Physician viewpoint: Don't abandon hospital mask policies, make them strategic

Physicians from Harvard Medical School, the Harvard Pilgrim Health Care Institute Brigham and Women’s Hospital in Boston published a dissenting opinion in the New England Medical Journal on the widespread removal of mask policies in medical settings across the country. Masking should be "strategic" they say, and remain in place for protection.

Even prior to the end of the public health emergency declaration in early May, health systems across the U.S. began to walk back mask policies at their facilities, but that has sparked concerns from physicians and vulnerable patients across the country. 

The authors of the viewpoint assert that there are two reasons to maintain masking in these settings:

  1. The needs and interactions of hospital populations are very different from those of the general population. Medical settings, particularly hospitals, have a high number of vulnerable individuals who are often in the hospital at the peak of their vulnerability and the risks are therefore much higher.

  2. Healthcare-associated infections are on the rise and are frequently caused by respiratory viruses, which can be prevented with mask wearing. 

Additionally, the authors point out that hospital staff often still come to work rather than staying home if they don't feel well. Masking of healthcare workers judiciously can eliminate some of the spread of viruses, too. 

"Despite repeated requests by health care system leaders for symptomatic staff to stay home, 'presenteeism' (coming to work despite feeling sick) remains common," the authors wrote. "Even during the height of the pandemic, some health care systems reported that 50 percent of staff diagnosed with SARS-CoV-2 worked while symptomatic."

Universal masking may not be necessary for general population settings, but the authors "believe it would be a mistake, however, to ignore the threat that SARS-CoV-2 continues to pose to some patients or to fail to recognize that many other respiratory viruses pose a similar threat," they explain. "Rather than abandoning universal masking for protection against SARS-CoV-2, health care facilities could reimagine masking polices to protect patients from the full array of nosocomial respiratory viral infections."

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