As healthcare workers, patients, parents, and caregivers, we at the People’s CDC urge public health officials and healthcare organizations, including hospitals, clinics, physician and dentist offices, nursing homes, and home health care services to require masking in all healthcare settings, and to provide masks (ideally N95 respirators) for everyone in those settings. The revised CDC guidance,1 which permits patients and staff in healthcare to stop masking when “levels of Community Transmission” are not “high,” is dangerous, unethical and based on flawed data.
REMOVING MASKS IN HEALTHCARE IS DANGEROUS.
Clinics and hospitals are sites for COVID patient care, so even if transmission rates are low, they will remain among the most likely locations to encounter people infected with COVID, and also people who are vulnerable to severe disease or death from COVID. Contagion in healthcare settings is already a problem even in well-equipped US academic medical centers.2 Removing masks in healthcare puts both patients and healthcare workers at risk, which could place even more strain on the healthcare system amidst severe staffing shortages.
REMOVING MASKS IN HEALTHCARE IS UNETHICAL.
Failing to require masks in healthcare settings violates medical ethical principles.3 Patients come to clinics and hospitals to improve their health. Healthcare providers have an ethical responsibility to DO NO HARM and ensure that they do not expose patients to COVID. Children and babies who cannot or may not wear masks and people in clinical situations that do not permit mask-wearing (such as post operative units) need others to protect them by wearing masks. Vaccines alone are insufficient to prevent COVID-19 spread. Although vaccines lower the risk of hospitalization and death, vaccinated people can die from COVID-19,4 or develop Long COVID,5 which may affect as many as one in five people6 after COVID infection.
CDC POLICY TO REMOVE MASKS IN HEALTHCARE IS BASED ON FLAWED DATA.
The CDC’s current policy relies on the Community Transmission7 map, which grossly underestimates COVID-19 infection rates. Back in September 2021 the CDC estimated that only 1 in 4 COVID cases8 were reported. And in New York, for example, a spring 2022 study suggested that infections were underestimated by a factor of 30.9 This is because far fewer people are testing for COVID now that much required routine testing has ended, federal funding for COVID testing has diminished, and most home tests are not reported. Further, most low-wage workers don’t have paid sick time,10 and therefore many are incentivized or compelled to go to work with COVID,11 or to avoid testing.12
In conclusion, we urge public health officials and healthcare providers to keep our communities safer from COVID-19, by requiring and providing high-quality masks for all. The healthcare system should be a place of healing, where the risk of acquiring infections is minimized. We urge you, as stewards of public health, to act in the best interests of the most vulnerable among us.
Noha Aboelata, MD
Margaret Benson Nemitz, MPH
Lauren Frey, MPH
Sam Friedman, PhD
Rosa Greenberg, MPH
Rita Valenti, RN
Ellen Isaacs, MD
Shimi Sharief, MD, MPH
Deborah Socolar, MPH
Kaitlin Sundling, MD, PhD
See and download the full statement below
1) CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic
2) The Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission from Patients With Undiagnosed Coronavirus Disease 2019 (COVID-19) to Roommates in a Large Academic Medical Center Abraar Karan, Michael Klompas, Robert Tucker, Meghan Baker, Vineeta Vaidya, Chanu Rhee CDC Prevention Epicenters Program Clinical Infectious Diseases, Volume 74, Issue 6, 15 March 2022, Pages 1097–1100, https://doi.org/10.1093/cid/ciab564 https://academic.oup.com/cid/article/74/6/1097/6305137?login=false
3) Principles of Biomedical Ethics Eighth Edition Tom L. Beauchamp and James F. Childress Publication Date – October 2019
4) Peterson-KFF Health System Tracker COVID-19 mortality preventable by vaccines. Krutika Amin, Jared Ortaliza, Cynthia Cox, Joshua Michaud, and Jennifer Kates KFF April 21, 2022 https://www.healthsystemtracker.org/brief/covid19-and-other-leading-causes-of-death-in-the-us/
5) TIME: You Can Still Get Long COVID If You’re Vaccinated and Boosted BY JAMIE DUCHARME SEPTEMBER 8, 2022 1:46 PM EDT
6) CDC: Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021 Weekly / May 27, 2022 / 71(21);713–717 On May 24, 2022, this report was posted online as an MMWR Early Release. Lara Bull-Otterson, PhD; Sarah Baca; Sharon Saydah, PhD; Tegan K. Boehmer, PhD; Stacey Adjei, MPH; Simone Gray, PhD; Aaron M. Harris, MD
7) CDC COVID-19 Integrated County View
8) CDC Estimated COVID-19 Burden
9) The prevalence of SARS-CoV-2 infection and other public health outcomes during the BA.2/BA.2.12.1 surge, New York City, April-May 2022 Saba A Qasmieh, McKaylee M Robertson, Chloe A Teasdale, Sarah G Kulkarni, Heidi Jones, David A. Larsen, John J. Dennehy, Margaret McNairy, Luisa N. Borrell, Denis Nash doi: https://doi.org/10.1101/2022.05.25.22275603
10) Economic Policy Institute Over 60% of low-wage workers still don’t have access to paid sick days on the job Posted September 23, 2022 at 2:47 pm by Elise Gould
11) Princeton bus drivers intend to strike in October if bus company won’t agree to paid time off
Madeline Mitchell Cincinnati Enquirer Sept 27, 2022
12) WKRN Nashville: MNPS board members raise COVID concerns as 100+ teachers test positive by: Mye Owens Posted: Aug 24, 2022