Get involved
Back to all

HICPAC and Masking in Healthcare

HICPAC Update

The Healthcare Infection Control Practices Advisory Committee to the CDC (HICPAC) met on Nov 14th and 15th and wrote a response to questions posed by the CDC, which were in response to draft guidance previously submitted by HICPAC. HICPAC voted against recommending N95 respirators for airborne diseases, a notable decrease in protections from previous guidelines for COVID-19 in hospitals and nursing homes from the Centers for Medicare & Medicaid Services. HICPAC also voted against explicitly recommending that healthcare organizations allow voluntary use of N95 respirators (Voting slides: Infection Control in Healthcare Personnel Workgroup). https://journals.asm.org/doi/10.1128/cmr.00124-23). The HICPAC draft guidance clearly goes against the known science stated by the CDC, which shows that N95 respirators can help reduce the spread of infection compared to surgical masks (https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm, 

A recent study indicated that ending universal masking and testing policies was associated with a 25% increase in hospital-onset respiratory viral infections. Likewise, the study also found that restarting masking among staff resulted in a 33% decrease in hospital-onset respiratory viral infections. Furthermore, they observed 8 deaths out of 100 cases of hospital-onset COVID-19 cases after universal testing had ended, indicating a high death rate for hospital-acquired infections https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827170. WHN recently published an open letter to the hospital this study took place at, urging its board of directors to implement masking policies as supported by the study. [Letter to Mass General Brigham Board (MGB) of Directors about the study at MGB and the need for masking
Open Letter to Dr. Klibanski and the MGB Board: A Call for Urgent Action on Infection Control – WHN] Furthermore, a study published in early 2024 also supported masking as an effective infection prevention tool in healthcare settings. (https://academic.oup.com/cid/article/78/5/1204/7517603?login=false ). The HICPAC guidance therefore goes against the direct evidence for masking in healthcare settings.

HICPAC also recommended that healthcare workers with viral respiratory infections be restricted from work for only three days from onset of symptoms or confirmed positive test (https://www.cdc.gov/hicpac/media/pdfs/HCP-WG-HICPAC-Voting-Slides-Nov-2024-508.pdf) even though the infectious period is known to last longer. In several studies, infectious virus has been isolated from patients for 8-10 days after symptom onset, https://www.nature.com/articles/s41579-022-00822-w https://whn.global/guidelines/isolation-time-and-exit-process/ indicating a need for 8-10 days of isolation at minimum. Furthermore, some cases may be infectious for longer than 10 days (https://pmc.ncbi.nlm.nih.gov/articles/PMC7547320/) .

COVID-19 Mask Policies in Healthcare 

As respiratory season returns, healthcare facilities worldwide are reinstating masking and testing policies to protect patients and staff. Notable updates include mandatory masking in patient care area at NIH patient clinics (https://www.cc.nih.gov/patient-services/masking-policy) and mandatory masking in most Bay Area counties. Hospitals across the U.S., including MD Anderson Cancer Center and Tufts University Medical Center, and international facilities like St. Joseph’s Hospital and Toronto’s University Health Network, have implemented similar measures. These actions reflect a growing commitment to infection prevention during a challenging respiratory season. See below for a more extensive list of local governments and healthcare systems that have instituted masking policies and links to more details. 

You can advocate for yourself by contacting your local healthcare system and requesting that they implement similar masking policies to protect both patients and staff. If your local healthcare system is already masking, it’s also important to let them know that these policies are an important step in the right direction to protect patients and healthcare workers. Most healthcare systems will have a patient experience survey or a place to give feedback on their websites, often at the bottom of the page. 

Who We Are 

The WHN Science Content Team produces the WHN Newsletter and other science-based content. We are currently working on policy-relevant literature reviews on transmission in schools, and air purifiers. If you would like to join us, our Slack channel is #science-content-team, and if you’re not on Slack, you can email info@whn.global or fill out our interest form at https://whn.global/join-our-science-content-team/ . No formal science writing experience is necessary. 

List of Mask Policies

Please note that this is not a comprehensive list of local governments and healthcare systems with masking policies, and policies are subject to change. For more information, check your local healthcare system. 

Canada

USA