Experts say universal masking for Covid-19 in hospitals is not necessary

A return to pre-pandemic guidelines for masks.

ISLANABAD (Web Desk) - Universal masking in healthcare settings is no longer needed, a group of U.S. epidemiologists and infectious diseases experts proposed April 18 in a commentary published in the journal Annals of Internal Medicine.

These policies, which were enacted early in the pandemic to reduce illness and death associated with COVID-19, required staff, patients and visitors to wear face masks in hospitals and other healthcare facilities.

However, given recent shifts in the pandemic, the eight experts argue that healthcare settings should treat the coronavirus that causes COVID-19 like other endemic respiratory pathogens — using standard infection control practices.

A return to pre-pandemic guidelines for masks

These standard practices require healthcare workers to wear a mask and eye protection when doing activities that could generate sprays to the face. Staff should also use additional precautions when caring for patients with a suspected or confirmed respiratory infection.

In addition, those protocols require staff, patients and visitors with respiratory symptoms to wear a mask while in healthcare settings.

“With the arrival of effective vaccines and a large portion of the population who developed immunity from natural infection, transmission from individuals with asymptomatic infection is now less common than in the earlier stages of the pandemic,” commentary author Dr. Sharon Wright, chief infection prevention officer at Beth Israel Lahey Health in Boston, told Healthline.

When SARS-CoV-2 first emerged on the scene, it was a silent spreader — more than 50% or so of transmissions resulted from people without symptoms, some studies Trusted Source found.

In contrast, recent data — after the emergence of the Omicron variant — suggests that most transmissions now occur around or after the start of symptoms. Given the small number of studies, though, asymptomatic transmission is still a possibility, even among a population with a high level of immunity.

Wright points to other developments that have made COVID-19 easier to deal with in healthcare settings, including treatments for people with infection — such as the antiviral Paxlovid — and widely available clinic-based and at-home testing.

Masks can make communicating with patients difficult

Wright and her colleagues argue that while maintaining universal masking in healthcare settings may marginally reduce the risk of transmission, masks could impede communication, especially for those whom English is not their preferred language and for people who are hard-of-hearing and rely on reading lips and other facial cues.

Masks also contribute to feelings of isolation and negatively impact interactions between doctors and patients, the authors wrote. Some researchTrusted Source suggests that the use of masks may even increase the mental load for both patients and clinicians during clinical encounters.

“At this stage in the pandemic, masking is only one tool to reduce overall transmission and there should be a calculus weighing risks and benefits,” said Wright.

Masks may have little effect on fast-spreading SARS-CoV-2 strains

Other research suggests that mask policies may not have that much effect in the face of fast-spreading variants such as Omicron. For example, a recent preliminary study, not yet peer-reviewed, found that a mask policy at a hospital in London, United Kingdom, did little to slow the spread of the Omicron variant.

This study was not able to compare masking to non-masking in high-risk areas of the hospital, which continued with the masking policy. In addition, the policy required people to wear surgical masks, not respirators such as N95, KF94 and FFP2, which are more effective at protecting the wearer when worn correctly.