Hospitals plan to continue mask wearing, regardless of updated CDC guidance

Health systems are looking forward to the Centers for Disease Control and Prevention's new focus on hospital beds and admissions to determine a community's COVID-19 risk level, though they are concerned about pulling back safety precautions amid an ongoing pandemic.

The CDC said Friday that hospital capacity and pandemic-related hospitalizations will be factored into local mask guidelines, as part of the Biden administration's long-term pandemic strategy.

Under the new guidance, around 70% of the U.S. population is categorized as residents of low- or medium-risk areas and can go indoors without masks. The CDC still recommends individuals use masks in communities where serious COVID-19 cases are constricting the local health system.

While it is reasonable to reassess public masking guidance due to the recent downtrend in COVID-19 cases, face coverings keep staff and immunocompromised, vulnerable patients safe and should still be used, said Avinash Virk, an infectious disease consultant at Mayo Clinic in Rochester, Minn.

"We will still be requiring our patients and visitors to be masked so we can keep everybody within our institution safe and keep functioning to provide the healthcare that people need," Virk said.

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The University of Pittsburgh Medical Center and Kaiser Permanente said they will continue to require patients, visitors and employees to wear masks.

Even as other community settings drop mask use, health systems will keep prioritizing patient health, Nancy Foster, the American Hospital Association's vice president for quality and patient safety policy, said in a statement.

The CDC said it still recommends universal masking in healthcare settings, and its new guidelines do not apply to hospitals, which are often considered high risk.

Any future masking guidelines for hospitals will hopefully take into account how easily implementable the recommendations are, and will not involve relying on everyone’s vaccination status, said Tammy Lundstrom, chief medical officer and senior vice president of Trinity Health.

Generally speaking, the pandemic is expected to become more of a local issue versus a global surging issue, she said, which is why it's crucial that the CDC has redefined low, medium and high rates of transmission and recommended prevention measures for each of these levels.

"I'm welcoming the change to really look at the impact of severe illness on hospitalizations versus new cases, because we learned a lot since omicron started, and new cases are not as translatable into hospitalizations as they were with alpha or delta," Lundstrom said.

Other providers are still hesitant about the broad guidance to unmask.

"I do have concerns considering where we are across the country right now with COVID-19," said Richard Martinello, medical director for infection prevention at the Yale New Haven Health System. "We're still seeing high rates in most of our communities, we're still seeing a significant number of Americans dying each day due to COVID-19."

Masks, while not perfect at preventing COVID transmission, are one of the easiest and most adequate measures to keep people safe from infection, he said.

Moving forward, public health experts and providers will have to remind communities that not all guidelines are applicable everywhere and stricter mask guidelines can always come back if COVID-19 cases begin to surge again, Martinello said.

"I recognize the growing frustration and impatience to get beyond masking and some of the restrictions that have been placed during the pandemic," said Lisa Maragakis, senior director of healthcare, epidemiology and infection prevention for the Johns Hopkins Health System. "But as an infection prevention expert, it feels too early, and I worry that pulling back too quickly on our safety precautions in setting up the conditions for another surge."

In spite of optimism surrounding the rapid improvement in COVID-19 cases and the impending warm weather, Maragakis said patients and their caregivers should be aware of high levels of transmission in their communities and how the pandemic can still negatively impact their health due to medical vulnerabilities.

"My hope is that the vast majority of them will continue to understand that it's prudent to wear masks, at least for a bit longer in the healthcare setting," she said.