The World Health Organization recently published COVID-19 prevention and infection control guidelines, but some experts don’t think the standards incorporate enough of what healthcare workers learned during the pandemic.
Raina Macintyre, PhD, professor and head of the biosecurity program at the Kirby Institute in Sydney, Australia, said the guidance doesn’t include many of the lessons that frontline workers learned during the pandemic, especially about how COVID-19 can spread in people who don’t have symptoms.
“The guidelines suggest using symptoms to screen people,” she told CIDRAP in an email. “This is seen in health guidelines in many countries — emphasis on symptoms (‘Wear a mask if you feel unwell’), when we know a substantial proportion of transmission is asymptomatic, which is a major rationale for universal masking in high-transmission settings.”
David Michaels, PhD, an epidemiologist and professor at George Washington University School of Public Health and a former administrator at the US Occupational Safety and Health Administration, said he was “very disappointed” in the guidelines because they don’t recognize the airborne properties of the virus in prevention or control measures.
Additionally, the WHO guidance doesn’t fully acknowledge that N95 respirators are better than surgical masks, experts said.
“Masks are good as source control for coughing and sneezing, but if a virus is truly airborne, as we think this coronavirus is, while it’s useful, it’s not adequately protective,” Michaels said.
Macintyre and Michaels both support universal respirator use in healthcare settings, especially during times when respiratory viruses are spreading.
“I think it depends on the overall risk in the region, but certainly universal [respirator use] in periods of increased risk is absolutely vital, because you can’t predict who will be infectious,” Michaels said.
Additionally, the WHO guidance included details on physical barriers such as clear screens, which some evidence shows can block airflow, Macintyre said.
According to the WHO, everyone in healthcare settings should stay about three feet apart when possible, but Michaels noted that there’s no discussion about where that figure was derived.
