National Nurses United (NNU), the largest union of registered nurses, sent a letter to the Centers for Disease Control and Prevention (CDC) yesterday urging the agency to take immediate action to protect public health in the face of elevated transmission of Covid-19 around the country, the dominance of the extremely contagious and immune evasive BA.5 variant, and the development of additional Omicron subvariants.

“As nurses, NNU’s members see the impact of lax public health measures on patients—in the form of more Covid-19 infections and hospitalizations, as well as an increase in patients seeking care for the effects of long Covid,” states NNU President Jean Ross, RN, in the letter. “Now, as cases are once again rising and remaining at high levels across the country, and as we are contending with the BA.5 variant with increased transmissibility and immune evasion, and with more Omicron subvariants spreading around the world, NNU’s members are concerned for the health and safety of our patients, our colleagues, and our communities.”

The letter calls on the CDC to:

• Strengthen guidance and communications regarding Covid-19 transmission and when to implement mitigation measures, including wearing masks;
• Strengthen post-exposure quarantine guidance to recognize the risk of reinfections with Omicron subvariants and future variants of concern in order to effectively prevent transmission of Covid-19;
• Strengthen isolation guidance after testing positive for Covid-19 to better reflect the available data regarding infectious time periods; and
• More fully recognize the risks and impacts of long Covid and to conduct more effective public education regarding the risks of long Covid.

The letter cites scientific evidence for each of these points and notes the effectiveness of reducing transmission by wearing masks indoors combined with other prevention measures, such as improving ventilation, testing, quarantining, and isolating. However, as the letter points out, “on February 25, 2022, the CDC changed the metrics it uses to recommend when people should wear masks indoors in public.” The new community levels metric “means that the CDC is now waiting for cases to skyrocket and hospitalization to rise before recommending people take measures to protect themselves from infection.”

NNU expressed serious concern about the new metric in a letter to the CDC on March 1, 2022, “because it creates a dangerous lag time between widespread transmission of the virus and implementation of prevention measures.” In addition, the CDC’s new community levels metric is “based on flawed assumptions that future variants will be mild and immunity will not wane over time.” NNU urged the CDC to “return to the four-tier ‘community transmission metric’ used previously but now is used only in health care settings.”

The letter also notes that the CDC’s “current guidance for quarantining after an exposure to Covid-19 is insufficient to prevent transmission” of the virus; that the CDC’s “guidance on isolation following a positive Covid-19 test is insufficient to prevent onward transmission of the virus;” and that the CDC does not effectively communicate the risks of long-term impacts of Covid-19, noting that “study after study indicates that long Covid poses a serious threat to public health, leading to neurodegeneration, cardiovascular disease, diabetes, and damage to other organ systems.”

“The only way to effectively prevent long Covid is to prevent infections,” states Ross. “Data indicates that reinfection poses an increased risk of long Covid.”

“We urge the CDC to immediately strengthen its Covid-19 guidance, based on the available scientific evidence and the precautionary principle, to more effectively stop transmission of Covid-19 in order to protect the public’s health,” concludes Ross in the letter.

National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the United States with more than 175,000 members nationwide.