When the California Department of Public Health lifted mask mandates in healthcare settings last month, as the Physician and CEO of Roots Community Health Center, dropping masks at the clinics I oversee in the East Bay and San Jose was a no-brainer. It didn’t occur to me.
The lack of public health mandates has never dictated the policy of medical facilities, so I was shocked that some medical systems dropped masks the moment they were no longer needed. Sometimes I didn’t have to be obligated to do the right thing for my patients and staff. Nor does the removal of obligations remove the obligation to protect and advocate for critical frontline workers and marginalized community members.
Rapid unmasking resulted in COVID onset at Kaiser Permanente’s Santa Rosa Hospital within about two weeks, and we were not surprised that the facility quickly returned to masks. We should all be disappointed that staff and patients were allowed to fall ill despite this.
The withdrawal from organizational medical masking is shameful. This is not data driven and there is no empirical evidence to support the unmasking decision. As such, the statement issued by the hospital fails to cite science for the policy change. Instead, the faceless commission puts out clichés about being in a “new phase” and references available treatments.
But they highlight the very problem they’re creating: It’s ethical for healthcare providers to infect their own patients with SARS-CoV-2 when masks reduce its spread so effectively. What kind of universe is appropriate for
Physicians and hospital administrators seem to confuse giving COVID to patients in healthcare settings with patients contracting COVID themselves in the community. With precautions removed in most other environments, we repeatedly hear from vulnerable individuals that hospitals are the only last place they can feel safe. Many hospitalized patients must now be prepared to fight new infections in addition to those that originally required hospitalization.
For example, I could not forgive myself if I made a patient who had been entrusted to care for me sick.
The early days of the pandemic were plagued with news of PPE shortages leading to deaths of healthcare workers and outbreaks of skilled nursing facilities. This issue was addressed with his appropriate PPE. Yes, we have come a long way since then. But our amazing vaccine doesn’t stop contagion. And being treated for an infection was no excuse for putting the infection on the patient.
Facilities that accept the risk of infecting patients should quantify, justify, and report on that risk on an ongoing basis. They should educate the public and stakeholders on facility-acquired COVID incidence and infection mortality, as well as clinical outcomes and prognosis after the SARS-COV-2 outbreak at the facility.
If mask removal is sound policy, the data speaks for itself. But care facilities that identify staff and visitors should collect and report this data. To do otherwise would unjustly abandon a tool repeatedly shown to prevent the spread of SARS-COV-2.
Healthcare providers must incorporate new knowledge into practice. When HIV first spread, we recognized the need for gloves and safe sharps handling. These practices quickly became the norm. Subsequent development of HIV treatments has not abandoned these preventative measures.
Universal masking should become the new infection control standard as we continue to tackle a widespread, mutating, airborne pandemic. Anything less harms everyone.
Dr. Noha Aboelata is the founder of Roots Community Health Center, serving the East and South Bays, working to close health disparities and improve the well-being of marginalized communities.