Doctors Advocate for Increased Preventative Measures to Protect Vulnerable Patients in Medical Settings
Published October 5, 2023 12:00PM (EDT)
Earlier in the pandemic, hospitals across the country faced severe shortages of personal protective equipment (PPE), leaving healthcare providers on the frontlines to reuse dirty masks or find alternative methods of cleansing them. As masks became scarce, healthcare workers suffered from bruised faces due to the pressure of wearing N95 masks for extended periods. Some even went to the extreme of renting separate apartments to protect their families from potential contamination.
Eventually, global supply chains ramped up production, vaccines were developed, and the combination of vaccination and natural immunity significantly reduced the number of COVID-19 hospitalizations and deaths. In May 2023, the Centers for Disease Control and Prevention (CDC) eased some of its transmission prevention rules, recommending hospitals to reinstate mask mandates in response to rising community transmission. However, it is up to individual hospitals to decide when and how to implement these measures, while also removing universal testing requirements for patients and staff.
With COVID-19 cases steadily increasing since June and the emergence of the EG.5 mutation (“Eris”), at least 18 hospitals nationwide have reintroduced mask mandates. However, no federal mandate has been implemented. Doctors are particularly concerned about vulnerable patients in hospitals, as these settings are susceptible to various disease-causing pathogens, not only the SARS-CoV-2 virus. Hospitals also face a heightened risk of long COVID, even among vaccinated individuals and young, healthy patients.
“Our elderly relatives, people with serious illnesses — these are the only places they can go to get care when they are in the worst shape of their lives,” said Dr. Theodore Pak, an infectious diseases fellow practicing in Boston, Massachusetts.
President Joe Biden declared the pandemic “over” in September 2022, but COVID-19 remains the seventh leading cause of death in 2023. Despite ample evidence supporting the effectiveness of masks in reducing COVID-19 transmission, mask mandates in schools and other settings continue to be controversial and politicized. The same is true for hospitals, with some doctors arguing that universal masking is unnecessary.
However, healthcare providers on the frontlines emphasize that loosening protective measures in hospitals can lead to increased infections not only from COVID-19 but also from other viruses like the flu. Studies have shown that when community transmission of COVID-19 rises, hospitals experience a significant increase in COVID-19 spread. A study in England and Scotland found a 41% jump in hospital-originated COVID-19 cases after they stopped universal testing upon admission. Another study revealed a higher number of COVID-related deaths among cancer patients during the winter Omicron wave due to relaxed transmission prevention policies.
Maintaining strict protective measures in hospitals is crucial, as these measures have been proven to reduce the spread of not only COVID-19 but also other respiratory viruses. Hospitals implementing COVID-19 protocols have seen a 50% decrease in the spread of flu and respiratory syncytial virus (RSV), benefitting vulnerable patients. While the general public may feel that the pandemic is over in other settings, hospitals and healthcare facilities carry a different moral responsibility.
Unfortunately, the testing and treatment system for COVID-19 outside of hospitals has been dismantled, leaving public health agencies to rely on hospitalization data and wastewater analysis to gauge the level of the pandemic. However, hospitalization metrics are delayed and put healthcare workers and vulnerable patients at risk.
The CDC is currently revising its isolation precaution guidelines for healthcare facilities, but the agency has faced criticism for potentially weakening protective measures. The National Nurses United organization expressed concern that frontline personnel were not adequately involved in the workgroup developing the revisions. The agency plans to issue a response soon after consulting with experts.
Dr. Andrew Wang, a health equity researcher at Northwestern University Feinberg School of Medicine, believes that the responsibility to mitigate the spread of COVID-19 should not solely fall on patients, who are already sick and vulnerable. Health leaders and policymakers must establish standard practices for everyone to follow.
As the COVID-19 pandemic continues, it is essential to prioritize the safety of vulnerable patients in medical settings. Implementing and enforcing preventative measures, such as universal masking and testing protocols, can significantly reduce the spread of COVID-19 and other respiratory illnesses in hospitals.