Most major health care and hospital systems across Massachusetts will end or substantially modify their policies on wearing masks next week, on May 12, after the federal public health emergency for COVID-19 officially comes to a close.
In conjunction with the end of the federal emergency, the state mandate for masks in health care facilities, including doctors’ and dentists’ offices, also expires next week, along with most of the state’s other pandemic-related rules.
Several organizations said they based their decisions to not require masking on a number of factors, including the declining rates of reported COVID cases, as well as the widespread availability of vaccines and treatments, and a desire to align their policies with federal guidance.
But the news worries some health advocates and lawmakers, who say the changes will leave older people and those with compromised immune systems vulnerable to severe complications if they’re infected, and they are urging state health officials to continue requiring masks in health care settings.
The changes for universal masking come as the country enters a new phase of living with COVID. The end of the nation’s public health emergency will also herald a substantial reduction in federal requirements for tracking COVID infections in hospitals, making it more challenging to measure the true impact on infection rates once the mask requirements are dropped.
A bulletin from the American Hospital Association last week said federal regulators plan to reduce the amount of COVID-related data hospitals must report by nearly one-third and the reporting frequency will move from daily to weekly, shortly after May 11. Among the data that will become optional, the association said, are the total number of adult intensive care patients with COVID and the total number of patients who became infected within two or more weeks of admission.
On Thursday, the Massachusetts Department of Public Health reported 897 new cases of infection over the last week, with 172 patients hospitalized with the virus, and 14 people who died from the illness.
Among the Massachusetts health systems announcing an end to mask requirements on May 12 are: Mass General Brigham, the state’s largest health care system; Boston Medical Center, Tufts Medicine; Beth Israel Lahey Health; and UMass Memorial Health, the largest system in central Massachusetts.
“If not now, when? Then it’s forever,” said Dr. Shira Doron, Tufts’ chief infection control officer.
“I will acknowledge there are infectious disease experts who have come down on the side of forever,” Doron said. “What I am hearing from colleagues who have dropped masking in hospitals is that the human connection cannot be overstated. When you take care of a patient and you see their faces . . . it makes a difference and it improves the communication and care and it improves the morale of health care staffers.”
In a notice to employees Thursday, Mass General Brigham said it, along with many other facilities across Massachusetts and New Hampshire, will end universal masking at all of its hospitals, clinics, other facilities, and programs.
“Due to a combination of factors, including widespread immunity against severe disease, available vaccines and therapeutics, and less virulent variants, we are moving towards treating COVID-19 the way we do many respiratory viruses,” the statement said.
The move by many hospitals to drop masking is concerning, said Carlene Pavlos, executive director of the Massachusetts Public Health Association.
“Simply put, masking increases safe access to life-saving care for those with health conditions that make them more vulnerable to COVID,” Pavlos said. “We know hospitals are a place where those with COVID seek care. People who are more vulnerable will be put at greater risk, which undermines our shared goal of health equity.”
The Massachusetts Coalition for Health Equity also urged state officials to retain masking rules in health care settings as well as universal screening for COVID upon hospital admission and before procedures.
“People should not have to take their baby in for a well child visit and come out with COVID,” said Dr. Lara Jirmanus,a primary care physician and instructor at Harvard Medical School who cofounded the coalition.
She noted that since the start of 2023, nearly 39,000 people nationwide have died from COVID, including about 1,500 in Massachusetts, according to federal data.
“Doesn’t everyone know someone with cancer? People with cancer, heart problems, people with strokes go to the doctor and dentist,” Jirmanus said. “They shouldn’t have to get COVID at all of these places.”
And she added, “People are being exposed to COVID without their informed consent.”
Not all Massachusetts hospitals are dropping their masking rules outright. UMass Memorial Health, for instance, noted in its announcement to employees that caregivers will need to still wear a mask during patient encounters in its emergency department and oncology clinics at each facility, as well as in the bone marrow transplant unit, oncology infusion center, and with transplant patients at the Medical Center.
It said masking will be optional but encouraged in all other areas for caregivers, patients, and visitors.
“We will plan to reevaluate this policy after four weeks to see if further adjustments need to be made based on COVID-19 activity,” UMass Memorial said. “We will continue to monitor the level of COVID-19 activity in our patient populations as well as with all caregivers at each entity, so that we can continue to adjust as needed.”
The UMass notice said it was still awaiting guidance from the state health department around health care masking mandates.
A spokesperson for the state’s Executive Office of Health and Human Services said regulators will issue guidance Friday to all licensed health care facilities requiring they update infection prevention and control policies to include information on how they will mitigate the risks of transmitting respiratory illnesses within their facilities when infection rates rise in their communities.
“The Department of Public Health will continue to carefully track COVID-19 cases in Massachusetts and adjust as circumstances change,” she said in a statement.
Some top lawmakers are also urging the state to extend mask mandates for health facilities. The cochairs of the Legislature’s Joint Committee on Elder Affairs, Senator Patricia Jehlen and Representative Thomas Stanley, sent a letter last week to the state’s new public health commissioner, Dr. Robbie Goldstein, asking him to reconsider extending the mandate.
“We are all aware of the devastation wrought by COVID-19 among older people, especially those residing in nursing facilities and other congregate care and congregate living sites, along with the caregivers employed there,” the letter said.
“Even with the advent of lower caseloads statewide, we believe it is imperative to protect the most vulnerable among us, as well as the frontline workers who are already in short supply,” they wrote.
The lawmakers asked Goldstein to extend the mask mandate in health care settings at least until when booster rates increase; only 29 percent of residents have taken the current bivalent booster, which contains more protection from Omicron variants than the original shots.
Despite the low adoption rate of the booster, Mayor Michelle Wu announced that Boston is formally dropping its vaccine requirement for city workers on Thursday. Her announcement comes as the amount of COVID-19 detected in Boston-area waste water has been ticking up over the past two weeks, according to data from the Massachusetts Water Resources Authority.