Guest columnist David Alpern: Resume universal masking in health care settings to safeguard against Covid-19

By DAVID ALPERN

Published: 06-20-2023 4:13 PM

I am writing to strongly advocate for the reinstatement of universal face-masking in health care settings, to protect patients, health care staff, and visitors alike.

With nearly five decades of work in medicine, and over 30 years as a board-certified internist practicing primary care medicine at Cooley Dickinson Hospital, I have witnessed firsthand the short- and long-term effects of COVID-19. Studies show that this virus can affect multiple body systems, including the lungs, heart, liver, kidneys and intestines, and even cause abnormal functioning of brain cells.

COVID is airborne and asymptomatic in 40% of cases. Therefore, anyone (staff or patient) can potentially transmit the infection. Not wearing face masks in health care settings will inevitably lead to increased COVID transmission in patients and health care workers. Furthermore, COVID in staff will only worsen the health care workforce crisis.

An editorial in the prestigious Annals of Internal Medicine highlights that universal masking, along with other personal protective measures, significantly reduces the risk of health care personnel acquiring COVID-19 from occupational exposures. By employing these measures, health care facilities can safeguard their employees from contracting the virus in their workplace.

Also, health care personnel often come to work while ill, even with symptoms that could indicate a potential COVID-19 infection. With the unavailability of free home COVID tests, staff members experiencing mild cold-like symptoms or allergies may be less likely to be tested. I recall times before the pandemic when I and other health care staff continued to see work despite having respiratory illnesses.

An editorial by the executive medical director of Infection Prevention and Control at the University of Chicago reminds us that hospitals and clinics are places where the sick are in close contact with the vulnerable. Adopting a universal masking strategy is a harm reduction approach that protects everyone, much like hand washing, glove usage and room disinfection, which are well-accepted infection control practices.

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Terminating infection control measures, particularly in health care facilities, puts individuals with physical and mental disabilities who require frequent medical care at even greater risk. The Americans with Disabilities Act safeguards the rights of disabled people, as well as those who live with or care for them. According to the CDC, age is the most significant risk factor for severe COVID-19 outcomes. The risk of death is 60 times higher in the 65-74 age group compared to the 18-29 age group, 140 times higher in the 75-84 age group, and a staggering 340 times higher in those aged 85 years and above. Medical units within hospitals typically care for these higher risk age groups.

It is very important to know that people of all ages can develop debilitating long COVID-19 symptoms, even after being vaccinated. Studies show that the risk of getting long COVID-19 is approximately 10% after the first infection, with a higher risk following subsequent infections.

Given that the primary focus of health care facilities is the health and safety of patients and employees, it is imperative to apply the precautionary principle and honor the Hippocratic oath, which compels physicians to “do no harm.” As such, health care facilities must reinstate universal masking as a safety measure to protect everyone, especially our more vulnerable older population.

Finally, universal precautions including masking will offer protection against future pandemics, the likelihood of which is increasing due to climate change. Let’s take this simple and intelligent step now. Please contact your state legislators.

David Alpern, M.D., emeritus medical staff at Cooley Dickinson Hospital, lives in Florence. ]]>