The agency has not fully reckoned with airborne transmission of the coronavirus in settings like hospitals, schools and meatpacking plants, experts said.
Nearly a year after scientists showed that the coronavirus can be inhaled in tiny droplets called aerosols that linger indoors in stagnant air, more than a dozen experts are calling on the Biden administration to take immediate action to limit airborne transmission of the virus in high-risk settings like meatpacking plants and prisons.
The 13 experts — including several who advised President Biden during the transition — urged the administration to mandate a combination of masks and environmental measures, like better ventilation, to blunt the risks in various workplaces.
In a letter to the administration, scientists detailed evidence supporting airborne transmission of the virus. It has become even more urgent for the administration to take action now, the experts said, because of the slow vaccine rollout, the threat of more contagious variants of the virus already circulating in the United States, and the high rate of infections and deaths, despite a recent drop in cases.
“It’s time to stop pussyfooting around the fact that the virus is transmitted mostly through the air,” said Linsey Marr, an expert on aerosols at Virginia Tech.
“If we properly acknowledge this, and get the right recommendations and guidance into place, this is our chance to end the pandemic in the next six months,” she added. “If we don’t do this, it could very well drag on.”
The letter was delivered on Monday to Jeffrey D. Zients, coordinator of the Biden administration’s Covid-19 response; Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention; and Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
The letter urged the C.D.C. to recommend the use of high-quality masks, such as N95 respirators, to protect workers at high risk of infection. At present, health care workers mostly rely on surgical masks, which are not as effective against aerosol transmission of the virus.
Many workers vulnerable to infection are people of color, who have borne the brunt of the epidemic in the United States, the experts noted.
But OSHA will only mandate standards that are supported by guidance from the C.D.C., said David Michaels, an epidemiologist at George Washington University and one of the signatories.
(Dr. Michaels led OSHA during the Obama administration; the agency has not had a permanent leader since his departure.)
“Until the C.D.C. makes some changes, OSHA will have difficulty changing the recommendations it puts up because there’s an understanding the government has to be consistent,” Dr. Michaels said. “And C.D.C. has always been seen as the lead agency for infectious disease.”
In an emailed statement, C.D.C. officials emphasized the proper use of cloth and surgical masks to protect against the virus and said that N95 respirators were not recommended for the general public “for reasons supported by science, comfort, costs and practicality.” The statement did not address ventilation in workplaces.
But the agency’s recommendations on workplace accommodations did not reflect this change.
Early in the pandemic, the C.D.C. said health care workers did not need N95 respirators, and could even wear bandannas to protect themselves. It also did not recommend face coverings for the rest of the population.
The agency has since revised those recommendations. It recently recommended that people wear two masks or improve the fit of their surgical masks to protect from the virus.
“But they don’t talk about why you need a better fitting mask,” said Dr. Donald Milton, an aerosol expert at the University of Maryland. “They’re acknowledging the importance of breathing it in and the route of transmission, and yet they don’t say it clearly in their various web pages.”
The agency recommends surgical masks for health care workers and says N95 respirators are needed only during medical procedures that generate aerosols, like certain kinds of surgery.
“The C.D.C. has not emphasized the risk of aerosol transmission enough,” Dr. Gounder said. “Unfortunately, concerns about supply continue to muddy the discussion.”
“We really do need to stop this reuse and decontamination approach to N95s,” she added. “We’re a year into this, and that’s really not acceptable.”
“If you go to other workplaces, this idea that aerosol transmission is important is virtually unknown,” Dr. Michaels said. In food processing plants, for example, a refrigerated environment and the lack of fresh air are ideal conditions for the virus to thrive. But the industry has not put in safety measures to minimize the risk, he added.
Employers instead hew to the C.D.C.’s recommendations for physical distancing and cleaning surfaces.
Dr. Marr was one of the experts who wrote to the W.H.O. last summer to push for an acknowledgment of airborne transmission. She did not expect to be in a similar position again so many months later, she said: “It feels like Groundhog Day.”
Source: New York Times