A growing number of hospitals and healthcare systems across the United States have reinstated mask requirements in recent weeks due to a troubling triple threat – simultaneous surges of COVID-19, influenza and respiratory syncytial virus (RSV) that are straining resources.
COVID Cases Rising After Months of Decline
After COVID-19 cases declined significantly in 2023 following the rollout of updated bivalent booster shots, cases began rising again in late 2022. The emergence of new omicron subvariants like BQ.1 and XBB, which are more adept at evading immunity, has led to a fresh wave of infections. According to the Centers for Disease Control and Prevention (CDC), the current 7-day moving average of daily COVID-19 cases sits around 65,000 as of January 8th – up from around 25,000 in early November.
“We had been lulled into a false sense of security that the pandemic was largely behind us,” said Dr. Anthony Fauci, chief medical advisor to President Biden. “But SARS-CoV-2 continues to mutate and present new challenges. Even those who are fully vaccinated and boosted should not assume they are completely protected, especially high-risk individuals.”
Hospitalizations and deaths, which typically lag a rise in cases, have also ticked upward, prompting unease among healthcare leaders.
Flu Season Hitting Hard and Early
Meanwhile, seasonal influenza is also battering much of the country. Cases began spiking in November – weeks earlier than usual – and continue to climb at worrying rates. An estimated 8.7 million illnesses, 78,000 hospitalizations, and 4,500 deaths from flu have occurred so far this season, according to the latest CDC weekly flu report.
“This is one of the worst early flu seasons we have witnessed in years,” said CDC Director Dr. Rochelle Walensky in a statement. “The hospitalization rate right now is the highest at this point in the season in over a decade.”
Walensky urged those who have not yet gotten a flu shot to do so immediately and stressed the importance of mask-wearing to limit transmission.
RSV Further Stresses Pediatric Units
As if COVID and flu were not enough, yet another virus has emerged as a formidable foe this winter – RSV. Cases of respiratory syncytial virus, which can cause severe illness in young children and older adults, began surging in the fall.
Pediatric hospital beds and ICUs in many states are overflowing with RSV patients. A recent analysis found nearly 75% of pediatric hospital beds are filled in Maryland, with many children’s hospitals operating at or above capacity nationwide. Those under age 5, especially infants, as well as seniors over 65 are most vulnerable.
“The pressure being put on our pediatric facilities right now is just enormous,” said Dr. Patricia Checko, Vice President and Medical Director of Pediatrics at Johns Hopkins. “Many children are requiring supplemental oxygen, with a disturbingly high number needing to be intubated and placed on ventilators due to respiratory failure.”
Mask Mandates Return to Healthcare Settings
| Hospital/Health System | Location | Date Mask Mandate Reinstated |
|---|---|---|
| Cooper University Health Care | Camden, NJ | Jan. 3, 2023 |
| Main Line Health | Suburban Philadelphia, PA | Jan. 3, 2023 |
| Penn Medicine | Philadelphia, PA | Jan. 3, 2023 |
| Rush University Medical Center | Chicago, IL | Jan. 3, 2023 |
| Bayhealth | Delaware | Jan. 4, 2023 |
| UMass Memorial Health | Central Massachusetts | Jan. 5, 2023 |
| New York City Public Hospitals | New York, NY | Jan. 5, 2023 |
In response to overwhelmed hospitals and elevated community spread, a growing number of hospital networks have reinstated universal masking policies regardless of vaccination status. Facilities in COVID hotspots like New York, New Jersey, Pennsylvania, Delaware and Illinois have led the way.
As shown in the table above, institutions reinstating mask mandates have done so primarily in the first week of January 2023. Cooper University Health in Camden, NJ was one of the first to bring masks back on January 3rd after a major spike in patients testing positive.
“We have seen a significant jump in the number of patients infected with respiratory viruses that are straining healthcare resources across the state,” Cooper President and CEO Anthony J. Mazzarelli said in a statement. Similar reasoning has been behind most facilities’ decisions to require masks again.
Many hospital leaders have voiced fears that the surge could overwhelm staff and resources if stricter measures are not implemented.
“There are very few airplanes, trains, concert venues and movie theaters that see the kind of traffic we see every day,” said Philadelphia-based Jefferson Health CEO Bruce Meyer. “A mask mandate simply helps us to provide the safest care environment for our patients and staff during this challenging time.”
In announcing the return of universal masking at its New York City public hospitals on Jan. 5th, Mitch Katz, CEO of NYC Health + Hospitals, urged New Yorkers not to delay medical care out of COVID fears. “We encourage all New Yorkers to seek care when they need it,” he affirmed.
Mixed Messaging Causing Confusion
After nearly three years of fluctuating state and local mask policies, the latest revival of mandates has elicited mixed reactions from the public.
While many express support for face coverings in hospitals, others argue yet another round of mask rules strips personal choice and breeds mistrust. A January 5th editorial in the New York Post blasted healthcare administrators for “once again forcing healthy people to wear masks” instead of providing clearer guidance on their necessity and efficacy to the public.
Trust in public health agencies like the CDC took a hit in 2022 when federal transportation mask mandates were hastily reversed. Confusing messaging around the benefits of masking versus quality of life impacts has also led to skepticism.
“Public health officials lose credibility when restrictions flip-flop seemingly arbitrarily without explanation,” said Dr. Vinay Prasad, Associate Professor of Epidemiology at University of California San Francisco. “We have to be transparent about the evidence and tradeoffs behind mask policies.”
Future Course Uncertain
Looking ahead, it remains unclear how extensively masks will return across US hospitals or whether new state and local mandates might follow. Much depends on if COVID, flu and RSV cases have peaked or continue accelerating into February.
“As always, we need to closely monitor the data and let science guide our ongoing recommendations,” said Dr. Fauci. “Only time will tell if this triple viral threat worsens and warrants broader masking precautions.”
With COVID vaccines and treatments still limited for young children, keeping RSV and flu cases down through masks and other measures remains vital. Continued research into next-generation shots and anti-viral pills also offer hope.
For now, hospital systems aim to balance staffing, beds, resources and community health needs amid a perilous winter viral surge. Their ability keep up with demand in the coming months may hinge on whether Americans heed warnings and act cautiously until the storm passes.
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.
