Yesterday, NNU called out the CDC/HICPAC planning to vote on the infection control guidance before public review and comment.

National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the United States with nearly 225,000 members nationwide. NNU affiliates include California Nurses Association, DC Nurses Association, Michigan Nurses Association, Minnesota Nurses Association, National Nurses Organizing Committee, and New York State Nurses Association.