00:00:00:00 - 00:00:07:26 Unknown but before we do that, I'm going to pass it to Mike Lin. If anything, to say. 00:00:07:28 - 00:00:37:26 Unknown Thank you. We'll start the public comment period. And, following that, we will revisit the voting slides. Thank you. Again, public comment should be limited to three minutes. We ask that you please state your name and organization for the record before providing your comment. Please note that the public comment period is not a question and answer session. I would like to introduce our zoom Coordinator, Angela, who will be managing the public comments. 00:00:37:28 - 00:00:48:18 Unknown Our first commentator is live near Barham. 00:00:48:20 - 00:01:15:12 Unknown Hello. Can you hear me? Yes, we can hear you. Thank you. My name is Jennifer Bryant. I am president of the New and Complex Systems Institute, co-founder of the World Health Network. I'm here not to impress people directly, but to speak to those listening healthcare professionals, patients and advocates who are committed to public health and safety. Let me highlight several critical concerns. 00:01:15:14 - 00:01:42:28 Unknown Members of Hitech and the organizations they represent have significant financial conflicts of interest. This issue, documented a complaint submitted to the HHS Office of Inspector General, raises serious questions about the integrity of their guidance. Additionally, Hitech is operated in secrecy. We work released close to the public scrutiny. This violates the Federal Advisory Committee Act, which mandates transparency. Such closed door decisions erode trust and undermine accountability. 00:01:43:00 - 00:02:11:29 Unknown Kickback also lacks the legally required number of voting members, further undermining the legitimacy of its recommendations and decision making process. Most importantly, the science of airborne transmission is essential for understanding diseases like Covid 19 and rookie losses is glaringly absent from expert guidance. Ignoring this, science compromises the safety of both patients and health care workers. Compounding this issue, the voting members of Hick pack like the necessary expertise in airborne transmission. 00:02:12:01 - 00:02:39:10 Unknown While they may consider themselves infection control experts. Their opinions on this critical topic cannot be treated as expert input. Science must drive policy. It provides the essential and necessary evidence for informed decisions about safety and prevention. When science is sidelined, lives are put at risk. One actionable step is for illness that Covid 19 and other airborne infections to the list of health care acquired infections for which treatment is not reimbursed. 00:02:39:12 - 00:03:01:07 Unknown This would align with existing policies and create a powerful incentive for hospitals to implement necessary precautions. Far too many have suffered illness, acquired and acquired in health care, become disabled with long Covid, or died from preventable infections. Far too many have avoided necessary care due to these risks. Every preventable case is a tragedy and a failure of the system. 00:03:01:09 - 00:03:36:09 Unknown Please call the HHS Office of Inspector General and ask them to investigate our complaint against the HHS Secretary, CDC director, and designated federal officer for gross misconduct regarding suspects violation of the law. The Inspector General's office is very receptive to direct phone numbers. 202649314820261932148. The HHS Inspector General Christy Grimm, operates independently of political administrations. Her office will continue to oversee investigations regardless of the change in leadership. 00:03:36:11 - 00:04:11:04 Unknown It's time to restore. First, do no harm. Every provider, institution and policy maker must prioritize safety based on the best available science. Anything less is a disservice to those who trust the health care system with their lives. Thank you, Jennifer, for your comment. We can move on to the next one. Our next commentator is Jamie Leo Castro. 00:04:11:06 - 00:04:20:17 Unknown Jamie, are you on the call? 00:04:20:20 - 00:04:37:22 Unknown Our next commentator is Michelle, though. 00:04:37:24 - 00:05:15:19 Unknown Hello. Good morning. My name is Michelle. I am a registered nurse and president for the California Nurses Association. National Nurses Organizing Committee, a state affiliate of National Nurses United and English, is the largest labor union and professional association for registered nurses in the US. And in you commends the CDC for responding to our concerns about Hic PACs process to update the 2007 Isolation Precautions guidance, including by ensuring HIG PAC hears from the public prior to voting, posting meeting recordings, adding additional experts to PAC and its isolation precautions. 