Written by Lambert Strether of Corrente.
For readers who don’t know what the Healthcare Infection Control and Prevention Advisory Committee (HICPAC) is, we’ll learn about it in Section 1 below. Guided by Stafford Beers’ principle that “the purpose of a system is to do what it does,” HICPAC’s purpose is to create CDC (Centers for Disease Control) guidelines that do not require universal guidelines to protect patients in hospitals and nursing homes from COVID and other airborne diseases. It’s infecting. By masking and denying the reality of airborne transmission.
Below is a post about the original complaint from the World Health Network (WHN). WHN’s New Supplementary Complaint add this Four additions:
1. Illegal membership of HICPAC
2. Conflicts of interest among HICPAC members
3. Failure to resolve aerial radio waves
4. Confidential Workgroup Procedures for FACA Violations
In this brief post, I’ll look at all four points of the complaint, but I’ll also cite some material from NC’s HICPAC post. Because I’m told – here by Lambert Preens – that they’ve had beneficial results for WHN’s lawyers. Idea. So to point 1.
1. Illegal membership of HICPAC
For those of you who are late, I’ll quote my previous post because I promised I would explain HICPAC in more detail in number 1.
The CDC explains: HICPAC and its assumed mission As follows:
HICPAC is a federal advisory committee appointed to provide advice and guidance to DHHS and CDC regarding 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.
The structure of HICPAC is as follows: CDC Information Page:
HICPAC is comprised of 14 voting members who are not federal employees. These experts are appointed by the Secretary of HHS following an application and nomination process. HICPAC voting members include infectious diseases, infection prevention and control, healthcare epidemiology, nursing, clinical and environmental microbiology, surgery, hospital medicine, internal medicine, epidemiology, health policy, health services research, public health, and related medical fields.
HICPAC also includes six ex officio members representing federal agencies within HHS and liaisons who provide relevant patient safety expertise from health associations, consumer groups, public agencies, and partners. These ex officio members and liaisons are included in the HICPAC charter, which HHS renews every two years. Ex-officio representatives and liaison representatives are non-voting members of HICPAC.
“Allied health care” is doing a lot there. Since airborne transmission and its prevention are fundamentally engineering problems, some may find the fact that there are no aerosol scientists or ventilation engineers on the committee surprising, given that #CovidIsAirborne. And that may not be so surprising if you view HICPAC as the highest expression of the infection control hive mind.
Note especially the requirement for 14 voting members. Page 1 of the supplemental complaint:
According to the HICPAC charter, the committee must consist of 14 members. These charter violations have already been brought to the attention of the Inspector General through WHN’s initial complaint. However, on August 22, 2024, HICPAC held a meeting with only 11 members. These actions by HICPAC demonstrate a disregard for its charter and the Inspector General’s authority to enforce it. From the time of WHN’s original complaint to the present, HICPAC was and remains an illegally constituted committee with no legal validity or enforceability.
That’s a good thing, because if auditors find WHN, it could prevent HICPAC from achieving its Beersian goal of infecting patients.
2. Conflicts of interest among HICPAC members
This material begins on page 2 of the supplemental complaint. I’m going to lightly place the gauntlet on the table (“A”) and rearrange it a bit in the order in which I place it (“C”). We also need to explain the Federal Advisory Committee Act (FACA). I wrote the following in this post:
HICPAC meeting is held, CDC saysunder the protection of Federal Advisory Committee Act (FACA), Explained by the Congressional Research Service (CRO):
Federal advisory committees are formed 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 Committee Act (FACA, 5 USC Title 10), which includes statutory meeting and transparency requirements. The General Services Administration’s (GSA) Office of Committee Management (the “Office”) is responsible for matters related to advisory committees subject to FACA. In the final rule, GSA stated: [w]Because FACA is not a public participation statute, it directly impacts how the Executive Branch is responsible for using and managing federal advisory committees as its primary means of obtaining public participation.
I pursued what I believed to be a formal open meeting violation, but now WHN really Jugular: Following the money.
A. Financial Relationship. WHN wrote:
An important principle of FACA is that no employee of the advised entity (in this case CDC) may be a member of the committee due to the inherent nature of the financial relationship that may interfere with independence. Although fundraising is not strictly prohibited, it is clear that conflicts of interest must be avoided.
