Adapting for endemic not pandemic: Time to reassess universal masking in healthcare

In a recent commentary published in Annals of internal medicine, researchers reviewed the usefulness of universal masking in health care professionals (HCPs) during the coronavirus disease 2019 (COVID-19) pandemic and identified it as standard precautions, infection-based precautions (pathogen-specific precautions) ) and in future medical practice. In addition, they addressed future situations that may trigger a reconsideration of mandatory masking for medical personnel.

Ideas and Opinions: Universal Masking in Healthcare Settings: A Pandemic Strategy Outdated for NowImage credit: Andy Dean Photography / Shutterstock

Current masking policies in healthcare settings

The World Health Organization (WHO) has announced that the public health emergency caused by COVID-19 is coming to an end, but widespread use of masking continues in healthcare settings.

Universal masking was an important infection prevention and control (IPC) measure when the pandemic began, as there were no drug-based treatments or pharmaceutical options such as vaccines. Also, at that time, testing capacity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was limited, and the world’s population had not acquired immunity. Therefore, non-pharmaceutical interventions (NPIs) were the only means to mitigate SARS-CoV-2 infection.

Under Standard Precautions, HCPs, regardless of their patient’s symptoms, are required to wear a face mask and eye protection to protect themselves from exposure during activities that could generate splashes and sprays on the face. Use the. HCPs take infection-based precautions when caring for patients with suspected or confirmed respiratory infections. For example, use personal protective equipment (PPE). During the pandemic, mandatory and extended face masks for healthcare workers, patients, and visitors in healthcare settings effectively minimized pathogen transmission risk. It also reduced the risk of morbidity and mortality from SARS-CoV-2.

Maintaining a policy such as universal masking has both advantages and disadvantages. Most important of all its benefits is that masks can protect HCPs engaged in direct patient care, regardless of symptoms or diagnosis, and slightly reduce the risk of transmission from HCPs to patients and vice versa. It can.

In addition to increasing costs, masking impedes communication between HCPs and patients. These effects are more pronounced in patients whose native language is not English or who have hearing problems, who rely more on nonverbal cues. Such clinical encounters also increase the cognitive load of patients and HCPs. In addition, masks hide facial expressions and negatively affect relationships, trust, and empathy. Going forward, the debate about the incorporation of face masks for medical personnel will continue.

The future of masking in medical settings

Masking policy remains an important IPC strategy. As with other pandemic strategies such as asymptomatic testing and contact tracing, moving away from universal masking policies requires rethinking the balance of risks and benefits. However, it is important to spread awareness among HCPs, patients, and others about the usefulness of masking in healthcare settings and why masks continue to be used as the pandemic evolves and transitions into the SARS-CoV-2 epidemic. Essential.

Targeted masking policies and their widespread use may be components of a bundled response during future pandemics or regional disease outbreaks. However, studies that quantify the incremental value of different intervention measures under different epidemiological circumstances can help scale decisions about the same.

Providing healthcare systems with high-quality epidemiological data, based on regular reassessments of local conditions, will enable them to strengthen masking decisions when necessary.

In fact, an advisory panel operating under the Centers for Disease Control and Prevention (CDC) is currently reassessing common transmission-based methodologies to inform future mitigation strategies in healthcare settings. Further studies assessing the risk of infection from infected HCPs or patients with different types of respiratory viruses, depending on exposure intensity and stage of infection, may inform future policy. Nevertheless, researchers have advocated the dynamic deployment of masking as an IPC strategy in which HCPs adapt in response to ever-changing conditions.