00:05:15:19 - 00:05:47:00 Unknown Guidance guidelines recruit and most recently, ensuring that both oral and written public comments are solicited for each meeting, as required by law. We commend the CDC for sending back Hic PACs. November 2023 draft update for further work. In response to some of our concerns. I strongly encourage you to ensure that PACs response recognizes the following. As the World Health Organization acknowledged earlier this year, the droplet airborne paradigm has been disproven. 00:05:47:03 - 00:06:29:06 Unknown Extensive research indicates that aerosol or inhalation transmission can occur at both short and long distances. CDC guidance must recognize this science, including recommending that multiple layers of protection are necessary to prevent transmission in healthcare settings, including ventilation, screening, isolation, PPE, contact tracing, masks for source control and more. Respirator ERS are essential. Yet preliminary results from News Infectious Disease Survey found that less than two thirds of Americans have access to a sufficient supply of n95s or other kinds of respirators on their units. 00:06:29:08 - 00:06:59:12 Unknown Nurses and other health care workers must be able to utilize N95 or more protective respirators when and where we need them, because we assess that we need a higher level of protection than is recommended because we or someone we live with or care for is at higher risk of severe outcomes. If infected, it would be deadly and irresponsible for healthcare employers and the CDC to deny us access to the PPE we need to care for our patients safely. 00:06:59:14 - 00:07:22:06 Unknown Working as a nurse in a clinical setting for 26 years, I have witnessed so many infections, hospitalizations and even deaths that could have been prevented if we had had access to the necessary precautions. Moving forward, it is essential that the CDC continues to expand the perspectives presented on that and its work groups to ensure that a balance is created. 00:07:22:13 - 00:07:40:17 Unknown That includes direct care, health care workers, unions, patients, and scientific experts in addition to infection prevention management. Thank you. Thank you for your comment. We can move on to our next commenter. 00:07:40:19 - 00:07:49:28 Unknown Vasser. Bailey. 00:07:50:01 - 00:08:20:23 Unknown Hello? Yes. Hi. Thank you. I'm vasser Bailey. I'm a person with long Covid and an activist with long Covid action project known as El Cap. El cap is a nonpartisan, diverse group of individuals taking action to end the long Covid crisis. We demand urgent treatment and support for the long Covid community through public awareness and government accountability. I've had long Covid since my first infection in 2022. 00:08:20:25 - 00:08:52:02 Unknown I Omicron, even though I was vaccinated and masking, I wore a surgical mask because I didn't know respirators offered stronger protection. I'm not unique. According to NIH data, approximately 10% of the population. That's 33 million Americans are living with long Covid. Currently, there are zero effective treatments for long Covid. Since Tic TAC is aware of the transmissibility of Covid even during asymptomatic increase symptomatic illness. 00:08:52:05 - 00:09:23:21 Unknown Why haven't you mandated respirators be worn in medical settings at all times? One way protection is not enough. People caught Covid from medical appointments wearing despite wearing N95 and eye protection. One friend has covered four times for medical visits. Despite wearing an N95, her care providers either refused to mask or would only wear a surgical mask. Patients are frequently met with hostility by healthcare workers. 00:09:23:27 - 00:09:55:27 Unknown If we asked for respirator use during appointments, problems like this start at the top. Everyone has seen photos of the CDC director visiting various healthcare settings without any PPE. Covid transmission has occurred in rooms that have been unoccupied for four or more hours. Medical offices and hospitals are now one of the best places to catch an illness. Nash clearly states that respirators should be used not for surgical masks. 00:09:56:00 - 00:10:26:11 Unknown We need n95s or better to be worn at all times by all who can in health care facilities. CDC is infection control guidance for SARS-CoV-2 does nothing but confuse. That's easily fixed simply by setting forth two rules. One, everyone in health care settings must wear a respirator, and two facilities must clean the air. Numerous studies have demonstrated correlations between Covid and subsequent diseases. 