Policy-Based Evidence Making w/ Jane Thomason (03/14/24)
Mar 13, 2024
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The podcast delves into the CDC's sudden change in Covid isolation guidance and efforts to uphold infection control in healthcare settings. They discuss the efficacy of surgical masks vs. N95 respirators, the impact of policy decisions on worker protection, and the evolving landscape of Covid responsibilities. The conversation also highlights the misconceptions between Covid and flu, advocating for stronger protections and healthcare equality.
Policy-based evidence making prioritizes employer profit over worker and patient safety in CDC guidance changes.
Individualized infection prevention measures shift costs and burdens onto healthcare workers, deviating from collective response.
Selective use of 'real-world evidence' by CDC and HICPAC raises concerns about cherry-picking data to support predetermined policy changes.
Deep dives
CDC and HICPAC Guidance Challenges
The CDC and HICPAC guidance for health care settings faced criticism for proposing changes that shift the responsibility for infection prevention onto individual health care workers, rather than employers. This move, criticized as benefiting employer profit over worker and patient safety, was described as policy-based evidence making, where predetermined policy goals influence the use and interpretation of scientific evidence.
Focus on Individual Responsibility vs. Collective Response
The guidance changes emphasized individual responsibility for infection prevention, framing it as an issue of personal choice and autonomy rather than systemic protections. This shift towards individualized measures was viewed as a departure from a collective response to health hazards, leading to concerns about costs and burdens being shifted from employers to individuals.
Emphasis on Real-World Evidence and Imbalance in Evidence Selection
The emphasis on 'real-world evidence' by CDC and HICPAC led to a restriction in the types of studies considered, prioritizing randomized controlled trials conducted in practical settings. This selective approach to evidence selection raised concerns about cherry-picking data to support predetermined policy changes, rather than considering a diverse range of scientific research methodologies and evidence.
The Focus of HICPAC on N95 Respirators and Ventilation in Healthcare Settings
The podcast episode discusses the Health Industry Practices Advisory Committee's (HICPAC) focus on using N95 respirators less frequently in healthcare and separating N95 respirator use from airborne infection isolation rooms. Despite evidence reviews on N95 respirators and surgical masks, there is a lack of evidence review on ventilation and airborne infection isolation rooms. The decision to disregard ventilation in healthcare settings was made without substantial evidence, highlighting the need for diverse expertise, including ventilation engineers and respiratory protection experts, in developing comprehensive guidance.
CDC's Changing Isolation Guidelines and the Influence of Economic Considerations
The episode delves into the CDC's shifting isolation guidelines for COVID-19 patients, reducing isolation from 10 days to 5 days primarily due to economic concerns about workforce impact. The decision reflected more business-focused considerations than new scientific insights, jeopardizing public health. The revised isolation guidelines prioritize economic interests over health, pressuring individuals, especially low-wage workers without sick leave, to return to work prematurely, potentially resulting in increased infections and health risks.
Beatrice speaks with Jane Thomason of National Nurses United (NNU) about the CDC’s recent abrupt decision to drop its 5-day covid isolation guidance and the latest developments in the campaign to stop the CDC from dramatically weakening infection control practices in healthcare settings.
Sign on to NNU’s latest campaign here: nationalnursesunited.org/cdc
Transcript: https://www.deathpanel.net/transcripts/nnu-hicpac-3
Find our book Health Communism here: www.versobooks.com/books/4081-health-communism
Find Jules' new book, A Short History of Trans Misogyny, here:
https://www.versobooks.com/products/3054-a-short-history-of-trans-misogyny
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