Several major hospital systems across Massachusetts have reinstated universal masking requirements for staff and visitors in recent weeks due to a surge in respiratory illnesses, including COVID-19, influenza, and RSV.
Mask Mandates Return as Respiratory Viruses Surge
Mass General Brigham, the state’s largest hospital system, announced on December 28th that it would reinstate a universal masking requirement for all staff, patients and visitors at its hospitals and clinics, citing a “dramatic spike” in flu, RSV and COVID-19 cases.
UMass Memorial Health followed on December 31st, announcing it would require staff to resume wearing procedural masks at all times when providing patient care or working in clinical areas. Baystate Health had already brought back a universal masking policy several days earlier on December 27th.
Other Massachusetts hospital systems that have reinstated mask mandates in recent weeks include Beth Israel Lahey Health, Boston Medical Center, Lowell General Hospital, and Care New England.
This comes as respiratory viruses, including influenza, RSV and COVID-19 have been surging nationwide in recent weeks after two relatively mild years during the pandemic. The return of colder weather and more indoor gatherings around the holidays is also driving increased transmission.
| Hospital System | Date Mask Mandate Reinstated |
|---|---|
| Mass General Brigham | December 28, 2022 |
| UMass Memorial Health | December 31, 2022 |
| Baystate Health | December 27, 2022 |
| Beth Israel Lahey Health | December 30, 2022 |
| Boston Medical Center | January 2, 2023 |
| Lowell General Hospital | December 30, 2022 |
| Care New England | December 29, 2022 |
Many hospitals had lifted universal masking requirements for vaccinated staff and visitors earlier in 2022 as COVID-19 cases declined. However, the recent spike in multiple respiratory illnesses has led them to bring masks back. Most of the mandates require staff to wear procedural or medical masks, while visitors are “strongly encouraged” to mask.
Flu Cases Triple, COVID Hospitalizations Double
According to CDC data, flu hospitalization rates have nearly tripled nationally over the last month. Cases started increasing earlier this season than usual. The dominant strain right now appears to be influenza A (H3N2), which tends to cause more severe illness in older adults.
COVID-19 hospitalizations have also jumped, with the 7-day daily average up 60 percent in the last two weeks. Wastewater surveillance indicates the XBB.1.5 omicron subvariant is now dominant nationally. Early lab data suggests it may be more transmissible and better able to evade immunity than previous variants.
RSV continues to strain children’s hospitals as well, though cases may have peaked in parts of the Northeast. More than three-quarters of pediatric hospital beds are filled nationwide.
With multiple viruses circulating widely, hospitals are being hit with a surge of patients just as holiday staffing shortages make operations more difficult. Many emergency rooms and urgent care centers have also been overwhelmed in recent weeks.
Reinstating universal masking is intended to limit viral spread amongst staff and patients within hospitals. It provides an additional layer of protection amidst the tripledemic wave.
Most of the masking policies indicate they will be kept in place temporarily before being reevaluated based on local conditions. However, with multiple respiratory viruses likely to keep circulating over the next couple months, many experts think masking requirements could remain through the rest of the winter season.
Long-Term Effects Still Unknown
While the initial omicron wave a year ago was associated with less severe outcomes compared to previous COVID variants, the long-term effects for those infected remain unknown.
There is emerging evidence that even mild or asymptomatic COVID infections can increase the risk of cardiovascular complications, kidney injury, cognitive issues and diabetes months later. How the latest omicron subvariants may affect long COVID risks is still under study.
Given many have now been reinfected multiple times, there is heightened concern about cumulative effects. Researchers also do not fully understand potential impacts to children’s long-term development and learning.
On top of COVID considerations, being co-infected with multiple respiratory viruses simultaneously could worsen outcomes. There have been case reports of flu-RSV, flu-COVID, and RSV-COVID co-infections over the last month, but the true frequency is unknown. How triple co-infections may affect disease severity or duration has not been characterized.
More research is still needed, but limiting overall exposure remains prudent to reduce potential long-term effects. Universal masking requirements in healthcare settings aim to help minimize transmission risks.
Calls for More Funding and Preparedness
The convergence of influenza, RSV and COVID-19 this season has highlighted cracks in the public health infrastructure. Testing and surveillance capabilities for flu and RSV lag far behind COVID-19 tracking.
Many experts argue more preparation should have been done for the inevitable return of seasonal viruses after two quiet years. The tripledemic wave may be just the first of more collisions between COVID-19 and other respiratory pathogens to come.
Public health leaders say more funding is desperately needed for pandemic and influenza planning, medical supply stockpiles, upgraded hospital capacity, vaccine development, and general preparedness for new outbreaks.
Recent congressional gridlock and staff attrition at health agencies have left the public health system on unstable footing at the very time we need to be investing in and strengthening capabilities most. Leadership commitment along with prompt action this year will be key to averting crisis conditions next respiratory virus season.
Mitigation Measures Still Needed
While no single intervention is perfect, layering evidence-based mitigation measures does help reduce virus transmission and severity of illness if infected.
Many experts advise wearing high-quality, well-fitted masks anytime you will be in crowded indoor settings this winter. Staying home and isolating if you feel sick, even just with mild runny nose or scratchy throat symptoms, helps avoid infecting others unknowingly.
Improving ventilation via HEPA air filters, regularly opening windows, and holding gatherings outside as weather allows can also reduce airborne transmission risks substantially indoors.
Vaccination remains our best tool for preventing severe disease and death. Only 16 percent of Americans have received the latest, updated bivalent COVID booster so far. Flu vaccine uptake is not much higher. Getting both the new COVID booster and annual flu shot provides optimal protection this respiratory virus season – including some cross-immunity benefits against severe illness.
While inconvenient, returning to masks universally indoors may be a necessity over the next couple months in hard hit regions until this tripledemic wave starts subsiding. Preserving hospital capacity amidst staffing shortages remains paramount so anyone needing medical care can access it.
Outlook Remains Uncertain
What comes next this respiratory virus season remains highly uncertain. Whether the US hits a peak soon or continues seeing a meteoric rise in flu, RSV and COVID cases through January depends on numerous variables. How much population immunity exists, emergence of new variants, holidays, schools, human behavioral changes and weather shifts can all influence future trends dramatically.
Vaccine efficacy, waning immunity, uneven global vaccine access enabling more variants, long COVID risks, stressed hospitals, critical staffing shortages, health infrastructure gaps and pandemic response funding deficiencies all add further uncertainty.
Health officials strongly recommend staying up-to-date on the latest recommendations in your local area, including any renewed masking guidance for indoors or mandates in medical facilities. With high likelihood of continued virus spread over the next couple months, remaining vigilant with safety precautions protects us all.
To err is human, but AI does it too. Whilst factual data is used in the production of these articles, the content is written entirely by AI. Double check any facts you intend to rely on with another source.