00:10:26:13 - 00:10:51:27 Unknown The virus remains in the body for most people with long Covid, as proven in studies showing viral persistence alongside continuing health problems. The most alarming of which are immune changes. T-cell dysfunction is occurring in more and more patients. This is now being referred to by the World Health Network as Covid. We're in the fifth year of the pandemic and protections have become more lax. 00:10:51:29 - 00:11:12:04 Unknown You mandate is to first do no harm. No campus is watching. Thank you. Thank you for your comment. We can move on to our next commenter, Eric Stein. 00:11:12:07 - 00:11:35:06 Unknown Hello. We can hear you. I'm Eric Stein, and I have no conflicts of interest to declare. I've had less access to health care for the last four years, starkly less because CDC infection control standards are insufficient. The absence of unambiguously pro respirator guidance means patients like me get pressure to remove our masks inappropriately, and ignoring questions from healthcare workers on why I wear a respirator. 00:11:35:08 - 00:11:53:08 Unknown I have the privilege to have diagnosis, and now I'm high risk for Covid complications. Plenty of people lack a diagnosis but have an underlying high risk condition. Should they be placed at high risk? There's constant pressure to senselessly unmasked coming from healthcare workers who may have a Covid infection. The less privilege someone has, the more compliant they will feel they must be. 00:11:53:11 - 00:12:15:07 Unknown Every infection with Covid comes with the risk of long term complications, even for healthy people. These are the equity issues that aren't CDC standard precautions already, say to use PPE whenever there is an expectation of possible exposure to an infectious material. The significant possibility of aerosol transmission from patients or staff, even without symptoms in the ongoing pandemic, makes this true always. 00:12:15:09 - 00:12:41:06 Unknown Now, this committee is considering moving us further in the wrong direction. Many pathogens spread by aerosols, in particular SARS-CoV-2, measles, flu and many others. There's a reason CDC is the parent organization which sets PPE standards. Surgical or procedure masks are not rated for airborne particulate contaminants. Everyone here knows this. So why discard respirator use a common sense precaution to address this major transmission pathway of the most consequential pathogens we face every day. 00:12:41:09 - 00:12:58:28 Unknown Doctor Fauci was right when he said, quote, bottom line there's much more aerosol than we thought, unquote. People go to hospitals, pharmacies and other facilities because they trust it will benefit their health, not harm it. Decided evidence in the draft isolation workgroup slides is a mixed bag. For instance, Rabinovich et al. 2019 was clearly a poor study design. 00:12:58:29 - 00:13:27:23 Unknown It uses A68 guideline, which is nonsense for an aerosol spreading pathogen like flu. Aerosolized virus doesn't die at a magical six foot distance respirators and provide a much higher level of protection and source control than surgical procedure masks when actually used appropriately. The evidence for that is clear if you set aside the many problematic comparison studies that undermine respirator performance by implying it's fine to remove respirators and maintain risky spaces to separate the same pathogen into pandemic phase for special precautions and seasonal in the false dichotomy. 00:13:27:26 - 00:13:45:23 Unknown We don't start wearing seatbelts when car accidents go down. Just because Ecola has been here forever doesn't mean we take risks so that we do. Food recalls. An average 70 people fell ill, so I know people who found him and indeed died because of ongoing use of innocence, crisis, standards of infection control, long term practices should be safer, not even more unsafe. 00:13:45:23 - 00:14:04:14 Unknown There is no shortage of respirators and hasn't been in years. Only grim calculus subsumes health to short term profits and the comfort of people who believe themselves to be low risk can explain the impetus to accept high transmission risk. We need a full reckoning with the risks and alerts and system of controls, including ventilation, respirator, PPE at all times, case tracking and tracing, etc.. 00:14:04:16 - 00:14:26:15 Unknown Patients like me need progress. We need you to make health care a safe, accessible fixture of our lives. Not a grim risk. Calculus. You must live with. Thank you for your comment, Eric. We can move on to our next commenter, artist snip. 00:14:26:18 - 00:14:54:23 Unknown Hello? Can you hear me? We can hear you, right? My name is Artist Smith and I advocate with the disability organization Pan and IT. Please employ guidelines that protect patients from infection in the work of both work groups. I cannot emphasize enough the sheer difficulty. It is as an immunocompromised patient to try to access health care so that disability accommodations, including mask or N95 wearing by providers and share common spaces with patients who are visibly sick and not masking. 