With COVID-19 a continuing threat to at-risk populations, it’s important to draw on lessons learned during the COVID-19 pandemic and continue to mask up in healthcare settings, according to commentary from some public health experts.
Rates of severe COVID-19 decreased due to increasing community immunity and access to countermeasures, but severe outcomes still are occurring and still disproportionately affect older adults and those with underlying health conditions.
This situation has public health experts from Public Health – Seattle & King County, as well as the University of Washington, advocating for updated approaches to masking in healthcare facilities to prioritize patient, resident and direct care worker safety, according to commentary published Monday in Annals of Internal Medicine.
The end of the COVID-19 public health emergency led to discussions about the future of masking in healthcare settings, as it became apparent that COVID-19 would be an ongoing health threat.
“In our view, the ongoing disease burden among persons at highest risk for severe COVID-19, the large proportion of transmission from asymptomatic and presymptomatic cases, uncertainty about the future course of the pandemic, and the effects of post-COVID-19 conditions merit integration of lessons learned from the pandemic into healthcare precautions and policies,” wrote lead author Eric Chow, MD, chief of communicable disease epidemiology and immunizations at Public Health — Seattle & King County.
They argue that many healthcare workers still come to work with active COVID-19 infections — both symptomatic and asymptomatic — due to limited testing options and pre-pandemic sick leave policies that have not changed.
“This may increase further as people transition to an “endemic mindset” and workplace culture shifts back to pre pandemic habits of presenteeism and limited sick leave allowances,” the authors wrote, adding that testing is now less available, testing behaviors are changing and there is less awareness of local transmission levels.
As healthcare systems navigate the next phase of the pandemic, the authors suggested varying approaches to prioritize resident and patient safety by implementing masking as routine healthcare policy.
Those recommendations include year-round masking, targeting settings with high-risk populations, masking during certain months during the local respiratory viral season, or masking when community burden of respiratory viruses approaches a “critical threshold.”
“Our appreciation and understanding of both patient and healthcare system impacts associated with SARS-CoV-2 and other respiratory viruses have been reshaped as a result of the COVID-19 pandemic,” the authors concluded.
In Washington, statewide healthcare masking requirements were dropped in long-term care and healthcare settings in April. Regional healthcare organizations, however, agreed to extend universal masking in patient care areas of healthcare facilities, with plans to update the policy through a regional approach to masking as the pandemic continues to evolve.
Oregon, New Jersey and California also rescinded pandemic-era orders requiring workers in healthcare settings, including senior living communities, to wear masks once the COVID-19 national emergency and public health emergency ended.
