A growing number of hospitals and healthcare networks across the United States are reinstating mask requirements in response to a troubling rise in flu, RSV, and COVID-19 cases that is straining capacity. With overcrowded emergency rooms and limited beds, providers aim to curb viral transmission among patients and staff to maintain operations.
Johns Hopkins Medicine Reinstitutes Mask Rules
Johns Hopkins Medicine announced this week that it is bringing back mandatory masking at all of its hospitals and health facilities in Maryland starting Friday, citing “the recent marked rise in flu and other respiratory infections.” The policy applies to employees, patients and visitors regardless of vaccination status. Masks must be worn in all Johns Hopkins owned and operated locations.
This represents a major shift as Johns Hopkins had lifted masking requirements back in March 2022 when cases declined after the Omicron surge. However, a Johns Hopkins spokesperson said “the current spike in flu and other respiratory infections happening right now in the middle of the COVID-19 pandemic makes reinstating our mask guidelines absolutely the right thing to do.”
Johns Hopkins reports that emergency departments are very crowded with long wait times, hospital beds are around 95% full, and it has seen a dramatic influx of flu cases alongside elevated COVID-19 and RSV numbers. Requiring masks aims to relieve some of the strain.
Pennsylvania Health Systems Follow Suit
On the heels of the Johns Hopkins announcement, two of Pennsylvania’s largest health networks also moved to bring back masking rules this week:
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Penn Medicine updated its guidance to require staff, patients and visitors to mask in all inpatient areas, emergency departments, infusion centers and transport vehicles. Masks remain optional elsewhere. Penn says it is responding to the early surge in seasonal viruses that is limiting bed capacity. As of January 9th, only 4% of Penn Medicine’s 1,500 beds were available amid an influx in admissions.
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Jefferson Health instituted a similar mask mandate in higher risk settings like ERs, clinics, labs, waiting areas and elevators. Jefferson reports all-time high numbers of sick calls among staff in recent weeks with more than 500 employees out with respiratory illnesses. That combined with full hospital beds led them to expand masking rules to curtail spread.
Both Penn Medicine and Jefferson Health plan to reevaluate their masking policies on a weekly basis and loosen requirements if admissions and pressure on staffing decreases.
| Health System | Mask Requirement Details |
|---|---|
| Johns Hopkins Medicine | Required for all staff, patients and visitors in all Maryland hospitals, offices and facilities |
| Penn Medicine | Required for staff, patients and visitors in inpatient areas like ERs, ICUs, infusion centers & transport vehicles |
| Jefferson Health | Required for staff, patients and visitors in ERs, clinics, labs, waiting rooms, elevators |
Southern California Providers Respond to Viral Spike
On the West Coast, an influx of viral illnesses is also prompting revised masking guidance. Some examples:
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Los Angeles County updated its health order to require masks for healthcare personnel and strongly recommend them for patients and visitors. The county is officially at the “high” COVID-19 community level where indoor masking is advised. Hospitals are over 90% occupied – higher than average.
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Many major SoCal providers like Cedars Sinai, UCLA Health and UCSD have instituted temporary patient and visitor mask mandates amid long ER waits and full ICUs. Kaiser told non-employees this week they “must wear well-fitting medical masks at all of our facilities.”
Dr. James Trotter, an emergency physician in San Diego, told NBC 7 that “wearing a mask is such a simple thing we can all do to help decrease transmission, flatten the curve, and help healthcare workers.” With hospitals already overwhelmed by an early flu season and rising RSV cases, maintaining staff health is crucial.
What’s Causing the Surge?
A “tripledemic wave” of influenza, RSV and COVID-19 has arrived. The U.S. is being hit harder than recent years by flu and RSV, likely because immunity has waned after several mild seasons during the pandemic. COVID-19 is spiking with submitted sequences showing over 70% are the newest variants BQ.1 and BQ.1.1 evading immunity.
The combination is causing very high patient volumes in hospitals nationwide. New Hampshire’s state epidemiologist Dr. Benjamin Chan said they are seeing “unprecedented levels of these three viruses circulating at the same time.” Experts say we may be facing one of the worst respiratory illness seasons in modern history, and it’s just getting started.
For context, here are the latest available numbers nationally:
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Flu hospitalization rate is now over 13 per 100,000 residents – the highest at this point in the season in over a decade and more than triple last year.
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RSV has sent over 7,000 children under 5 to hospitals in recent weeks compared to just a few hundred in prior years.
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COVID-19 deaths are the highest since February at over 500 per day on average. Over 5,000 virus patients are being admitted to hospitals daily outpacing last winter.
With viral transmission ramping up as colder weather drives activities indoors, health systems aim to clamp down. Requiring masks again protects staff and avoids diverting resources from normal operations to handle surging admissions. For example, some Maryland hospitals stopped performing elective surgeries to free up staff.
Dr. John Brownstein, epidemiologist and ABC News contributor said, “N95s & boosted immune systems are essential as this viral gauntlet continues.”
What Happens Next?
More healthcare providers nationwide may reimplement masking rules if the “tripledemic” wave escalates further. New York state health officials already sent guidance urging hospitals to strengthen face covering policies with Gov. Kathy Hochul saying they should “start masking today.”
The coming weeks will prove crucial. If viral transmission keeps accelerating, school closures could even be on the table alongside more extensive masking guidance. Former Baltimore Health Commissioner Dr. Leana Wen told CNN stricter measures may be imminent if the situation continues worsening.
For now, the onus is on individuals to mask up, get booster shots if eligible, and practice basic precautions like hand washing and social distancing when possible. Staying home when sick can significantly curb infection spread. Healthcare leaders also advise getting flu shots and COVID-19 bivalent boosters which help reduce severity.
With respiratory viruses coming earlier and stronger than prior seasons, everyone must pull together to flatten the curve. If not, hospitals risk being overwhelmed and unsafe while schools and workplaces face disruptions. Masks are the easiest tool to immediately lower risk and avoid crisis scenarios as this “tripledemic” plays out.
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