00:14:54:26 - 00:15:19:18 Unknown Source control should be recommended at all times in healthcare and N95 use. Please choose narrative B for questions for one and two with the proposal to weaken healthcare worker isolation. Kickback is making it much more difficult for patients to access care. Patients should not have to worry whether their provider is infectious. Many workers deny masking requests from patients, which emphasizes that a short isolation period and then source control will not be followed by many. 00:15:19:21 - 00:15:39:24 Unknown It is important to make policy for the most at risk patients in order to protect all patients. For example, imagine suggesting which this change does, and it's okay for a still infectious provider in a surgical mask to meet with a cancer patient. From the slides presented yesterday, it was written that at least 80% of transmissions are estimated to have occurred by end of day five. 00:15:39:27 - 00:16:03:28 Unknown But this means that Hate Back is saying it's acceptable, for up to 20% of workers are 1 in 5 to return infections. A high rate of high exposure. This committee is meant to advise on best practices for infection control. It is outside of its mandate to advise based on staffing issues. These guidelines will increase staff absences and levels of long Covid, and decrease paid sick leave to contribute to higher levels of serious illness and death for patients. 00:16:04:00 - 00:16:24:25 Unknown Studies show that patients who get Covid 19 and healthcare die at a higher rate. A more precautionary period of isolation is needed because workers who may be infectious have a higher risk of injuring patients. The committee should instead adopt recommendations shown to reduce staffing in eyes. Studies show that universal, safe use of n95s reduces sick days and saves hospitals money. 00:16:24:27 - 00:16:49:23 Unknown It is also essential for language to explain that providers are responsible for accommodations, like wearing n95s, and explicitly recommend that hospitals make N95 plentifully available for workers to use. The healthcare personnel recommendations also do not describe source control type, and 95 should be required through day ten. It is clear the patient's needs and comments are not being represented and hectored when they work, group meeting and meeting summary says. 00:16:49:25 - 00:17:20:06 Unknown A discussion ensued on whether all the key stakeholders are included. Members expressed it as clinicians working in various health care settings. They do represent patient interests. The statements concerning clinicians and health care systems do not adequately represent patients. As you can see from the committee's recent discussions, paper should add representation from a patient advocate and from a disability organization to ensure that infection control issues for patients, not just workers, are considered because patients have an asking kickback for better infection control approaches for a long time. 00:17:20:09 - 00:17:35:23 Unknown Thank you. Thank you for your comment. We'll move on to our next commenter. McLane white. 00:17:35:25 - 00:18:11:10 Unknown Hi, my name is McLean white. Last year I shared a community group in my city for people who were still taking Covid precautions. Mostly people who are maybe compromised or had a high risk condition or ongoing Covid like myself. I just want to share some of the risk calculations we make when considering whether or not to get healthcare, when people have to go through procedures that require the patient to be unmasked and relying on their healthcare providers to mask recycling, but they usually have to be asked to wear a mask, and sometimes they refuse. 00:18:11:12 - 00:18:37:03 Unknown So we have to weigh whether that procedure is worth the risk of an infection. And a lot of time people decide is not. People who live with higher rates of loved ones, perhaps away, whether they're getting their own healthcare, is worth the risk of being Covid, going to someone on chemo or on another immunosuppressive medication who will have to stop that treatment if they got an infection. 