Written by Lambert Strether of Corrente.
For those readers who don’t know what HICPAC (Healthcare Infection Control and Prevention Advisory Committee) is, Section 1 below explains it. Based on Stafford Beers’ principle that “the purpose of the system is the function of the system,” HICPAC’s purpose is to develop guidance for hospitals and nursing homes that does not require universal action. of patients with coronavirus and other airborne diseases. By masking and denying the reality of airborne transmission.
here it is our post At WHN (World Health Network) original complaint. WHN’s newly filed supplemental complaint add these Four additional points:
1. Illegal Membership of HICPAC
2. Conflicts of interest among HICPAC members
3. Failure to deal with airborne infections
4. Confidential Workgroup Litigation in Violation of FACA
In this short post, I will consider all four points in the complaint, but I will quote some material from North Carolina’s HICPAC post. Because Lambert is preening here. Because I have heard on good authority that they have produced positive results for WHN lawyers. idea. Now on to point 1.
1. Illegal Membership of HICPAC
For those of you who joined me late, I promised to explain more about HICPAC in point 1, so let me quote. From previous posts:
The CDC explains: HICPAC and its putative mission Like this:
HICPAC is appointed to provide advice and guidance to DHHS and CDC on infection control practices and strategies for the surveillance, prevention, and control of healthcare-associated infections, antimicrobial resistance, and related events in U.S. healthcare settings. Federal Advisory Committee.
The structure of HICPAC is: CDC overview page:
HICPAC is comprised of 14 voting members who are not federal employees. These experts are appointed by the Secretary of HHS through an application and nomination process. HICPAC voting members bring expertise in infectious diseases, infection prevention and control, medical epidemiology, nursing, clinical and environmental microbiology, surgery, hospital medicine, internal medicine, epidemiology, health policy, health services research, public health, and more. but not limited to. and related medical fields.
HICPAC also includes six ex-officio members representing federal agencies within HHS and a liaison representative who provides relevant patient safety expertise from healthcare organizations, consumer organizations, public agencies, and partners. I am. These ex-officio members and liaison representatives are included in the HICPAC Charter, which is updated every two years by HHS. The ex-officio representative and liaison representative are non-voting members of HICPAC.
This is where the “related medical field” plays an active role. Given that #CovidIsAirborne, some may be surprised that there are no aerosol scientists or ventilation engineers on the committee, as airborne transmission and its prevention is fundamentally an engineering problem. But then again, if you view HICPAC as the highest expression of collective consciousness for infection control, that may not be all that surprising.
Please note that there must be 14 voting members. Supplemental Complaint, from page 1:
The HICPAC Charter requires the committee to consist of 14 members. This Charter violation had already been brought to the attention of the Inspector General in WHN’s first complaint. However, on August 22, 2024, HICPAC held a meeting with only 11 members. This action by HICPAC demonstrates its disregard for its own Charter and the Inspector General’s authority to enforce it. From the time of WHN’s initial complaint to the present, HICPAC has remained an illegally established commission without legal validity or enforceability.
This is a good thing, because if the Inspector General finds out about WHN, HICPAC will no longer be able to accomplish its Beersian goal of infecting patients.
2. Conflicts of interest among HICPAC members
This document begins on page 2 of the Supplemental Complaint. Rearrange the order slightly from gently placing the gauntlet on the table (“A”) to throwing it (“C”). We also need to explain FACA (Federal Advisory Committee Act). I wrote it on this post:
HICPAC conference was held, CDC saysunder the protection of Federal Advisory Committee Act (FACA), Explanation by Congressional Research Service (CRO):
Federal advisory committees are established by Congress, the President, and executive branch agencies to obtain expertise and policy advice from individuals outside the federal government. Many federal advisory committees are subject to the Federal Advisory Committees Act (FACA; 5 USC Chapter 10), which includes statutory meeting and transparency requirements. The General Services Administration (GSA) Office of Commission Management (the “Office”) is responsible for matters relating to advisory committees covered by FACA. In the final rule, GSA states that FACA is not a public participation law and directly impacts how the executive branch is responsible for the use and management of federal advisory committees as a primary means of obtaining public participation. He said he would give it.
I pursued what I thought was a serious public meeting violation, and now WHN is acting like it is. Really Jugular: Chase the money.
A. Financial relationships. WHN writes:
A key principle of FACA is that employees of the agency being advised (in this case, the CDC) are not permitted to serve on committees due to the inherent nature of financial relationships that may impede independence. That means no. Although funding is not strictly prohibited, it is clear that conflicts of interest should be avoided.
