4 masking policies hospitals should consider for pandemic's next phase: Experts

An uptick in COVID-19 admissions in the U.S. is reinvigorating focus on hospitals' masking policies. Now, 10 experts are calling for healthcare facilities to integrate masking as part of routine policies. 

"As health care systems navigate this next phase of the pandemic, different approaches could be considered that place patient safety first and integrate masking as part of routine healthcare policies," Eric Chow, MD, chief of communicable disease epidemiology and immunization at the University of Washington in Seattle, and nine other colleagues wrote in a commentary published Aug. 22 in the Annals of Internal Medicine. 

While many hospitals did away with masking rules when the public health emergency ended, some physicians say the measure should be reconsidered given the high risks COVID-19 poses to certain populations, uncertainty about how the pandemic could evolve, and the significant role asymptomatic and presymptomatic cases play in transmission.

"We should be mindful of continuing areas of uncertainty while integrating the lessons learned into our hospital-based practices to prevent harm to vulnerable patients rather than reverting to suboptimal prepandemic behaviors," the authors wrote. 

They called on healthcare facilities to consider different approaches when it comes to masking policies, such as: 

  • Across healthcare spaces year-round
  • In targeted settings, such as transplant, oncology and geriatric units where risk is highest for those populations
  • In certain months during local respiratory viral season 
  • When the community burden of respiratory viruses reaches a certain threshold, although appropriate metrics would need to be defined 

At least three hospitals in New York have reinstated mask mandates amid an uptick in the number of patients testing positive for COVID-19 and staff out sick with the virus. New Hyde Park, N.Y.-based Northwell Health doesn't currently have a mandate in place, although it is "encouraging it in high-risk areas," Peter Silver, MD, the system's chief quality officer and associate medical officer, told Medpage Today. 

Dr. Silver added that the number of patients testing positive has increased over the past several weeks, noting most of them are admitted for other reasons "and coincidentally have COVID," and that the number of those critically ill from the disease is "virtually zero." Leaders are watching moving trends carefully and will revisit policies as needed, he said. 

"We have to see what happens with these new variants. … We're taking it not only a week at a time but a day at a time, and if we need to get back to [mandatory masking], we will," Dr. Silver said. 


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