Some Experts Warn That Revised WHO COVID Prevention Guidelines Might Pose Risks Instead of Safeguarding
The World Health Organization's (WHO) recent update to its
COVID-19 prevention and control guidelines is aimed at safeguarding healthcare
workers, patients, and communities. However, some experts argue that the
guidelines may inadvertently promote risky behavior by perpetuating outdated
notions about virus transmission.
According to Lisa Brosseau, an expert in respiratory
protection and infectious diseases, the guidelines could pose significant risks
to healthcare workers, patients, and communities. Raina Macintyre, a professor
at the Kirby Institute, highlights a key flaw in the document: its failure to
incorporate lessons learned during the pandemic, particularly the role of
asymptomatic transmission.
Macintyre criticizes the emphasis on symptom-based
screening, stating that many transmissions occur asymptomatically. David
Michaels, an epidemiologist, expresses disappointment in the guidelines'
adherence to "droplet dogma," an outdated belief that SARS-CoV-2
primarily spreads through droplets rather than aerosols.
The guidelines also fall short in recognizing the superior
protection offered by N95 respirators compared to medical masks. Brosseau
underscores the importance of respirators in preventing small particle leakage,
emphasizing that masks and respirators differ in their filtering capabilities.
Macintyre points out a contradiction in recommending
physical barriers like Plexiglass screens, which may hinder airflow. The
guidelines introduce the term "targeted continuous," creating
confusion around mask usage. The experts question the rationale behind the
1-meter distancing recommendation, lacking evidence or explanation.
Additionally, Brosseau critiques the focus on improving the
fit of medical masks, which are not designed to prevent small particles from
escaping. She questions why the guidelines discuss mask fit but neglect
respirator performance.
The bias against respirators has a historical context,
dating back to the 1980s during tuberculosis outbreaks. Brosseau notes that
OSHA proposed a standard requiring respirator use for healthcare workers during
tuberculosis care, but influential organizations lobbied against it.
The experts advocate for universal respirator use in
healthcare settings, especially during periods of high community transmission.
They challenge the guidelines' failure to acknowledge aerosol transmission's
significance and stress the need for a cultural shift towards universal respirator
use.
The CDC has sought updates to its guidelines, recognizing
aerosol viral spread. Proposed new categories include Special Air Precautions,
Routine Air, and Extended Air Precautions. The request aims to protect patients
and healthcare workers, emphasizing an iterative process to refine guidelines
based on evolving evidence and experience.
In conclusion, the WHO's updated guidelines face criticism
for potential risks posed by outdated concepts, inadequate acknowledgment of
aerosol transmission, and insufficient recognition of respirator superiority.
The experts call for a paradigm shift toward universal respirator use in
healthcare settings.
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