Who Needs RFK Jr. When We've Already Got a Corrupt CDC?
Misinformation from a place of power.
You're supposed to get better in the hospital, not worse.
That basic fact was lost on the CDC last week as a key committee voted against recommending N95 respirators over surgical masks in healthcare settings. In their own words, “N95 respirators should not be recommended for all pathogens that spread by air.” Dubbed the Healthcare Infection Control Practices Advisory Committee (HICPAC), its members have spent the last year working largely without participation from experts on aerosols, ignoring evidence and outcry at every turn. Honestly, you can’t get more anti-science. They even declined to strengthen guidance protecting voluntary use of N95 respirators, saying their existing language was sufficient. During the meeting, only one HICPAC member, Lisa Baum of the New York State Nurses Association, consistently spoke out in favor of N95 masks. (She was also the only person wearing one.)
Hundreds of public health experts have spoken out against HICPAC’s equation of surgical masks with N95 respirators. During their meeting, public commenters declared, “CDC guidance must recognize the science.”
While the CDC was busy undoing public health, outgoing director Mandy Cohen decided it was perfect timing to announce her concerns about RFK Jr.’s ascension to head the Department of Health and Human Services. As she said, “the sharing of misinformation from a place of power is concerning.”
Yes, Mandy.
It is.
Meanwhile, the brunch brigade is dragging RFK Jr. for… eating a cheeseburger. And yet, who needs RFK Jr. to kill public health when Cohen and friends have already been doing such a great job? On top of ignoring the worst crisis in generations, Cohen has said absolutely nothing about mask bans sweeping the country, and her agency has dropped the ball time and again on H5N1 bird flu. At every possible moment, Cohen only shows up to downplay and minimize.
She herself shares misinformation from a place of power.
For the record, the new HICPAC guidance adopts an anti-science attitude that completely contradicts stacks of research and data, including an official statement by OSHA that “surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants” and “are not designed to seal tightly against the user’s face. As they further state:
During inhalation, much of the potentially contaminated air can pass through gaps between the face and the surgical mask and not be pulled through the filter material of the mask… so they cannot be relied upon to protect workers against airborne infectious agents.
A major study in eBioMedicine (a Lancet Journal) reached similar conclusions, stating that “an N95 is significantly better than the other options.” The authors of the study have stated very clearly that “N95 masks should be the standard of care in high-risk situations, such as nursing homes and healthcare settings.” They work even without training or fit-testing. How do surgical masks stack up? Not well. In this study, even cloth masks with a good fit outperformed them.
A review of studies by Michael Klompas and Chanu Rhee in the Journal of Infectious Diseases also shows that “surgical masks provide substantially less protection against viral inoculation of the respiratory tract compared to fitted N95 respirators” and refers to “a wealth of real-world studies that document failures of surgical masks worn by healthcare workers… to prevent transmission, as well as case-control studies that found respirators to be more protective than surgical masks.” In fact, the authors end by declaring it’s time for the CDC to update its infection control guidelines in the face of such overwhelming evidence.
In fact, we had a growing body of evidence in favor of N95 masks before the pandemic began. One 2017 study in Influenza and Other Respiratory Viruses found that N95 masks “provide superior protection” for droplets.
Nonetheless, a handful of poorly designed studies and reviews reinforces the myth that surgical masks work just as well as respirators. In reality, these studies simply reveal that healthcare workers aren’t trained or educated on how diseases transmit. They don’t wear protection as often as they should, and they don’t understand asymptomatic transmission.
Not only does the HICPAC committee’s guidance ignore the evidence in favor of respirators, it also oozes with other misinformation.
The first draft of their guidance appeared last November. Those guidelines directly state that "less intensive effort” at controlling the spread of disease “might be indicated when outcomes are not usually severe, the population has a high degree of immunity, and effective therapeutics and vaccines are available." Mandy Cohen confirmed this new approach when she spoke at Yale University in October 2023. From the beginning, they planned on officially recommending baggy surgical masks as equivalent to N95s.
When it comes to Covid, we haven’t met any of these criteria. This disease is currently driving a mass disabling event. The population doesn’t have immunity. In fact, the virus itself attacks and destabilizes our immune systems. We don’t have access to therapeutics, and vaccine efficacy wanes within months. So even by their own criteria, we need more intensive efforts, not less.
The biggest problem of all:
It completely ignores the long-lasting and often permanent damage Covid does in nearly half of infections, including mild ones. Of course, the CDC has been downplaying these risks for nearly four years. This crisis alone would provide the HICPAC with more than enough reason to update its guidance in favor of N95 masks, not to mention the immanent risk of H5N1 bird flu and other disease with pandemic potential. It was time to listen to science.
And yet, they refused.
This failure makes it hard for anyone in the current administration to point fingers at anyone else when it comes to misinformation.
This wasn’t even debatable.
More than 900 experts and healthcare workers sent a letter to the CDC last summer, urging them to reconsider their stance in light of current research. The CDC basically blew them off, saying they would seek input from researchers after they sent their proposal to the CDC. They’ve finalized that guidance, and now it’s heading to the CDC for one last round of review and comment. As experts have warned, it’s very unlikely for major changes to happen at this point—especially since the committee and the CDC at large have spent the last four years downplaying the airborne nature of viruses and hardly ever recommending masks.
The guidance will get people killed.
Hospital-acquired infections already happen on a regular basis. They happen so often that healthcare researchers have given them a special name, healthcare-associated infections (HAIs). They’re lethal. One study estimates hospital-acquired infections run as high as 19 percent in the ICU, with a rate of 4 percent for general patients. If you get sick while recovering from a severe illness, your mortality rate shoots up to 50 percent. If you're in the ICU, it runs above 70 percent. Infection during surgery isn't even the most common risk. You can catch an airborne disease like tuberculosis, measles, or Covid in your room during recovery.
The HICPAC committee has been working on updating their guidelines for more nearly three years, since February 2022. They appear to be accommodating demands from healthcare CEOs to lower costs, at the expense of our safety and our lives, as well as the safety of healthcare workers.
For a healthcare CEO, it’s cheaper to pretend airborne viruses don’t exist while forcing nurses, doctors, and paramedics to work while they’re sick, exposing patients to diseases when they’re the most vulnerable.
To them, it's about money.
Jane Thomason with National Nurses United was one of the first to blow the whistle on this disaster in early August 2023.
Sadly, we've grown to expect these maneuvers from a CDC that's been increasingly corrupt over the last few years. Previously, we saw them relax self-quarantine and testing guidelines for everything from airlines to schools. Now we have a pilot shortage and a rising number of near midair collisions. We have a teacher shortage, student attendance problems, and record drops in test scores.
Seriously, who needs RFK Jr.?