Face masks are always a good idea in the doctor’s office, study finds

CNN
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Signs urging everyone to mask up have largely disappeared from places like grocery stores and schools in the third year of the Covid-19 pandemic. But they remain in many doctor’s offices, and a study published Monday says they might still be a good idea.

Even after the public health emergency declaration in the United States expires and with many Americans moving away from pandemic precautions, masks continue to offer some protection, reducing your risk of catching Covid-19 in a community setting as in a close interaction between doctor and patient, according to the study, which reviewed the latest scientific knowledge on the protective quality of masks.

The study, published in the journal Annals of Internal Medicine, also found there was no significant difference in protection between surgical masks and N95 respirators in a health facility. N95s may be slightly more beneficial, but it hasn’t been entirely clear from the research.

Researchers looked at three randomized trials and 21 observational studies from around the world to understand what the evidence says about the effectiveness of N95, surgical and cloth masks in reducing the transmission of Covid-19.

Some of the research they used had limitations. The evidence on surgical masks versus cloth masks, for example, or the more or less consistent use of masks was “insufficient”, the researchers wrote.

In an editorial published alongside the new study, Drs. Tara Palmore of the George Washington University School of Medicine and David Henderson of the National Institutes of Health note that mask use has become a politicized topic during the pandemic. Because benchmark evidence on their protection is not available, they say, masks for patients and healthcare workers should be considered a good safety measure.

Laboratory studies show that surgery masks and respirators are good for limiting the spread of aerosols and droplets from people with influenza, coronaviruses and other respiratory viruses. Although not 100% effective, they greatly reduce the amounts of virus that are expelled when someone speaks or coughs.

There can still be transmission of a virus from patient to staff or from staff to patient when both people are masked, but this is rare.

Palmore and Henderson say one of the main reasons they think people should wear masks in health care settings is that people who work there, for various reasons, are “known to come to work so that they are ill”.

Previous research showed that half to two-thirds of people who work in healthcare settings have worked while experiencing respiratory symptoms. Pre-symptomatic people can also spread the virus, or it can be difficult to tell if someone is sick if they have been vaccinated and have milder symptoms, so simply asking sick people to put on a mask may not stop the spread. .

“Unnecessarily exposing patients to infections preventable by masking appears directly contrary to the principles of patient safety,” the commentary reads. “For all of these reasons, we advocate remaining masked when interacting with patients.”

Dr. Syra Madad, infectious disease epidemiologist at Harvard Belfer Center for Science and International Affairsagrees that it is important that healthcare systems do all they can to prevent the transmission of Covid-19, including requiring workers to wear a mask when interacting with patients – “especially among our patients the most vulnerable, and sometimes it’s hard to know who is the most vulnerable and immunocompromised,” said Madad, who was not involved in the new research.

She said people don’t necessarily have to wear them in elevators or hallways, but in clinical encounters it’s good to play it safe.

Now that people have gotten used to masks, she says, with flu season and RSV season coming up this fall, more healthcare workers should consider wearing them.

“We all realize the importance and usefulness of a mask,” Madad said. “A culture of safety shows that you are respectful to your patients.”

She added that if a patient prefers the provider not to wear a mask, as if they have trouble hearing or understanding the other person, that should also be acceptable. But she says the default should be a mask in clinical interactions.

“Even though the public health emergency for Covid-19 has been declared over, we still see over 1,000 Americans dying every day from this virus, and that’s still unacceptable. It’s still very high, which means that it’s still a threat,” Madad said. “As much as we want to minimize it, and it’s not an emergency anymore, but it’s definitely a threat.”