Current Data Are Not Conclusive That Masks are Required in Non-pandemic Settings

Wearing a surgical mask or N95 and other personal protective equipment (PPE) protect health care workers (HCWs) from developing respiratory infections, including SARS-CoV-2, respiratory syncytial virus, and rhinovirus. Further, with more novel variants SARS-CoV-2 expected to emerge, wearing PPE is highly recommended because it protects both the HCW and the patient. In fact, mitigation strategies, like wearing PPE, are highly recommended to decrease the spread of respiratory viruses. However, the limited current data are not conclusive that everyone must wear a surgical mask in a non-pandemic setting, according to a recent study on the subject.

The study was presented at The Society for Healthcare Epidemiology of America (SHEA) Spring conference, held April 12-14 in Colorado Springs, Colorado, by Bernard C. Camins, MD, MSc, who is currently Professor of Medicine at the Icahn School of Medicine at Mount Sinai and Medical Director for Infection Prevention at the Mount Sinai Health System in New York.

“No matter what we recommend, it is really a health care workers’ perception of their own risk for contracting an infection [that determines whether they will wear PPE or not],” Camins told Infection Control Today® ICT® in an exclusive interview. “The HCW says, ‘I keep my mask on, [so] I am already protected.’ That's the biggest challenge to making it mandatory in terms of wearing a mask is that compliance or adherence to that intervention.”

However, justifying mitigation mandates is difficult “when [the facility leadership has] to be very strict about masking in their workplace, but they can see that there is no [mitigation strategies in the community], or they can go watch a movie and there is no one wearing a mask,” Camins told ICT®. “So it's really very difficult [for the facility] to make the case [to wear a mask], and it doesn't help that the rest of society seems like they have moved on.”

Despite the ambiguity of the study’s results, Camins still urges HCWs to wear masks. “At this point, I do agree with the CDC recommendation that if cases are high, meaning if your risk for transmission to the community is high enough, then you should protect yourself…When it's slow, then you can make an individual judgment for yourself, [wearing PPE] if you would like to have a higher level of protection, even to wearing an N95 and eye protection for every single encounter that you have in health care.” Overall, there is a need for a large well-designed randomized controlled trial results to be more definitive.

About the SHEA Spring conference, Camins told ICT®: “It feels good to be back together with my colleagues. We did not have [this spring conference] in 2020 or 2021, and this is the first time that I'm seeing the rest of my colleagues in person again, so it feels good. That said, this hybrid way of having a national conference makes it easier for [everyone to attend],” Camins said. “Even myself, I cannot attend annually in person, but [being able to have] the experience, that we do have a hybrid meeting, I know that in the future that I don't have to attend in person, that I can still get the experience and learn a lot from my colleagues.”