Thread by @PeoplesCDC

We testified today at a closed door meeting where @CDCgov HICPAC Commitee recommended that #N95s are no longer needed to prevent #COVID19 transmission, although #COVIDisAirborne
The presenter wore a KN95 while sharing a flawed collection of mask studies #HICPACUndemocratic 🧵

First and foremost, the public should be included in the development of public health and PPE guidelines, including impacted workers, and unions, and patients and communities and utilizing the expertise of occupational health experts, industrial hygienists & aerosol scientists.

#N95RespiratorsWork and #COVIDisAirborne.
Decades of science support the efficacy of #N95 Respirators. The appropriate way to assess efficacy of PPE is via engineering assessments not by experimenting on health workers by exposing them to lethal and disabling pathogens via RCT

Studies in the HICPAC review diluted results from studies which showed N95 respirators prevent COVID transmission by inappropriately including studies about flu & including studies where HCW were primarily infected in the community (not the way to assess efficacy of work PPE)

#1 The first study they include is Ang 2010, which looked at surgical masks vs respirators in health workers during H1N1, but COVID is much more infectious than flu, and the comparison is not appropriate pubmed.ncbi.nlm.nih.gov/20178418/

#2: Belan 2022. The primary conclusion was that healthcare workers were more likely to be infected with SARS-CoV2 by outside of work than at work (OR 19.9). If they caught COVID outside of work then how can you assess the mask they wore at work? pubmed.ncbi.nlm.nih.gov/35777605/

#3: Haller 2022. FFP2 use was clearly protective among those with frequent COVID-19 exposure. Even including those with household COVID exposure, FFP2 use was protective although not significant. pubmed.ncbi.nlm.nih.gov/35123572/

#4: Khurana 2021: Healthworkers (HCW) reported on mask use at home and in community, few participants identified household exposure, majority suspected workplace exposure.
COVID negative HCW were significantly more likely to wear N95s than surgical masks. thescipub.com/abstract/ajids…

#5: Li 2021 Over 95.8% of HCW acquired COVID-19 outside of a known patient-related exposure event, "possibly due to improper donning and doffing of masks or social interactions" so the findings are less applicable to assess the mask they wore at work. pubmed.ncbi.nlm.nih.gov/34156456/

#6: Loeb 2004 "Risk was reduced by consistent use of a surgical mask, but not significantly. Risk was lower with consistent use of a N95 mask than with consistent use of a surgical mask." ncbi.nlm.nih.gov/pmc/articles/P…

#7: Loeb 2009. RCT in Ontario hospital nurses, surgical mask vs. N95 resulted in noninferior rates of influenza. Flu is much less contagious than COVID, & may not persist the air for as long as SARS-CoV-2. So this study's findings don't apply to #COVID19 pubmed.ncbi.nlm.nih.gov/19797474/

#8 Loeb 2022 Authors selected a hazard ratio of 2 to as cutoff showing non-inferiority of surgical masks as compared with N95s, but because of large differences different among countries, "firm conclusions about noninferiority may not be applicable" pubmed.ncbi.nlm.nih.gov/36442064/

Not to mention many HCW in Egypt probably caught #COVID19 in the community during the Omicron surge in 2022.
@PaulSaxMD does an excellent job debunking the above Loeb 2022 study in @JWatch. Maybe @CDCgov should read it. blogs.jwatch.org/hiv-id-observa…

#9 Pipian 2020: #COVID19 outbreak among healthcare workers in Italy suggested that HCW who wore N95 respirators were infected in greater proportions than surgical masks but also noted improper use of PPE during HCW meetings played a major role in outbreaks
pubmed.ncbi.nlm.nih.gov/32805309/

#10: Wilson 2022:
When caring for #COVID19 patients, HCWs who wore respirators, for all patient care or only during aerosol-generating procedures, had lower infection risk compared w HCWs who wore mainly surgical masks
pubmed.ncbi.nlm.nih.gov/35313328/E

In sum, we demand improved airborne protections for healthcare workers and patients in healthcare & public input in development of public health guidelines.
Don't forget to tell Medicare and Medicaid we want hospitals to protect us from COVID-19! peoplescdc.substack.com/p/public-comme…