Health systems are weighing and making decisions for face masks to become optional for many individuals in certain spaces.
The largest U.S. airlines dropped mask requirements for domestic flights April 18, shortly after a federal judge in Florida struck down mask requirements on airplanes, trains, buses and other public transportation. The decision, while unrelated to healthcare settings, shows how masks can become optional in the same spaces where they were largely a given throughout the pandemic.
Hospitals are one of those spaces. The CDC has recommended universal masking in healthcare facilities throughout the pandemic. During the surge of the highly contagious omicron variant, more hospitals went one step further to require medical-grade masks for patients, visitors and staff. Now some hospitals are easing their guidelines for masking, at least while they see low community rates of COVID-19.
Houston Methodist Hospital changed its policy April 4 to no longer require masks in some public spaces, including reception and administrative areas, hallways and cafeterias. The modification followed the hospital's assessment of COVID-19 hospitalizations, community transmission and positivity rates. The 907-bed hospital still requires staff to wear masks while caring for patients and in waiting rooms.
"It's time to adjust with the times," Firas Zabaneh, director of system infection prevention and control for Houston Methodist, told local news station KHOU11. "Staff burnout, nationally, has been an issue. And we felt that it is time for us to ease some of that burden on them and allow them some breathing space. Especially during this time of low transmission."
Some hospitals within Des Moines, Iowa-based UnityPoint Health system are moving from universal to relaxed masking the week of April 18.
"Masks are now optional for most patients, visitors and fully vaccinated UnityPoint Health team members," the system's visitor guidance states.
The modification is effective at UnityPoint Health–St. Luke's Hospital in Cedar Rapids, UnityPoint Health–Allen Hospital in Waterloo and UnityPoint Health–Finley Hospital in Dubuque. Staff at these hospitals still are required to wear a mask when entering a patient room or while performing direct patient care, and patients may be asked to wear a mask while seeing a healthcare provider one-on-one.
UnityPoint recommends masks for those who are not fully vaccinated, are immunocompromised, desire to wear a mask, are experiencing respiratory symptoms, have had a known COVID-19 exposure in the last 10 days, or tested positive for COVID-19 in the last 10 days.
Connecticut's masking order expired April 15, and people will no longer be required by the state to wear face masks in hospitals and outpatient healthcare settings. The change arrives as COVID-19 hospitalizations have increased 25 percent over the last 14 days in the state, according to HHS data collected by The New York Times.
Hartford HealthCare, Yale New Haven Health and Trinity Health of New England all continue to require masks, at least in clinical settings, The Hartford Courant reports.
"It doesn't really make sense, especially in the healthcare environment, to loosen restrictions when we know the virus is spreading more rapidly," Syed Hussain, MD, chief clinical officer of Trinity Health of New England, told the Courant. "If anything, we need to double down on those measures."
The CDC eased community indoor mask guidance Feb. 25 to rely on how COVID-19 is affecting a community's healthcare system — rather than transmission rates alone — as a guide for mask recommendations. The agency calculates the level of COVID-19 by county and color codes it in a map.
This tool was not designed to guide hospitals' masking policies, however.
"CDC's COVID-19 Community Levels recommendations do not apply in healthcare settings, such as hospitals and nursing homes," the agency states. "Instead, healthcare settings should continue to use community transmission rates and continue to follow CDC's infection prevention and control recommendations for healthcare settings."
In its infection control guidelines for healthcare workers, the CDC says it is generally safest to implement universal masking for everyone in a healthcare setting, but allowances could be considered for healthcare professionals who are up to date with all recommended COVID-19 vaccination doses in facilities in counties with low to moderate community transmission. These individuals could choose not to wear masks in well-defined areas restricted from patient access, but should mask up when encountering patients.