00:18:37:06 - 00:18:51:20 Unknown This is not the way that it should be. Patients shouldn't have to make these basic conclusions because public health has failed at infection control. Hospitals shouldn't be a main source of Covid infections and hospitalized 00:18:51:20 - 00:19:01:27 Unknown people. Voting against recommending N95 respirators for all pathogens spread by air would be going backwards. I wish the user nothing from the Covid pandemic. 00:19:02:00 - 00:19:12:06 Unknown It's shameful because apparently only one person on the committee who believes that people should be able to safely access healthcare. 00:19:12:09 - 00:19:27:02 Unknown Thank you for your comment and we can move on to our next commenter. Kate. Nathan. 00:19:27:04 - 00:19:55:14 Unknown I'm Kate Nathan. I'm a public health librarian at Yale University, but I am not speaking on behalf of my employer. I'm also a board member of the nonprofit Community Access to Ventilation Information. I'm likewise not speaking on their behalf, but also a caregiver. I'd like to thank the members in advance for considering my public comment, which is relevant to both the Isolation Precautions Guideline Workgroup and the Health Care Personnel Guideline Workgroup. 00:19:55:16 - 00:20:21:20 Unknown First, as a medical librarian and evidence synthesis. I'd like to comment on the meta analysis produced last fall on healthcare personnel use of N95 respirators. The conflation of continuous use respirator interventions and respirator interventions that involved donning the respirator after already having breathed shared air that may contain infectious respiratory aerosols exhaled by patients or indeed workers family is not justified. 00:20:21:22 - 00:20:47:26 Unknown In the words of the Cochrane Handbook, differences in intervention characteristics across studies occur in overviews in general, differences that alter decisions about how an intervention is implemented or whether the intervention is used or not are likely to be important. The conflation of targeted and continuous use of respirators reflects a heavy reliance backpack on the outdated model of transmission through either large ballistic droplets or small aerosols. 00:20:47:29 - 00:21:02:29 Unknown Notably, broadly, decision to engage with only probabilistic evidence from randomized controlled trials is not justified and doesn't comport with the Ebben plus approach, which tells us that for evidence of mechanisms should be integrated with evidence of 00:21:02:29 - 00:21:19:12 Unknown correlations to better assess and to the extent that happened, to the extent that is to be to be used in other interventions and other interventions to reduce through the air transmission, you could and should commission realist reviews to learn what works, how and why, for whom. 00:21:19:13 - 00:21:49:10 Unknown To what extent and in what circumstances. Second, my real world experience with transmission of disease through the air in a health care setting. I care for an elderly person who is vibrant and engaged in the community, who also has two degrees and disabilities. Where she got Covid is impossible to say for sure, but it was likely. During an outpatient visit to a physician at a health system whose infection prevention program is led by a hick pack member, whom I won't name names in. 00:21:49:11 - 00:22:16:06 Unknown Cases like hers exist. They are not detected by surveillance programs to the extent that surveillance still exists at all, but may have negative effects on patients health and on a patient's willingness to seek care for other conditions. The Isolation Precautions Guideline Workgroup Final List of Shared Interests says that the workgroup wants to protect patients and healthcare personnel from infection that is transmitted via infectious particles in the air. 00:22:16:08 - 00:22:35:16 Unknown But if you think your responses to the CDC letter will not reflect that, well, thank you. Thank you for your comment, Kate. We're going to move on to our next commenter, May Sherry. 00:22:40:10 - 00:22:57:02 Unknown Maybe you unmuted. 00:22:57:04 - 00:23:21:00 Unknown And can you hear me now? Yes. Thank you. Okay. Sorry. Good morning. My name is Mave Sherry, representing the organization pan-India, and I'm a long Covid patient from Albany, New York. I'm providing public comment today because it concerns me how many decisions around airborne disease precautions are constructed around staffing and employee comfort, rather than protecting patient. 