Financial relationships between the agency and individual members, such as those that currently exist between CDC and virtually all HICPAC committee members, pose a serious threat to independence of judgment. This is true not only because funding links can influence certain decisions, but also when:
Broadly speaking, if you fill out a HICPAC check at the CDC’s handwashing desk, airborne transmission will not be given the attention it deserves.
B. Competition for funding from rival silos. WHN wrote:
Additionally, HICPAC members have recognized expertise in areas such as bloodstream infections, sepsis, sharps injuries, hand hygiene, fomite transmission, sterilization and disinfection, antimicrobial resistance, and Ebola. This creates a potential conflict of interest that could interfere with the decision to shift the focus of infection prevention to airborne diseases. This is necessary to effectively combat hospital-based COVID-19 transmission. [IPC]And that of my colleagues. These inherent tensions are further exacerbated by similar conflicts of interest between current and former HICPAC federal officials and CDC officials responsible for nominating HICPAC members and setting the committee agenda, including NCEZID directors.
I don’t know anyone who has a problem with threatening the IPC. you are? (And if these two sections make HICPAC and the CDC seem like cesspools of self-dealing, well, they are. It would be interesting to know whether the CDC Foundation is steeped in this “inherent tension” at all.)
C. Distorted incentives in the fee-for-service system due to hospital-acquired infections. WHN wrote:
The HICPAC charter mandates that it provide guidance on the “prevention and control of healthcare-associated infections.” Committee members are thus rewarded for encouraging the spread of infection (or for being willfully or knowingly ignorant of the science of infection control in healthcare settings). There is a conflict between HICPAC’s objectives and interests.
More specifically, it is well known that direct payment systems can create perverse incentives against hospital-acquired infection (HAI) prevention. In a fee-for-service payment model, hospitals are reimbursed for services provided, including treatment of HAIs. In such a system, hospitals can generate more revenue by providing additional care to treat these infections rather than preventing them in the first place.
No matter how hard I try, I’m not cynical enough. Related Ads Top Financial Incentives You Don’t Want to Spend Money on a Respirator Instead of Cheap Baggy Blue Clothes. You don’t want to undo the belt on your HEPA air filtration system. It never occurred to us that all kinds of masking and non-pharmacological interventions would face institutional resistance because hospitals might be incentivized to make patients sicker, but the logic is clear.
3. Failure to resolve aerial radio waves
From page 4:
As submitted in the first report, the COVID-19 pandemic and continued presence of COVID-19 in the United States has made it urgent to understand airborne transmission of infection in healthcare settings. In fact, in 2024, the CDC confirmed the airborne transmission characteristics of COVID-19. However, despite still having three vacancies, HICPAC continues to lack members with expertise in aerial propagation.
Instead of adding members to HICPAC (i.e., people who can actually vote on the guidelines), HICPAC did the following:
4. Confidential Workgroup Procedures for FACA Violations
HICPAC designed “working groups” that met secretly without voting rights. From page 3:
HICPAC established the Isolation Precautions Guidance Working Group to evaluate the issue of airborne infection transmission in healthcare settings. However, this Workgroup’s transactions are not disclosed to the public under 5 USC App. § 10(a)(1) [FACA]5 There are exceptions to opening meetings to the public under the USC App. § 10(d) does not apply.
The composition of the working group highlights that HICPAC members do not currently have the necessary expertise to determine airborne transmission in healthcare settings. In direct violation of its charter, HICPAC still has three vacancies and the working group has qualified air transport experts, but instead of bringing the committee into legal compliance, it has decided to form a working group of these experts instead. We submit that this act of forming a working group may be interpreted by the public as a tactic by HICPAC to avoid exposing delicate and potentially contentious debates to public scrutiny. WHN submits that HICPAC should instead focus on filling remaining vacancies. [on the Committee proper] We work with experts who are well-versed in public broadcasting.
conclusion
It is difficult to understand why CDC and HICPAC act this way. Looks like you have something to hideMR subliminal kaching! Are the bodies piled too high?
Appendix: WHN Supplemental Complaints
The following is a supplemental complaint:
Supplement-Complaint-HICPAC-October 23, 2024-Final
The supporting material for the supplemental complaint is as follows:
Supplement-Complaint-Application-Data-HICPAC-23.10.2024
Congratulations to WHTN on a successful job.
