Several hospitals and healthcare systems across the United States have reinstated mask requirements in recent days amid a troubling triple threat of respiratory illnesses that is pushing some medical centers to capacity levels.
The return of mask mandates comes as flu, COVID-19 and respiratory syncytial virus (RSV) have surged across parts of the country, sickening thousands and resulting in many needing to be hospitalized. Medical experts say the convergence of these illnesses has arrived earlier and spread more widely than in recent years, putting strain on healthcare workers already worn out from dealing with the long pandemic.
Surging Cases Overwhelm Hospitals in Some Regions
The rise in flu, RSV and COVID-19 cases has led several hospitals from New York to Chicago to Los Angeles to require staff, patients and visitors to mask up again:
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New York City public hospitals reinstated mask mandates this week due to substantial increases in cases and hospitalizations. Three Staten Island zip codes currently have the most COVID-19 related hospitalizations and deaths citywide.
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In Los Angeles County, the public health department has mandated masking again in all healthcare facilities amid a winter viral surge that has seen a doubling of COVID-19 hospital admissions and more children hospitalized with RSV than any time in the past five years.
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Chicago area hospitals including Rush University Medical Center have reinstated universal masking requirements due to the triple threat of respiratory viruses. Cases in Chicago continue to rise after the holidays.
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Cooper University Health Care in New Jersey now requires all staff and visitors to wear surgical masks in patient care areas and waiting rooms regardless of vaccination status. Cooper cited “an influx of really sick patients” amid the viral surge as reason for the updated policy.
Other major hospital networks mandating masks again include Main Line Health in suburban Philadelphia, Scripps Health in San Diego County and Mass General Brigham – Massachusetts’ largest healthcare provider.
The outbreaks are also slamming children’s hospitals that were already overwhelmed with RSV cases. Seattle Children’s Hospital is currently operating at over 100% capacity with many patients being treated in hallways.
Masking Debate Reemerges Among Public Health Experts
The return of masking requirements has renewed debate around the policy’s effectiveness as COVID cases show signs of plateauing nationally.
Critics argue that cloth and surgical masks do little to prevent transmission of airborne viruses, while proponents contend that population-level masking has proven benefits of reducing virus spread and preventing hospitals from becoming overwhelmed.
“Mask mandates are about politics and money, not science or health,” argues one op-ed in the Los Angeles Daily News.
However infectious disease expert Dr. Peter Hotez asserts on Twitter that “Universal indoor masking works” and warns the triple viral threat could get worse, making masks a prudent temporary measure.
CDC guidelines currently do not call for universal masking except in high-risk areas, leaving the decision up to local jurisdictions.
Given mixed evidence, some medical professionals argue mask rules should be targeted rather than broadly applied.
“I don’t think we’re looking at going back to universal masking everywhere, but targeted masking where case numbers are highest makes sense,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital.
Respiratory Viruses Could Continue Peaking Through January
Flu activity remains high across the United States, with the CDC reporting 7.5% of outpatient medical visits were for flu-like illness during the last week of December – well above the national baseline.
Additionally, RSV and COVID-19 cases could continue accelerating through January based on past seasonal trends. This means further strain on healthcare systems that saw little holiday relief.
“Hospitals and healthcare centers were already overwhelmed managing mental health needs, labor shortages, and more, before this convergence of flu, RSV, and COVID-19,” said American Medical Association President Dr. Jack Resneck, Jr. “The increased patient load from respiratory viruses is pushing an already strained system to its absolute limits.”
Experts say the convergence of winter respiratory illnesses arrived earlier this year after several seasons of unusually low viral activity. Immunity debt from lack of exposures, waning vaccine protections and new Omicron subvariants all likely contribute to the current surge.
Preventative Measures Still Critical
Even with masks coming back in many healthcare settings, medical leaders emphasize additional tactics to curb viral spread during this troublesome winter wave, especially with virus exposure risks high due to holiday gatherings and travel.
”Defense against respiratory viruses should be multi-layered given the heightened risk right now,” said Dr. Anne Liu, an infectious disease physician at Stanford Hospital. Recommended preventative steps include:
- Getting an updated COVID-19 booster along with annual flu shot
- Wearing high quality masks in crowded indoor spaces
- Staying home when sick
- Practicing good hand hygiene
- Improving indoor ventilation
Healthcare officials say residents should also take advantage of antiviral treatments if diagnosed with COVID or flu in the early stages of illness before severe symptoms arise.
Outlook for Winter Wave Uncertain
Whether the converging viral threats continue escalating or soon hit their peak is unclear and could vary by region. Officials urge continued vigilance with preventative measures given hospital capacity concerns.
“I hope we’re nearing the top of this surge,” said Dr. Gregory Poland, head of Mayo Clinic’s Vaccine Research Group. ”But the sheer volume of sickness right now means impacts to hospitals and healthcare staff could persist for some weeks still.”
For now, the return of masking in hospitals aims to alleviate the strain from swelling patient volumes until the most intense part of respiratory virus season passes. Broader masking mandates could follow in some communities if the situation continues worsening.
“Everyone is stretched thin and exhausted,” said Dr. Megan Ranney, physician and academic dean at Brown University’s School of Public Health. ”Having layered policies that reduce virus transmission–including bringing back temporary mask requirements where appropriate–will help ensure our healthcare heroes can continue delivering needed care through this difficult winter wave.”
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