The case for mask mandates in healthcare settings

A lot of healthcare organizations have ended mask mandates in recent months, many of them citing guidance changes at state or local levels to no longer require this level of precaution. Some of this stems back to a CDC policy change last fall; the agency recommended that healthcare settings only need universal masking when COVID-19 spread is high.

Now, this is likely another case of the CDC—and potentially quite a few other health agencies—making recommendations that are, in fact, very dangerous. There’s plenty of evidence to support that mask mandates should continue in healthcare settings, to protect vulnerable patients from COVID-19 and many other illnesses.

Let’s go over some key points:

  • Hospital-acquired COVID-19 infections: Since the start of the pandemic, people who go to the hospital for issues other than COVID-19 have contracted the virus while there. The HHS tracks these cases, and their data show that this is a continued problem: even as new COVID-19 admissions in hospitals have declined in 2023, hospital-acquired infections have continued to be an issue, with hundreds of these cases reported each day in recent months. Universal masking reduces these infections.
  • Wastewater surveillance in hospitals: Another way to track COVID-19 in healthcare settings is through targeted wastewater surveillance, taking samples from a particular facility’s sewage. A few hospital systems are doing this, such as NYC’s public system (Health + Hospitals). While there are limited public data from these programs, researchers who run them have said that the results show consistent COVID-19 spread; masks help mitigate this transmission.
  • Healthcare facility outbreaks: After lifting a mask mandate, hospitals and other healthcare facilities may have COVID-19 outbreaks among patients and staff—both putting vulnerable patients at risk and exacerbating staffing shortages. One hospital in the Bay Area recently reinstated a mask mandate after such an outbreak, according to local paper the San Francisco Chronicle.
  • Patients hesitant to visit: Many patients at higher risk for severe COVID-19 may become wary of routine doctors’ visits or procedures if their clinics stop requiring masks. This is a sentiment I’ve seen frequently on social media over the last few months, as higher-risk people push for healthcare organizations to keep their mask mandates.
  • Harming long-term outcomes: Any already-vulnerable person who gets COVID-19 at a healthcare facility is likely to face long-term symptoms from the virus, potentially complicating their existing chronic conditions. This fact contributes to individual patients’ wariness, and it can also lead to complications for potential treatments or research studies. For example, a Stanford study testing Paxlovid for Long COVID has recently stopped requiring its staff to mask, according to patient reports; participants have pointed out that this could harm the study’s results.

If you’re interested in getting involved with advocacy in this area, I recommend checking out Mandate Masks US and connected organizations. These groups are pushing for masks to remain in healthcare through social media campaigns, petitions, contacting politicians, and even some in-person protests.

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