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Infectious Disease Experts Advise Health Care Workers Drop Universal Mask Policies

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In another sign of changing attitudes to pandemic policy, infectious disease specialists writing in the Annals of Internal Medicine this month argued against the continuation of universal masking policies for doctors, nurses, and other health care workers.

In the article, the eight authors, who are infectious disease specialists associated with Harvard and Washington University medical schools among others, offer a timeline of the evolving responses to the pandemic. The timeline leaves out the Centers for Disease Control and Prevention’s (CDC) initially confusing advice on masking but acknowledges that factors like the development of immunity, the evolution of the virus, and development of pharmaceutical “countermeasures” have fundamentally reshaped the landscape of the pandemic.

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© 2023 American College of Physicians. Used with Permission. Erica S. Shenoy, Hilary M. Babcock, Karen B. Brust, et al. Universal Masking in Health Care Settings: A Pandemic Strategy Whose Time Has Come and Gone, For Now. Ann Intern Med. [Epub 18 April 2023]

“The burden of SARS-CoV-2 has been mitigated over time,” the authors state, “through access to testing, substantial population-level immunity providing durable protection against severe disease, a series of less virulent variants, and widespread availability of medical countermeasures, which in combination have resulted in decreasing infection mortality rates.”

They conclude that “SARS-CoV-2 has transitioned to a more stable phase, during which the choice and intensity of mitigation efforts must be commensurate with the risk and align with management strategies” for other endemic, transmissible diseases.

“Recognizing these changes,” the authors state, “many pandemic interventions have been deimplemented,” but, “Masking requirements and other restrictions remain notable exceptions.”

Some in the medical field, such as Dr. Kalu Ibukunoluwa and co-authors writing in the journal Infection Control and Hospital Epidemiology in January, argue for making universal masking requirements in health care settings permanent, stating that such “universal source control masking … should become the ‘new normal’ for all healthcare institutions.”

However, Dr. Erica Shenoy, an infectious diseases physician at Massachusetts General Hospital, lead author of the study and her co-authors disagree.

While acknowledging that masking may “marginally reduce the risk of transmission” between health care workers and patients (and vice versa), the authors argue that this potential benefit is outweighed by the barriers to communication masking brings to interactions with patients.

According to the specialists, “masking impedes communication, a barrier that is distributed unequally across patient populations,” such as those for whom English is not their first language as well as those who are hard of hearing due to age or other causes.

“The increase in listening effort required when masks are used in clinical encounters is associated with increased cognitive load for patients and clinicians,” the authors contend, citing several studies to support their argument. “Masks obscure facial expression; contribute to feelings of isolation; and negatively impact human connection, trust, and perception of empathy.”

The authors go on to question other pandemic-era strategies, including asymptomatic testing and resource-intensive contact tracing, “which similarly have experienced a shift in their risk-benefit balance over the course of the pandemic.”

A controversial meta-analysis from the highly regarded research institution, The Cochrane Library, published in March found “no clear difference” between masked and unmasked health care workers in preventing transmission of the flu, nor any clear difference in results using N95 masks versus other masks.

According to Sherri Tenpenny, an osteopathic medical doctor who founded the Tenpenny Integrative Medical Center in Ohio, “Masks didn’t protect people from getting sick during the pandemic and they certainly should not be used now. More than 150 comparative studies and articles have been published that show mask ineffectiveness and document how masks harm the health of persons who wear them.”

She went on to tell The Epoch Times in an email that “masking policies for everyone, including health care professionals, should be eliminated because they are not an ‘effective infection prevention strategy.’”

“They don’t prevent infection or transmission,” she said. “They are a belief system, and beliefs are difficult to change. If a person chooses to wear a mask for ‘political correctness’ or as a sign of  ‘social signaling,’ it is even more difficult for them to stop. They will cling to the lie that masks are of value, even when they are shown a mountain of evidence to the contrary.”

The CDC continues to cite mask wearing along with other measures such as social distancing and school closures as contributing to the dramatic drop in influenza rates during the pandemic.

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