When it comes to masking in hospitals, '1 size doesn't fit all,' says Northwell Health's chief of infectious diseases

New York state dropped its masking requirement regardless of COVID-19 vaccination status in hospitals on Feb. 12, giving healthcare organizations the ability to set their own masking guidelines going forward.

But Bruce Farber, MD, chief of public health and epidemiology officer at Northwell Health in New Hyde Park, N.Y., says not so fast. 

Question: Will Northwell Health drop its COVID masking guidelines?

Dr. Bruce Farber: It's only February and it's far too soon to make that decision. We still have a mandate in New York state that says that if you have not been vaccinated against influenza, then you have to wear a mask in the hospital. That will stay in place until the end of flu season, around April 1.  

With regard to COVID masking? I'm not sure that we will ever take the mask off in selected parts of our healthcare system such as the emergency room and oncology areas where there will always be very high-risk individuals. It remains to be watched and discussed. One size doesn't fit all when it comes to masking and healthcare facilities. 

I would say if we give it a little bit more time, we'll be a little bit more comfortable. If we see COVID grades come down and stay down for a prolonged period of time, I think we could feel a little bit more comfortable taking masks off in hospitals.

Q: Do you agree with the decision to end the public health emergency on May 11?

BF: That was a political decision. I certainly would have preferred that it had been put off.

Q: Will we ever be able to say that COVID is in the rearview mirror? 

BF: No. COVID is not going to go away and we are going to have to learn to live with it as best we can — as we have been doing. If vaccine uptakes continue to be poor then, as time goes on, there'll be intermittent rises in COVID. And we will maintain our immunity as a population through ongoing recurrent infections, which is what's essentially happening now. 

Q: Do you support an annual COVID vaccine?

BF: Yes, I certainly support it for people over the age of 55 or 60. I'm not sure it'll be totally necessary for young, healthy people. 

Q: Does bird flu present a serious threat for humans?

BF: Absolutely. Bird flu could make COVID look like a walk in the park. The mortality rate for bird flu is up to 50 percent in humans. Fortunately, it doesn't spread very well among humans. But it spread from birds to many other mammals. 

We would be very foolish if we were not keeping a very close eye on flu variants. In fact, and I think most people in infectious diseases, including myself, would have always thought, and still do think, that the next pandemic would have been influenza. We were surprised that it was a coronavirus.

Q: With regard to infectious diseases, what else are you worried about right now?

BF: I'm always worried about and interested in hospital-acquired infections — in following how these bacteria and viruses affect people who are already in the hospital. This circles back to the issue of masking. This is a vulnerable group of people and you just have to be very careful about removing masks that provide protection against illness in the hospital.


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