Should universal masking stay?
Universal masking was implemented in many health care settings during the initial years of the COVID-19 pandemic to decrease nosocomial spread.
Continued masking could help prevent fallout from a consistent problem in hospitals: presenteeism (the feeling that one must go to work even if feeling ill). Interviews done at the NIH Clinical Center showed that among staff who presented as “asymptomatic” and tested positive for COVID-19, more than 50% of these employees who work in a health care setting had a symptom consistent with COVID-19 (Palmore, May 2023). Despite these findings, no transmission to patients was identified.
Proponents of incorporating universal masking into standard precautions also note the reduction in nosocomial transmission of all respiratory viruses, not just SARS-CoV-2, while employees were universally masking. Rather than suggesting universal masking in all settings, some proposals suggest universal masking based on clinical setting (such as in oncology wards) or time of year (e.g., during respiratory virus season).
Should universal masking go?
While universal masking was a part of standard precautions during the pandemic in many hospitals, as of spring 2023 universal masking is being removed from standard precautions for all direct patient care encounters in many health care settings. As infections have waned, the benefits of universal masking may be dwindling while negative effects of masking, such as impeded communication, remain (Shenoy, April 2023; Wong, December 2013).
In sum, universal masking was a widely used strategy during the early years of the pandemic and may still be an optimal infection prevention tool in certain settings, patient populations and/or clinical situations. However, many U.S. health care settings began to revise protocols as the public health emergency lifted, suggesting they will remain an optional tool to be adopted as needed for infection prevention policy moving forward.