By Phenelle Segal, RN, CIC, FAPIC
In early March 2020, it became clear that, despite decades of planning for a major pandemic, the United States and most of the world were unprepared for a respiratory virus as powerful and harmful as COVID-19.
The CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC) recently drafted updated guidelines to prevent transmission of pathogens in healthcare settings for CDC to review, and they are being met with concern and pushback by patient and staff safety advocates. While this pushback is necessary and warranted, for reasons explained well in this Medpage Today column, we need to also take into consideration the following:
These guidelines are a draft and forwarded to CDC for review. They are preliminary at this juncture.
Cause for concern is valid. Preliminary guidance can appear convoluted and complex, potentially create confusion and possibly result in a repeat of the chaos experienced in facilities as they worked to respond to shifting guidelines during the pandemic, as seen particularly in acute care hospitals and nursing homes.
Despite the CDC releasing many sets of guidelines during the acute phase of the pandemic (2020-2022), most providers followed previously instilled infection prevention practices to the best of our ability, just with more limited supplies. These practices were taught to us decades before the COVID-19 pandemic began, but there were still significant challenges we had never faced before.
We should be optimistic that CDC will go back to HICPAC for further discussion before finalizing the guidelines, as the CDC is fully aware of how confusing their COVID-19 guidance appeared.
We should be hopeful that, at a minimum, companies manufacturing personal protective equipment (PPE) will never experience another pandemic shortage as they did during the pandemic. We hope they will always be able to produce the PPE needed quickly and proficiently. Lessons learned from COVID-19 will hopefully be significant enough to maintain the changes made and fix the problems found in the supply chain.
Healthcare workers are naturally geared towards what’s safest and best for all. We should never deviate from this mindset. We need to trust our instincts, and while it is crucial to follow nationally recognized guidelines and standards, we need flexibility and may have to explain to authorities why we have chosen to interpret guidelines in the best possible way. They are, after all, guidelines and not mandates.
Finally, it is important to note that the Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) release requirements that are not only guidance, but required by law and must be adhered to. These rules could require more stringent infection prevention requirements than what is finalized in the new CDC guidelines.
In conclusion, we must continue to follow science and take precautions that go beyond what HICPAC is advising as the minimum. Doing so will help ensure we do all we can to keep patients and one another safe.