The CDC ended its healthcare infection control practices advisory committee on May 8, and healthcare associations and groups are decrying the decision.
Each year, hospitals incur $28.4 billion to $45 billion in direct medical costs due to hospital-associated infections. HAIs cause more than 72,000 deaths of hospitalized patients annually and up to 70% of HAIs are preventable when using evidence-based practices, according to the Emergency Care Research Institute.
“I urge HHS to consider: what will replace the advisory committee to ensure healthcare providers access and implement up-to-date, evidence-based practices to stop the spread of HAIs?” Marcus Schabacker, MD, PhD, president and CEO of ECRI, said in a statement.
What was HICPAC?
The healthcare infection control practices advisory committee — or HICPAC — crafted national standards on best strategies and practices for preventing and controlling antimicrobial resistance and infections in areas of healthcare such as home health, long-term care, outpatient clinics and hospitals, according to the CDC’s website. Since it launched more than 30 years ago, the committee has made 540 recommendations — 90% of which were fully implemented, NBC News reported. The committee consisted of federal health leaders, including HHS and the CDC, as well as leaders from hospitals and associations.
Dozens of professional organizations sent liaisons to the meeting, including representatives from patient advocates, nurses, long-term care associations, dialysis professionals, pediatric specialists and more, Karen Ravin, MD chief of the pediatric infection division at Nemours Children’s Hospital and the Pediatric Infectious Diseases Society liaison to HICPAC, told Becker’s. The committee also welcomed input from the public.
“HICPAC was one of those behind-the-scenes groups most people never hear about, but that had an enormous impact on patient safety and healthcare worker safety,” Dr. Ravin said. “I saw a group of deeply thoughtful professionals in healthcare epidemiology doing their best to create guidance that would truly work in the real world — guidance that was sensitive to various populations and practical for healthcare workers.”
The CDC said it shut down the 11-person committee to be in compliance with President Donald Trump’s “continuing the reduction of the federal bureaucracy” executive order, a spokesperson for HHS told Becker’s.
The committee was working on a number of guidelines before the shut down, including draft isolation precaution guidelines for healthcare facilities. Now, some members and association leaders fear those guidelines will be lost to time.
“At some point, when things need to change, the guidelines likely won’t change, and then people will be sort of flying by the seat of their pants,” Connie Steed, a HICPAC member since 2023 and former president of the Association for Professionals in Infection Control and Epidemiology, told NBC.
Reactions
For those who worked closely with the committee, the decision to end it was not a shock, as many suspected it might be coming based on the CDC’s behavior leading up to the final decision. In the weeks leading up to the announcement, the CDC had sent termination letters to several members of the committee and canceled some long-standing meetings.
“Still, I was angry,” Dr. Ravin said. “Angry about the lack of understanding regarding what HICPAC actually is and the incredibly important role it’s played in healthcare supporting institutions across the country. It’s frustrating and disappointing.”
Since the committee was cut, a number of national healthcare associations have released statements showing their displeasure with the decision.
“We were disappointed,” David Weber, MD, president of the Society for Healthcare Epidemiology of America Board of Trustees, told Becker’s. “We believe it will negatively impact public health.”
HICPAC guidelines played a significant role in reducing infection morbidity and mortality among patients, as well as protecting healthcare personnel when exposed to diseases.
“It’s disheartening that the CDC currently lacks the ability to convene this kind of expert advisory group to guide them in developing those essential recommendations,” Dr. Weber said.
The absence of this committee is creating a “significant void in the field” and “puts patients at risk,” according to a May 7 joint statement from the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, PIDS and Association for Professionals in Infection Control and Epidemiology.
“HICPAC is an essential component of patient safety, and its contributions cannot be replicated by the private sector,” the joint statement said. “Disbanding HICPAC jeopardizes decades of progress in preventing healthcare-associated infections.”
The potential impacts
A few weeks after HICPAC was disbanded, theories about the long-term implications are still circulating.
IDSA, among other associations, said the disbandment “creates a preventable gap in national preparedness and response capacity, leaving healthcare facilities without timely, evidence-based and expert-driven recommendations at a time when threats from emerging pathogens and antimicrobial resistance are on the rise.”
Jane Thomason, the lead hygienist at National Nurses United, told NBC the change removes important public transparency.
“Without HICPAC’s public meetings, there is no longer any public access to the process for drafting CDC guidance on infection control for healthcare settings,” she told NBC. “This further undermines safety for patients, nurses and other healthcare workers.”
Hospitals are evaluated based on their compliance with the guidelines HICPAC would set, and their compliance had impacts on accreditation by Medicare and Medicaid.
“So, without this committee, we lose a valuable structure that has helped keep patient care safe and consistent for decades,” Dr. Weber said. “Speaking on behalf of my professional organization, I hope that once we have a confirmed CDC director, they’ll take the time to recognize the impact and importance of HICPAC and reinstitute a similar expert advisory group. We need a team with diverse perspectives and deep experience to continue this work. Reinstating that structure should be a near-term priority.”
