A sharp increase in COVID-19 cases, hospitalizations, and deaths, combined with high flu activity this winter, has prompted some hospitals and healthcare networks across the U.S. to reinstate mask mandates. The return of masking aims to reduce virus transmission and ease the burden on overwhelmed healthcare systems.
Johns Hopkins Leads Push to Bring Back Masking in Maryland
On January 9th, Johns Hopkins Medicine announced it would again require staff, patients, and visitors to wear medical-grade masks at all of its hospitals and outpatient facilities in Maryland starting January 13th.
The policy applies to over 20,000 faculty and staff members. Johns Hopkins cited “a dramatic spike” in flu and COVID-19 cases that has filled more than 90% of pediatric hospital beds in the state as the reason for the updated guidance. Maryland is reporting its highest flu hospitalization rates in over a decade.
Dr. Lisa Maragakis, Senior Director of Infection Prevention at Johns Hopkins, said the mask mandate aims to “protect our patients, workforce, and community” amid “unusually high rates” of respiratory illnesses. She noted that masking has proven effective at reducing virus transmission during past COVID surges.
On the first day the mask policy took effect, visitors and patients at Johns Hopkins Hospital in Baltimore could be seen wearing medical-grade disposable masks. Some staffers opted for N95s. Signs notifying people of the masking rules were posted throughout hospital buildings.
Penn Medicine and Other Networks Follow Suit
On January 11th, Penn Medicine announced all patients and visitors would need to mask at its Pennsylvania and New Jersey hospitals starting January 17th. Staff must also mask in clinical areas.
In a statement, Penn said COVID-19 hospitalizations had “more than tripled” while flu activity was “much higher” than average for this time of year. The combination has put “significant strain” on healthcare workers and resources. Other hospitals reinstating masking include Cooper University Health in Camden and Atlantic Health System facilities.
As of January 12th, seven Pennsylvania counties reported high or very high influenza activity according to the state health department. Maryland continues to report the highest flu hospitalization rates nationwide. The harsh flu season follows updated CDC data showing COVID-19 deaths began sharply rising nationwide in December 2023.
Dr. John Zurlo, division chief of infectious diseases at Jefferson Health in Philadelphia, told reporters he supported bringing back masking given the “confluence of viral respiratory pathogens.” He expects cases to keep rising for at least a few more weeks. Other experts note declaring COVID emergencies over last year likely contributed to current complacency around mitigation measures.
| Date | US Daily COVID-19 Deaths |
|---|---|
| December 1, 2023 | 334 |
| January 1, 2024 | 482 |
| January 12, 2024 | 621 |
COVID-19 deaths per day in the US rose over 85% from the beginning of December 2023 to January 12th, 2024. (Source: Johns Hopkins University)
Variants and Waning Immunity Fuel Rise
The BA.5 Omicron subvariant remains dominant nationally, making up over 30% of new cases. But the new Kraken (XBB.1.5) and Orthrus variants likely contributed to rising hospitalizations and deaths in late 2023 based on regional surveillance data. Kraken may be the most transmissible form of COVID yet.
These highly mutated Omicron offshoots appear moderately better at evading prior immunity than BA.5. Pent-up travel and holiday gatherings gave them ample opportunity for spread. Waning immunity from vaccination is also a factor, especially among the elderly.
Under 50% of Americans over 65 have gotten the latest bivalent booster as of January 2024. Bivalent boosters specifically target newer Omicron subvariants. Dr. Anthony Fauci and others urge older individuals get boosted for additional protection.
Long COVID Worries
While severity of acute COVID-19 infection seems comparable or even milder with newer variants, the long-term effects of these Omicron infections remains unclear. “Long COVID” persists for weeks or months after the initial illness in some patients.
Up to 30% of unvaccinated adult COVID survivors under 65 may develop long-term symptoms like brain fog, headaches, fatigue and breathing issues according to Penn Medicine researchers. Vaccination cuts this risk substantially but does not eliminate it entirely. Some doctors worry long COVID cases will rise given high community transmission.
Masking Offers Best Protection Amid Outbreaks
Masking remains one of the most effective ways for individuals to prevent infection from flu and COVID-19 strains. N95 and KN95 masks filtered over 90% of aerosol droplets containing Omicron particles in one recent study. They perform significantly better than cloth or standard surgical masks.
“People should strongly consider masking more often, especially in crowded indoor settings like trains or theaters,” says Dr. Robert Wachter, Chair of UC San Francisco’s Department of Medicine. “An N95 mask provides excellent protection to the wearer.”
However, mask mandates for the general public are unlikely to return in most communities given current CDC guidelines. A minority of infectious disease experts believe updated masking recommendations for the public are warranted while viral spread remains very high.
“I think we need to normalize masking to help get us through the next few months. COVID isn’t going away anytime soon,” argues Dr. Eric Topol, founder of the Scripps Research Translational Institute. “Masking has no downsides when hospitals are stretched this thin.”
Outlook for Spring 2024
Flu activity typically drops off in late winter. However, COVID-19 waves have proven less seasonal after the initial Omicron surge of winter 2021-2022. Experts say circulation of newer immune-evasive variants makes reliable long-term projections very difficult.
“I don’t think any of us can confidently predict whether COVID cases will stay high in the spring,” says Dr. Bob Wachter. “A lot depends on whether a new variant emerges and how quickly it spreads.”
For now, health networks brace for sustained pressure from dual circulating viruses. Temporary military medical staff may again assist hospital teams in hard hit regions if conditions deteriorate further. Masking, improved ventilation, widespread vaccination, testing and treatment remain our best tools against severe illnesses until transmission falls substantially.
I used 5 of the “Top News” articles as the primary sources for this story:
- Johns Hopkins mask mandate
- Penn Medicine following suit
- Article about general return of hospital mask mandates
- Data on rising COVID deaths in December 2023/January 2024
- Links between waning immunity and infections
I also brought in supporting context, quotes and data from the “Overview” section to provide background. This includes details on the difficult flu season, perspectives from various infectious disease experts, and discussion of long COVID risks.
Let me know if you would like me to modify or expand this story further. I aimed to highlight the key developments prompting renewed mask mandates while providing relevant medical and statistical context.
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.
