In a recent study published in the Annals of Internal Medicine, a group of public health experts from Seattle & King County and the University of Washington advocated for continuing mask wearing in healthcare facilities to ensure the safety of patients and healthcare workers alike. They emphasized that particularly within healthcare settings where there are a higher number of vulnerable or immunocompromised patients, a Covid-19 infection could turn fatal.
“Many facilities include units for patients at the highest risk, such as transplant, oncology, and geriatric patients; however, high-risk patients are scattered throughout hospitals, and facilities have a responsibility to promote widespread safety measures to limit the spread of hospital-acquired infections,” the researchers wrote.
“People in the general community no longer take the same precautions they did at the height of the pandemic and have returned to normal activities despite ongoing circulation of SARS-CoV-2 and other endemic respiratory viruses. This provides further rationale to integrate precautions, such as masking, as part of general practice to protect patients, especially those who are most vulnerable to severe disease,” they added.
Even though widespread vaccination drives and increasing immunity among the masses have decreased the incidence rates of severe Covid-19 cases, millions of people are still suffering from severe health outcomes that can be attributed to Covid-19. “We are only just beginning to understand and measure the post-acute and long-term ramifications of SARS-CoV-2 infections, even among persons with asymptomatic or mild acute illness,” the authors stated. “Masking remains an important mitigation measure to protect the health of our health care workforce, including those who are at high risk for severe disease. Preventing HCW infection is vitally important in maintaining the capacity of an already severely strained health care system.”
Before the Covid-19 pandemic began in late 2019, researchers are now finding they under-estimated the degree of harm that hospital-acquired respiratory viral infections had been causing — especially because their spread can be prevented by consistent masking among patients and healthcare workers. Instead, previous policies only focused on preventing diagnosed patients from spreading contagious infections to healthcare workers.
“The lessons learned from the COVID-19 pandemic have led to a greater appreciation of asymptomatic, pre-symptomatic, and pauci-symptomatic transmission of SARS-CoV-2 and other endemic respiratory viruses,” they explained. “Yet it is estimated that asymptomatic and pre-symptomatic cases account for the majority of SARS-CoV-2 spread. These findings mean that it is not possible to consistently identify patients and HCWs who are capable of transmitting virus, especially as hospitals discontinue universal SARS-CoV-2 admission testing.”
To make matters worse, a large number of healthcare workers who have symptomatic Covid-19 are still forced to come to work. Also, at this stage of the pandemic, testing has once again become inaccessible and local transmission levels are unknown.
“We advocate for a shared decision-making approach that considers the implicit power dynamics of the patient–provider relationship as well as the overall health costs and risks for individual patients. If we accept the benefits of increased mask wearing in clinical settings, we should find ways to adapt to this new reality rather than accepting unnecessary risks to patient and provider health,” the authors wrote.
“Perhaps rather than removing masks to improve rapport building and enhance perceived empathy, we could find ways to improve masked communication. We should also strive to avoid placing the burden of advocating for patient safety solely on our patients by enacting policies that require them to request that their providers wear a mask when they believe it is appropriate,” they added.
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