A Medical Device Daily

The Centers for Disease Control and Prevention (Atlanta) has issued a statement that it terms "interim," providing advice concerning the use of facemasks and respirators "in public places (as opposed to workplaces) in the event of a pandemic, but emphasizes that the best protection is avoiding those who are infected. "

The advice, it said, "is temporary, pending a fuller scientific investigation of the effectiveness of facemasks and respirators."

The agency said it is attempting to address questions concerning the best precautions against pandemic infections, and it provides a straightforward caveat: that the advice "is based on sparse scientific evidence, gleaned mostly from using these devices in healthcare settings."
It said that in case of a pandemic "facemasks and respirators on their own are unlikely to protect people from becoming infected or reduce the spread of the virus. Spread and infection are more likely to be contained if people also:

  • Stay away from infected people;
  • avoid crowds;
  • stay home if infected;
  • take antiviral medication;
  • encourage family members and friends to stay at home if they are infected.

Julie Gerberding, director of the CDC, said, "During an influenza pandemic, we know that no single action will provide complete protection."

She said that many people will probably choose to use facemasks for extra protection even though there is little evidence of their effectiveness.

But she went on to provide an apparently contradictory conclusion: "If people are not able to avoid crowded places, large gatherings or are caring for people who are ill, using a facemask or a respirator correctly and consistently could help protect people and reduce the spread of pandemic influenza.

The guide suggests considering wearing a facemask in a flu pandemic if you:

  • are sick with flu and close to people who may become infected;
  • live with or spend time with people who have flu symptoms (they could be infectious).
  • Spend time in crowded places;

And it says people should consider using a respirator if they:

  • are well and spend time close to people who are infected (within 6 feet);
  • are taking care of a person who is sick with flu.

The CDC emphasizes that whether wearing a mask, respirator, or neither of these, should the time spent close to infected people if you are well should be limited, and if infected yourself, the time spent close to others should be limited to minimize the chance of passing it on.
It said that facemasks "are designed as a barrier to droplets from sneezes, coughs and splutters from other people. They also reduce the chance that the wearer will spray droplets onto others. They will not protect the wearer from breathing in small virus particles. "Respirators on the other hand have finer filters designed to stop most virus particles from being breathed in by the wearer and are probably your best bet if you are in frequent contact with an infected person. But the CDC said that facemasks and respirators bring additional problems not present when not worn. "For example they make you sweat and feel hot, and this increases the frequency of touching your face with your hands, adding an additional entry route for the virus. And they may also give you a false sense of security so you neglect other important precautions."

Weems picked by Bush to head CMS

Kerry Weems, a longtime federal health official, has been selected by President George Bush's to oversee the Centers for Medicare & Medicaid Services. If confirmed by the Senate, Weems would succeed Mark McClellan, who resigned in October.

McClellan left CMS to join a center for regulatory studies run by two Washington think tanks, the Brookings Institution and the American Enterprise Institute.

Weems is deputy chief of staff to Mike Leavitt, secretary of the Department of Health and Human Services. He also has served as an acting assistant secretary overseeing budget and technology issues.

The president also is nominating Tevi David Troy to be deputy secretary at HHS. Troy is the deputy assistant to the president for domestic policy.