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Some hospitals resume mask requirements as respiratory infections rise

Blake Nissen/The Boston Globe

With COVID-19 cases and other respiratory illnesses rising across the region, some area hospitals have begun to bring back face mask requirements to halt the spread of infections.

Boston Medical Center said Thursday it would resume masking requirements in all patient-care areas beginning Friday. On Monday, the Dana-Farber Cancer Institute reinstated its mask requirements in all clinical and public spaces, and the Beth Israel Lahey Health system (BILH) updated its policies to require masking for all health care personnel upon entry to a patient room or bed space.

“We continue to monitor metrics and will make additional changes as needed,” Dr. Sharon Wright, BILH’s chief infection prevention officer, said Thursday.

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The hospitals join a small but growing group that are returning to pandemic-era protections. The Cambridge Health Alliance reinstated its mask mandate in September for patients, staff, and visitors in any area where patient care is delivered. UMass Memorial Health extended its mask mandate to those interacting with patients on Dec. 8. The hospital had previously required masks for employees when they interact with patients in isolation, such as ICU, cancer, or transplant patients.

Most hospitals eased or eliminated their masking requirements last spring, after the federal government ended the Public Health Emergency for COVID-19 and the state lifted its requirements for masking in health care settings. The state has continued to require all health care workers to receive flu and COVID vaccines annually unless they have an exemption, and has required hospitals to provide masks to anyone who requests one at a clinical visit. The state also requires all licensed health care facilities to develop steps to prevent and control the spread of infections during periods of increased transmission in their communities, including implementing universal masking.

Anne Gross, senior vice president for patient care services at Dana-Farber Cancer Institute, said the hospital made the decision to bring back masks based on previously agreed upon criteria. Early last fall, hospital officials decided to consider reinstituting masking when the percentage of emergency room visits resulting from influenza-like illnesses, including COVID-19, influenza and RSV, rose above 2 percent. That percentage is now approaching 3 percent. Meanwhile, the amount of COVID-19 found in the region’s wastewater is among the highest in the nation, Gross said.

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“We take a pretty aggressive approach, and we know we’ve implemented masking probably a little ahead of some other hospitals,” she says. “But it really is a reflection of both our monitoring the data, but also in the context of understanding how vulnerable our patients are. Many of the therapies for cancer treatment do compromise the immune system and so make our patients more vulnerable to these illnesses.”

UMass Memorial Medical Center spokeswoman Debora Spano said her institution made the decision to bring back mandates based on the number of positive COVID cases seen in the hospital. UMass revisits the data weekly.

At other hospitals, masking remains optional, but officials say they are monitoring the situation closely.

The state’s largest hospital system, Mass General Brigham, has said it will reinstate masks for health care staff interacting directly with patients when the percentage of patients with respiratory illnesses coming to emergency rooms or outpatient facilities in the region exceeds 2.85 for two consecutive weeks.

“As of now, we’re in the mild/moderate category, which means we undertake a number of non-masking mitigation measures,” hospital spokesman Michael D. Morrison said Thursday.

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At Tufts Medical Center, experts on an infectious disease advisory council review and evaluate data on a weekly basis, including, but not limited to, staff absenteeism, patient infection rates, hospitalization numbers, as well as state and national data, including wastewater trends, to determine when masking should be reinstituted, a spokesman said Thursday in a statement.

“At this time, masks remain optional,” the statement said. “However, we will continue to closely monitor trends and metrics in Boston and across the state and will be prepared to make a change in policy when the data dictates it is necessary. The health and safety of our patients and employees remains our top priority.”

Boston Children’s Hospital also does not currently require masking. In a statement provided to the Globe, it noted that it does require all staff to get vaccinated against COVID-19 and flu.

“Masks are available at all entrances; if patients, families, or staff feel more comfortable wearing one, they are welcome to do so,” the statement said. “If visitors have respiratory symptoms, we ask them to continue wearing masks while visiting Boston Children’s. Additionally, if patients and families prefer to interact with staff who are masked, staff members will mask up if the request is made.”

Some advocates for the elderly, disabled and those with chronic conditions have decried the looser masking requirements and called on public health officials to reinstate the more stringent policies. In late November, a group of doctors and activists held a virtual news conference calling on the state to require universal masking in health care settings, to provide free access to COVID-19 testing and high-quality masks and enact new protections enabling disabled people to insist that their caregivers wear masks.

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The group, the Massachusetts Coalition for Health Equity, warned that the lack of more stringent protections jeopardized the lives of the most vulnerable, making visits to healthcare settings a “roll of the dice.”


Adam Piore can be reached at adam.piore@globe.com.