March 6, 2020 CDC Incident Manager for Coronavirus Eocevent193@cdc.gov Arjun Srinivasan, MD, FSHEA Captain, USPHS Associate Director for Healthcare Associated Infection Prevention Programs Division of Healthcare Quality Promotion Centers for Disease Control and Prevention 1600 Clifton Rd., MS H16-3 Atlanta, GA 30333 Dear Incident Manager and Dr. Srinivasan: Thank you for keeping us apprised of your efforts to respond to the current COVID-19 outbreak. Considering the dynamic and evolving nature of this situation, maintaining this open dialogue is vital. We appreciate and look forward to our continued collaboration. During our call yesterday, March 5, 2020, you reiterated that the Centers for Disease Control and Prevention remain committed to introducing flexibility into the current guidance for healthcare facilities that will mean weakened protections on the ground. After our discussion, we remain concerned about the following changes:   CDC’s indication that they will allow use of facemasks instead of respirators Change made to CDC’s guidance that decisions about precautionary leave for healthcare workers who have been exposed to a COVID-19 patient may not reflect scientific evidence about infectivity of asymptomatic infections We, the undersigned unions, agree that the proposed changes would not only decrease the level of protection for healthcare workers but would also contribute to the spread of this virus. Emerging diseases like COVID-19 are a pressing occupational hazard for many workers on the frontlines, especially healthcare workers. We are strongly opposed to any measures that fail to provide optimal protection and infection control standards. Now is the time to use every possible tool available to guarantee the highest level of protection, guided by the precautionary principle, to prevent further spread of infection, protect healthcare workers, and preserve our capacity to respond to a widespread outbreak. Sincerely, Bonnie Castillo, Executive Director, RN National Nurses United International Union, United Automobile, Aerospace and Agricultural Implement Workers of America, UAW Randi Weingarten, President American Federation of Teachers The International of Sheet Metal Air Rail and Transportation Workers (SMART) American Postal Workers Union Transport Workers Union of America Debbie White, President, RN Health Professionals & Allied Employees International Brotherhood of Teamsters Utility Workers Union of America International Federation of Professional and Technical Engineers, IFPTE Service Employees International Union New York State Nurses Association International Union of Bricklayers and Allied Craft Workers