00:23:21:02 - 00:23:51:09 Unknown I'd have long Covid since 2020. In 2023, the year that universal masking mandates were lifted in Health Healthcare, I acquired a reinfection at a primary care doctor appointment. I developed mast cell activation syndrome and have become allergic to all foods. I've needed emergency health care repeatedly for severe allergic reactions, dehydration, and malnutrition due to this condition, and I have often gone without care because I couldn't justify the risk of another infection requiring that healthcare workers wear masks upon request only is not sufficient. 00:23:51:11 - 00:24:09:22 Unknown I was masked, my primary care doctor was masked, but since Covid is airborne, the transmission was likely from a patient who was in the room earlier in the day. I was a 22 year old kickboxing instructor when I became disabled from long Covid. And to all of you unmasked faces I saw on the other side of my screen earlier, I ask if it could happen to me. 00:24:09:23 - 00:24:26:23 Unknown Why do you think it won't happen to you? Why do you think it won't happen and hasn't already happened to the health care workers who are exposed to Covid every single day without PPE? What would it take for you to link staffing concerns to the reality that health care workers are getting Covid multiple times a year, and not always recovering? 00:24:26:25 - 00:24:45:00 Unknown What would it take for you to reckon with the likelihood that someday you or someone you love, will need emergency health care and a Covid? I might be the reason you leave in a body bag. In 1850, a European doctor suggested that health care workers wash their hands in between patients because he suspected that physicians were transmitting diseases. 00:24:45:02 - 00:25:06:27 Unknown He was ridiculed, ignored, and ultimately died in a mental institution. It was decades before mainstream medicine finally conceded that he was right and implemented handwashing mandates in healthcare. Now, it would be unfathomable for a physician not to wash their hands. Someday, physicians not masking will be regarded in the same way. You have control of how many patients who need to die before that becomes the standard. 00:25:06:29 - 00:25:26:05 Unknown These scientific decisions around airborne disease precautions shape the future that will confront you and your family someday. You may be just interested in preventing Covid, but Covid is not disinterested in you. When you say that masking is optional, you say that patients have the onus of preventing infection rather than the people whose jobs it is to ensure our safety. 00:25:26:08 - 00:25:40:07 Unknown When you say that healthcare workers will only mask upon request, you open up patients to hostility and harassment. We have been working overtime to protect ourselves and health care. If you return. 00:25:40:09 - 00:25:53:02 Unknown Thank you for your comment. We can move on to our next commenter, Naomi Barham. 00:25:53:04 - 00:26:21:02 Unknown Can you hear me? Yes, we can hear you. Okay. Thank you. My name is Naomi Brown and I'm with the World Health Network. I hold a PhD in social policy and have worked for many years in maternal and child health, focusing on improving outcomes for our most vulnerable, including preterm babies. As the founder and executive director, now emerita of Mothers Milk Make Northeast, I have dedicated my career to ensuring the health and safety of newborns and their families. 00:26:21:04 - 00:26:47:29 Unknown Over the past year, I have attended and followed apex proceedings on isolation precautions, and I've been deeply disheartened by the lack of scientific rigor, transparency and expertise in urban transmission. And this committee, which is charged with creating guidelines that health care settings across the country rely upon. At each meeting, however, I have been profoundly moved and buoyed by the community of commentators. 00:26:48:05 - 00:27:29:12 Unknown They have eloquently shared their expertise, lived experience, wisdom, pain and compassion. It has become clear that he has its own set of considerations and priorities, and fortunately, protecting the public and health care workers is getting lost in other considerations and does not seem to be at the top of that list. I understand that healthcare is complex and expensive, with seemingly infinite competing priorities, but that is the challenge for the hospitals and health care institutions, including those where many of you work to solve within the essential imperative of caring for patients health and ensuring the safety of health care workers. 00:27:29:14 - 00:27:54:02 Unknown Those institutions look to hit back to provide up to date, accurate, evidence based scientific guidelines. These guidelines should empower them to make sound decisions that protect their patients, health care providers and staff. Each of you on this committee wears multiple professional hats. Some of you are administrators and leaders in some of the most esteemed healthcare institutions in the country. 