States set to lift COVID rules April 3: How hospitals are adapting

States across the U.S. rolled out healthcare worker vaccination and masking requirements since the start of the COVID-19 pandemic. Now, three years later, California, Washington and Oregon plan to end certain requirements, effective April 3, allowing hospitals and health systems to develop and implement plans consistent with CDC and other guidance based on their needs and local conditions.

Among the changes in California is the end of the state's masking requirement in indoor high-risk and healthcare settings, including healthcare, long-term care and correctional facilities as well as homeless, emergency and warming and cooling centers. 

Also beginning April 3, California will end its vaccination requirement for healthcare workers, including those in adult care, direct care, correctional facilities and detention centers, state officials said. 

In Washington, universal masking in healthcare, long-term care and adult correctional facilities for people 5 and older is slated to end April 3. And Oregon leaders plan to lift mask requirements in healthcare settings, including nursing homes, effective April 3.

Hospital and health system leaders said they are aware of the changes and continue to focus on safety measures. 

"We understand the excitement and sense of relief that many are feeling about putting aspects of the pandemic behind us, including the precautionary mask mandates that have been our reality for several years," Salem (Ore.) Health said in a statement shared with Becker's.

The health system also said it is assessing potential next steps and will recommend updated policies and procedures to implement for the safety of patients, visitors and staff. 

"While Oregon Health Authority's announcement signals a shift in how masking standards can be applied, our infection prevention team has reviewed [Occupational Safety and Health Administration] masking guidelines and is awaiting its final changes that will impact our decision as OHA's healthcare mask mandate lifts on April 3," Salem Health said. "Salem Health staff will be updated in preparation for this much-anticipated date."

San Diego-based Scripps Health, in a statement shared with Becker's, said changes in state guidelines allow health systems to customize mask protocols at their organizations but that Scripps "has always followed a higher standard to help further protect the health and safety of our staff, patients and visitors."

"As such, we will continue to require medical grade masks in some specific areas and circumstances," Scripps said. 

Effective April 3, the health system will require staff, patients and visitors to wear medical grade masks in direct patient care areas. However, masks now will be optional in nonclinical buildings and in most general areas of Scripps hospitals, clinics and other clinical buildings.

Scripps said medical grade masks are also highly recommended for staff, patients and visitors when in confined or crowded areas such as elevators, waiting rooms, meeting rooms and break rooms.

Regarding vaccination, Scripps said it will continue to follow federal guidelines. 

"And we expect the change in California to level the playing field for candidates for employment from across the country since there will no longer be a higher level of vaccination required in California as compared with other states," the health system said. 

John Lynch, MD, who has served in medical leadership roles at Seattle-based UW Medicine and its Harborview Medical Center since 2010, told Becker's in a March 30 interview that as the state requirement expires, the health system will continue to consider risk assessments as well as state and federal guidance.

Currently, UW Medicine requires patients, visitors and healthcare workers to wear a mask in patient care spaces and in public spaces such as hallways and elevators in any building where patients are being taken care of. 

Dr. Lynch said the health system will continue this policy after April 3. 

"Our plan is to continue that for at least three months to get a better sense of where [COVID-19] is going," he said. 

One thing that has recently changed is policies for places such as break rooms, where masks are optional for healthcare workers. Masks are also not required for workers in conference rooms where teaching or meetings may occur.

"We strongly recommend that they do [wear a mask], but in those settings, it's now up to the person," Dr. Lynch said. "But those spaces have to be separated from a patient care space by a closed door and/or distance."

Moving forward, he acknowledged there are a lot of unknowns regarding the trajectory of COVID-19. Additionally, he noted the potential effects of the COVID-19 national and public health emergencies being set to expire this spring.

"We have regulatory guidance updates that are pending that have profound impacts on healthcare facilities, [and] a conservative plan to maintain masking and healthcare facilities that keep people safe … makes good sense," Dr. Lynch said.


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