Financial relationships between agencies and individual members, such as the one that currently exists between virtually all members of the CDC and HICPAC committees, run a serious risk of compromising the independence of their judgment. This is true not just because funding links can influence certain decisions, but also because:
To put it bluntly, even if the CDC’s handwashing desk wrote a HICPAC check, it’s unlikely to pay due attention to airborne transmission.
B. Competition for funding with rival silos. WHN writes:
Additionally, HICPAC members are recognized for their expertise in areas such as bloodstream infections, sepsis, sharps injuries, hand hygiene, vomit infections, sterilization and disinfection, antimicrobial resistance, and Ebola. This creates a potential conflict of interest and could impede the decision to shift the focus of infection prevention to airborne diseases to effectively address hospital-acquired COVID-19 infections. (IPC) and colleagues. This inherent tension is compounded by similar conflicts of interest among CDC officials (including current and former HICPAC federal officials and NCEZID directors) responsible for nominating HICPAC members and setting the committee’s agenda.
I don’t know anyone who has a problem with threatening IPC. you? (And if these two sections make HICPAC and CDC look like self-serving snake pits, well, that’s what they seem to be. Also, why did the CDC Foundation get caught up in this “inherent tension” in the first place? It would be interesting to know if.
C. Perverse incentives in the piecework system due to nosocomial infections. WHN writes:
The HICPAC Charter requires that guidance be provided on the “prevention and control of healthcare-associated infectious diseases.” Therefore, committee members who are paid to encourage the spread of infection (or who are paid for knowingly or willfully ignorant of the science of infection control in health care settings) must comply with the objectives and interests of HICPAC. Conflicting.
More specifically, it is well established that direct payment systems can lead to perverse incentives for the prevention of hospital-acquired infections (HAIs). In a fee-for-service model, hospitals are reimbursed for services provided, including treatment for HAIs. In such a system, hospitals can make more money by providing additional care to treat infections rather than preventing them in the first place.
No matter how hard I try, I’m never cynical enough. The best financial incentive I could think of was related to line items. I don’t want to spend money on a ventilator instead of a cheap baggy blue one. You don’t want to remove the belt on your HEPA air filtration system. It never occurred to me that hospitals would be incentivized to make patients sicker. So I never thought that any kind of masking or non-pharmaceutical intervention would run into institutional resistance, but the logic is clear.
3. Failure to deal with airborne infections
From page 4:
As filed in the First Complaint, the COVID-19 pandemic and the continued presence of COVID-19 in the United States has heightened the urgency of understanding the airborne transmission of infection in health care settings. In fact, in 2024, the CDC confirmed the airborne nature of COVID-19. However, HICPAC has not yet been able to include a member with airborne infection expertise, although there are still three vacancies.
Instead of adding HICPAC’s original membership, the people who could actually vote on the guidance, HICPAC did the following:
4. Confidential Workgroup Litigation in Violation of FACA
HICPAC created “work groups” that met in secret without voting rights. From page 3:
HICPAC has formed the Isolation Precautions Guidelines Workgroup to assess the issue of airborne transmission in healthcare settings. However, this workgroup’s transactions are not publicly available, unlike the 5 USC app. Exception to making meetings public under § 10(a)(1) (FACA), 5 USC App. § 10(d) does not apply.
The composition of the workgroup highlights that current HICPAC members do not have the necessary expertise to determine airborne transmission in healthcare settings. There are still three vacancies in HICPAC, in direct violation of the Charter, and there are qualified airborne infection experts in the workgroup, but instead of bringing the committee into legal compliance, these It was decided to establish a workgroup of experts. We believe that this act of forming workgroups could be interpreted by the public as a tactic by HICPAC to avoid exposing sensitive and controversial discussions to public scrutiny. claim. WHN suggests that HICPAC should focus on filling remaining vacancies (on the commission itself) with experts familiar with airborne transmission.
conclusion
It is difficult to understand why the CDC and HICPAC would act this way. It’s like he’s hiding somethingMR Subliminal Kachin! Are bodies piled too high?
Appendix: WHN Supplemental Complaint
Additional complaints include:
Supplement – Complaints – HICPAC – 2024.10.23 – Final
The supporting documents for the supplementary complaint are as follows:
Supplementary Complaints Support Materials HICPAC-2024.10.23
Kudos to WHTN for their great work.
