Becker's Clinical Quality & Infection Control

6 INFECTION CONTROL Why hospitals won't keep universal masking around forever By Mackenzie Bean F ace masks have played a crucial role in reducing COVID-19 transmission in hospitals, but clinical and infection control experts are not convinced the pandemic has set a new precedent for widespread use of facial coverings in healthcare settings. "If it's going to set a precedent, it's probably going to set it for clinical areas … and maybe not all the time — maybe during the winter season or the flu season," Firas Zabaneh, director of system infection prevention and control for Houston Methodist, told Becker's. Early in the pandemic, respirators and other facial coverings emerged as crucial and highly coveted supplies for healthcare workers to protect themselves and others. Now, more than two years into the pandemic, some healthcare organizations are relaxing mask rules and looking to a future where masking is more strategic, versus comprehensive. e CDC also updated its infection control guidelines Sept. 23, dropping its universal masking guideline for healthcare workers in areas where community transmission levels are not high. e pandemic is not the first time an infectious disease threat has spurred sweeping changes to clinical practice. While disposable gloves were a norm for clinicians in operating rooms by 1966, they weren't used broadly across hospitals until prompted by the AIDS crisis in the 1980s, according to Baltimore-based Johns Hopkins Medicine. While widespread rubber glove use is still common in hospitals today, healthcare leaders are less confident that universal masking will solidify itself as a widely accepted infection control practice. "Masking is a tool and it's certainly become one we've leaned on more heavily than before the pandemic," Melanie Swi, MD, an occupational medicine physician at Rochester, Minn.-based Mayo Clinic, told Becker's. "I think that what we'll see is kind of this evolving from a universally applied tool in healthcare to a bit more targeted, and it will probably fluctuate." Infection control leaders cited several reasons why universal masking may not stick around aer the pandemic. For one, mortality rates for AIDS were much higher than the U.S. is seeing now for COVID-19 or flu, Mr. Zabaneh said. Masks can also hinder communication and connection between individuals, Dr. Swi added. Many health systems are also facing pressure from staff members to scale back masking. "Unlike wearing gloves, covering your face really challenges that human connection that's so important in healthcare. So much of communication is nonverbal," Dr. Swi said. "We're hungry for that human connection, so I think we'll continue to look for ways to unmask." As of Sept. 26, Mayo Clinic still required universal masking in all of its patient care areas. e system did relax masking in nonpatient care settings where staff may gather for breaks or meals, which employees have really welcomed, Dr. Swi said. With high community transmission rates, Houston Methodist also still had universal source control in place for patient care areas as of Sept. 28. Mr. Zabaneh said leadership will closely monitor these rates, along with the upcoming flu season, to decide when mask rules can be loosened in clinical areas. n US unveils plan to boost pandemic preparedness: 4 key objectives By Erica Carbajal T he White House on Oct. 18 unveiled a strategy to bolster the nation's ability to respond to future pandemics and other biological threats, including an objective to manufacture enough of a new vaccine to protect the population within 130 days of a new outbreak. Biden administration officials described the strategy — which is largely focused on early warnings of infectious disease threats, enhanced diagnostics, and accelerated vaccine and therapeutic development — as a "whole-of- government effort" that will require involvement from 20 federal agencies to implement. HHS will support a number of the national biodefense strategy's goals and said it is "already executing the strategy with existing funding." The White House said achieving all of the strategy's objectives will require additional Congressional support, including the $88 billion over five years President Joe Biden requested in March as part of the budget for fiscal year 2023. Here are four of the strategy's key objectives over the next five to 10 years: • Enable testing for any pathogen within 12 hours of a detected outbreak to support "thousands of samples on the first day, surge tens of thousands of diagnostic tests within one week, and develop rapid diagnostics within 90 days". • Develop vaccines for a new pathogen within 100 days and scale manufacturing to supply enough for the entire U.S. population within 130 days. • Repurpose existing drugs within 90 days or develop novel therapeutics within 180 days. • Expand the nation's personal protective equipment surge capacity by maintaining a minimum 90-day PPE surge capability. n

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