Experts say masks should still be worn in healthcare facilities

Masking should continue in healthcare settings to protect patients, experts from the National Institutes of Health (NIH) have suggested.

The request is because medical workers are notorious for working while sick and asymptomatic individuals can still transmit respiratory viruses – particularly Covid and RSV.

While initially viewed as a virus prevention measure, masks have become a prominent symbol of the Covid culture wars in the US.

Officials issued mixed messages about their effectiveness at the beginning of the pandemic. 

Studies that came later failed to show definitively that masks prevented Covid — yet millions of Americans were forced to abide by mandates.

It comes as the final pandemic restrictions were lifted last week and the World Health Organization (WHO) declared Covid was no longer a global health emergency.

Researchers from the George Washington University School of Medicine and the NIH said that ‘data shows that transmission from patient-to-staff and staff-to-patent, when both are masked, is uncommon.’

The document, published in journal Annals of Internal Medicine, said: ‘Although gold-standard evidence is not available, we argue that, despite the lack of clinical efficacy trials (as with the widely accepted practice of hand hygiene), masking in interactions between patients and health care personnel should continue to receive serious consideration as a patient safety measure.’

One of the researchers’ reasons for keeping up mask-wearing in healthcare facilities is presenteeism. 

This lost productivity happens when employees are not fully functioning in the workplace due to illness.

Half to two-thirds of healthcare staff, which the researchers said are ‘notorious for coming to work while ill’, said they came to work with symptoms of respiratory illness.

This is due to not wanting to place extra burden on colleagues, beliefs that respiratory viruses are mild, fear of being punished for being off work and a moral duty to be there for patients.

The paper said: ‘We can find no reason to believe these time-honored behaviors will change if masks come off.’

The researchers also argued that the fact that asymptomatic individuals can still transmit respiratory viruses, particularly Covid, means masking should continue.

They said up to a third of Omicron infections are asymptomatic but could ‘nonetheless cause severe or life-threatening disease or prolonged illness if transmitted to immunologically vulnerable patients’.

They suggested alternative policies such as masking only during respiratory virus season, starting in the fall, wearing masks onwards with higher risk patients, or masking staff and visitors but offering optional masking for patients.

While the researchers recognized the common criticisms of masks, including hindering communication and impeding empathy, they said this should motivate engineers to design masks better.

The message to mask is at odds with recent commentary from eight US institutions suggesting that the time for universal masking is over, also published in the journal Annals of Internal Medicine.

Masks have long been a controversial Covid strategy due to the lack of hard evidence that they are effective.

One of the most comprehensive meta-analyses of face coverings found that masks made ‘little to no difference’ to Covid infection or death rates in community settings.

The debate around masks first turned sour in 2020 when health officials flip-flopped on their effectiveness. 

Then-NIAID director Dr Anthony Fauci said in 2020 that masks were ‘not providing the perfect protection that people think that it is’. 

He later suggested people should wear masks as a mark of ‘respect’ for others. He admitted to lying to the public about masks’ effectiveness to prevent panic buying and preserve masks for healthcare workers.

The CDC website currently states that masks can help protect the wearer and others from Covid. 

The agency still recommends Americans wear masks in places with high transmission levels, such as on public transport. 

Critics of masks claim they have hindered communication and children’s development and progress at school. 

Rises in RSV and flu this winter was partly attributed to face-covering mandates because they prevented children from gaining natural immunity to other illnesses.