00:27:54:04 - 00:28:20:10 Unknown Well, you know which an institutional release brings value to this committee. They also present a challenge. You must separate your institutional priorities from your role and hit back. Your task is to provide the best safety guidelines for health care institutions everywhere so that those institutions, including yours in your other roles, can make decisions rooted in science. I urge you to do two things. 00:28:20:12 - 00:28:52:02 Unknown First. Step back and set aside your institutional roles. Focus instead on your heat pack responsibility to health care facilities, patients, and providers across the country and to reflect on the gaps in this group's collective knowledge. Identify what expertise is missing, particularly in airborne transmission science, to ensure that Heat Pack brings in the necessary voices to support the development of the most effective, evidence based recommendations possible. 00:28:52:05 - 00:29:12:11 Unknown Thank you. Thank you for your comment, Naomi. We can move on to our last commenter, Scott Squires. 00:29:12:13 - 00:29:39:11 Unknown Hello, I'm Scott Squires. I have no conflict of interest. Covid is a terrible disease that can lead to long Covid and death. Fortunately, it can be prevented with respiratory mask. It's been clearly established that Covid is airborne. That acts like invisible smoke that can hang in the air for hours. This is true for all airborne illnesses. Simply breathing produces over a thousand copies of the virus every minute. 00:29:39:14 - 00:30:04:13 Unknown It's not spread as droplets. 60% of those with Covid don't know they have it and are spreading it. The notion of using fever or symptoms alone to determine if someone or yourself as Covid, has had little value. N95 respirator masks are designed specifically to prevent tiny airborne particles, including viruses like Covid, from being breathed in or breathed out. 00:30:04:19 - 00:30:45:27 Unknown It's proven science, and numerous real studies confirm the effectiveness of N95 masks to prevent Covid in real world examples, including hospitals. Even in unfitted N95 masks, at least 85% effective surgical masks are designed to prevent splatter. They are not designed to prevent airborne illnesses, and their effectiveness is much inferior to respiratory masks. And looseness of surgical masks not only allows the air to easily leak out the sides, but also have the tendency to droop below the nose and encourage users to pull them down below their mouth, as is commonly seen by health care workers. 00:30:45:29 - 00:31:19:17 Unknown That makes them worthless. What I'm concerned about is what is the object of this committee because based on the discussions and preliminary votes, has nothing to do with preventing health care workers or patients in protecting them. Science and facts such as asymptomatic spread have been ignored. You voted no on the question should and 95 minute respirators be recommended for all pathogens spread by air and you ignore N95 at every opportunity where airborne is discussed. 00:31:19:19 - 00:31:39:24 Unknown There's a saying use the right tool for the right job, yet you are choosing to use the wrong tool, the inferior tool for protection. That's like not using an airbag and seatbelts in the car, which are proven to save lives and replace them with a foam pillow and a piece of rope in the hope it might provide some protection. 00:31:39:26 - 00:32:01:24 Unknown The idea that health care workers can evaluate whether they need to mask and what type is silly. Covid is always here because it's not seasonal. As long as you have many untested people, there will be Covid. The vaccine alone does not prevent Covid or long Covid. Those looking for care should not be subjected to a deadly virus in health care settings. 00:32:01:26 - 00:32:29:23 Unknown We need universal masking in hospitals and medical facilities and they should always be required. Right now we have hospitals switching, masking on and off willy nilly. We need the latest air standards to protect people. We need to stop sending infected healthcare workers back. They spread Covid. Do you? Part is prevent the next pandemic. Thank you for your comment, and we appreciate all those who are able to make an oral public comment today or written. 00:32:29:23 - 00:32:54:09 Unknown I would like it. Pass it back to our chair, Michael Lynn. Thank you very much for those comments. I think we will go ahead and take a brief break in order to load slides. We'll make it ten minutes and we'll come back when we're ready. Thank you.