Infectious Disease Specialists Recommend Masking Despite PHE Ending

In a paper published in the Annals of Internal Medicine Tuesday, experts recommended that inpatient personnel indefinitely use masks to mitigate disease and the seasonal spread of respiratory viruses, including COVID-19.

Despite the end of the COVID-19 public health emergency (PHE), the infectious disease specialists who generated the paper anticipate that providers nationwide will continue to mask up in healthcare settings.

Authors Tara N. Palmore, MD, and David K. Henderson, MD, suggest that notwithstanding a lack of clinical trial data, providers should utilize filtering facepiece respirators and other high-quality masks to avoid spreading coronaviruses and influenza in the healthcare setting.

Henderson, an epidemiologist, and Palmore, an infectious disease fellow, cited the real-world effectiveness of mask use in hospitals as the primary reason for continuing the practice after pandemic rules expire. According to their understanding, universal mask-wearing, among other safety precautions, reduced the occupational exposure to COVID-19 for healthcare professionals.

The two authors explained that healthcare-associated transmission of virtually all respiratory viruses had been reduced during the pandemic at their institution. They associate this drop in transmission largely with mask-wearing in the care setting. However, the authors did not suggest that other pandemic precautions that may have contributed to the same reduction, such as social distancing and isolation, remain in place after the PHE’s end. 

During the COVID-19 PHE, most healthcare providers were required to receive a vaccine for coronavirus, and the CDC also recommended that staff, patients, and visitors wear masks. Most institutions mandated the mask rule so that all who entered a care setting were required to wear a face covering.

“Universal masking may not be the only valid approach. One could envision other reasonable approaches to this issue based on the clinical setting. Examples include masking only during respiratory virus season, beginning in the fall; masking on wards housing patients at higher risk for serious sequelae of respiratory virus infections; or masking staff and visitors but allowing optional masking for patients (one-way masking),” suggested the authors of the paper.

Included in the plea for continued mask use is a survey that found 97% of hospital epidemiologists were not eager to eliminate masks in their facilities, implying that most hospitals, despite the end of the PHE, will continue to require masks as a preventative measure.

The authors also mentioned the negative consequences of masking, such as impeding communication, reducing empathy, and damaging patient satisfaction, as opportunities to create new functional face coverings that won’t inhibit important parts of the patient–physician interaction.