We’re putting our heads in the sand in this new phase
Re “Most hospitals in Mass. ready to drop mask rules next week” (Page A1, May 5): Public health institutions in America are weak, and the Biden administration’s response to COVID-19 has been feeble. We failed at the pandemic, with more than 1.1 million Americans dead from the coronavirus, and now we are putting our heads in the sand by ending requirements to mask in hospitals. The quality of COVID epidemiologic surveillance data is suspect, in the context of this new phase of ending the federal emergency and “living with COVID.”
Masking should continue for the time being, until our public health infrastructure is stronger and our surveillance data are of higher quality. It’s not forever, but infectious diseases ebb and flow, and immunocompromised and elderly Americans will continue to die if we follow the present course.
Dr. Philip A. Lederer
The writer trained in the Epidemic Intelligence Service at the Centers for Disease Control and Prevention from 2012 to 2014.
DPH caved to hospital pressure
The Massachusetts Department of Public Health caved to pressure from hospital system leadership, who urged the state to drop mask requirements in tandem with the May 12 end of the federal pandemic emergency. I am appalled that health and safety are being sacrificed for hospital bottom lines.
Health care settings are one place where masking should continue. Studies have shown that COVID-19 causes long-lasting symptoms in 10 percent to 20 percent of cases, even in people who were previously healthy, and further disables those whose health was already fragile. It’s hard to put into words the hell that is long COVID (yes, I’ve been diagnosed with it).
Parents taking newborn babies to well-child appointments, elderly grandparents, cancer patients receiving infusions, and survivors of post-viral illness shouldn’t have to risk catching this highly contagious airborne disease when seeking necessary and life-saving care. Now that hospital-acquired infections may not be reported, we won’t even have the data to show how disastrous this decision is.
Her partner is immunocompromised. The thought of entering an ER waiting room is terrifying.
Having worked in public health, I can say that the Centers for Disease Control and Prevention of today is not the CDC of the HIV pandemic, when I worked on HIV vaccine trials as a research analyst with a private research company. As David Wallace-Wells wrote in The New York Times Magazine, current public-health guidance is now “close to ‘you do you,’ ” which seems like the antithesis of public health.
My partner is immunocompromised, with renal and hepatic impairment as well as congestive heart failure. The only indoor spaces we have entered since the pandemic started have been health care facilities. While his primary care physician is willing to take heroic measures to keep him out of an emergency department waiting room, the thought of entering an ER is terrifying in terms of his risk. I imagine these settings will be even more flooded with uninsured people who cannot afford primary or urgent care as millions are losing Medicaid coverage at the same time the emergency has been declared over. And this is all while COVID surveillance measures are no longer required.
Where is the most important principle of “First do no harm”? Does the marginal inconvenience for staff and the added expense for the hospital outweigh the risk to immunocompromised and elderly patients?
I also feel this policy increases the stress on valiant primary care physicians who now are left to manage risk mitigation for their most vulnerable patients.
I ask Mass General Brigham and all other hospitals that are easing their masking requirements to please reconsider.
Who will be tracking fluctuating infection levels?
The last half of the last sentence of the last paragraph in the article “Most hospitals in Mass. ready to drop mask rules next week” contains what I believe is an important part of the story: the detail that “the amount of COVID-19 detected in Boston-area waste water has been ticking up over the past two weeks.” To my way of thinking (and as you journalists put it), that’s called burying the lede.
Was that information taken into consideration with regard to the easing of masking requirements discussed in the article? With about 1,000 people in the United States still dying of COVID-19 every week and many data collection and reporting requirements being dropped, we need to know who is keeping track of the fluctuating infection levels and what their findings suggest for public policy. Why is relatively little attention being paid to the reputable virologists and epidemiologists who continue to remind us that the pandemic is not over?
The writer is former director of education and programs for the Asthma and Allergy Foundation of America, New England chapter.
We remain awash in data, all of it troubling
The recent article “Tufts Medical reports zero COVID patients” (Metro, May 3), a development that is characterized in an online headline as a “happy milestone,” did not mention whether Tufts Medical Center still screens all patients for COVID. That would have been useful to know. Mass General Brigham and Boston Children’s Hospital have already stopped universal COVID testing for asymptomatic patients, besides removing mask protections. Yet the week of May 3, Massachusetts Department of Health data showed that 172 patients were hospitalized with COVID in Massachusetts, 15 of them in intensive care units and 39 in Suffolk County alone. Since the beginning of 2023, over 138,000 patients have contracted COVID in the hospital, including 4,436 Massachusetts residents.
More than 50 percent of COVID transmission occurs before patients develop symptoms, which is why universal masks and screening testing are critical to prevent spread. Patients have a nearly 40 percent likelihood of transmitting COVID to their hospital roommate, meaning you could go in for a heart attack or a surgery and leave with COVID. Without a negative screening test on admission, patients may have a harder time proving that they caught COVID in the hospital, should they experience harm.
As of April 27, the CDC ceased requiring hospitals to report hospital-acquired COVID, in spite of a study that shows that hospital-acquired COVID surged in England and Scotland after COVID screening upon admission was stopped. Hospital-acquired COVID has a 5 to 10 percent mortality rate.
Hospitals in Boston have been pressing the DPH to end infection control measures. Hospitals also have lost money rescheduling elective procedures when patients tested positive for COVID-19.
With hospitals in an unprecedented budget crisis, the question remains: Are they protecting our health or their financial interests?
Dr. Lara Jirmanus
Dr. Alan Meyers
Jirmanus, who also holds a master of public health, is a primary care physician and a clinical instructor at Harvard Medical School. She is cofounder of the Massachusetts Coalition for Health Equity. Meyers is a professor emeritus of pediatrics at the Boston University Chobanian & Avedisian School of Medicine and also holds a master of public health.
Doctors make many calls, but public health is a job for the policy makers
The claim, as the headline of your May 11 editorial puts it, that “doctors, not government, should decide when to require masks in health care” overlooks the difference between technical medical questions and questions of public policy. Doctors can tell us, for example, whether mask mandates reduce serious illness and death from COVID-19 among the old and immunocompromised. But whether protecting the medically vulnerable is worth the inconvenience to the young and healthy is a question of public policy, which should be settled by the will of the people through their government in a democracy.
Felicia Nimue Ackerman