Becker's Clinical Quality & Infection Control

10 INFECTION CONTROL How hospitals are deciding to unmask patients and staff: 6 execs from Atrium, Ochsner & more By Hannah Mitchell A s businesses lift mask mandates for fully vaccinated consumers, the healthcare industry has been untouched. Now, hospital leaders are determining what their mask mandates' next move is. Here, six hospital executives reveal to Becker's how they are strategizing when to remove masks for patients and staff: Editor's note: Responses were lightly edited for style and clarity. Sandra Kemmerly, MD. Infectious Disease Expert and System Medical Director of Hospital Quality at Ochsner Health (New Orleans): We are under a mask mandate in healthcare facilities in the state of Louisiana. Regardless of how we think about that, we're still compelled to adhere to the governor's order. Our strategy will depend upon the vaccine status of the employees. e hospital becomes a little bit more tricky, because of the patients' immunosup- pressed conditions. Until we can ensure that all of our employees are vaccinated, we're going to continue to follow the mask mandate and vaccine adherence, which is voluntary at the present time. Before we take masks off in the hospital setting, it's not what percentage of the staff is vaccinated, but "What are the individual battles with each individual employee?" Ideally, we'd have 100 percent of people vaccinated and take masks off, and everything would be great. I don't know that we'll ever get to virtually 100 percent. We've had flu shots mandatory for a number of years in our organiza- tion. We get close to 99 percent compliance. ere are certain health conditions, and some other reasons people are excluded from the mandatory flu vaccination program. We'll have to see what excep- tions may look like and we'll have to consider it on a case-by-case ba- sis. If our employees are not vaccinated, they will need to wear masks for at least the short term. COVID-19 is here to stay for at least a while. So as long as it circulates, we're going to have to continue to wear masks in the healthcare setting. Allison Baroco, MD. Infectious Disease Specialist, and Scott Crab- tree, Associate Vice President for Professional Services at Augusta Health (Fishersville, Va.): Augusta Health's strategy for the unmask- ing of patients and team members relies on following the state public health department and CDC guidance. Both agencies still recommend that patients, visitors and healthcare workers performing direct patient care remain masked when able during a healthcare encounter. A key driving factor is the local rate of transmission. Our county has contin- ued to have a moderate rate of transmission with approximately 30 to 60 cases per 100,000 for the past several weeks. Best practice guidance is to continue masking in patient care settings until local prevalence is less than 10 cases per 100,000 (low to minimal transmission). Recog- nizing that coronavirus will likely become a seasonal virus post-pan- demic, we will need to continue to utilize the strategy of monitoring community prevalence to determine if and when patient and team member universal masking needs to be resumed. Augusta Health recognizes the critical role vaccinations serve in decreasing the transmission of coronavirus; therefore, in accordance with CDC, much of the guidance and masking mandate relies on team members being vaccinated. In regards to areas and activities outside of direct patient care, the high vaccination acceptance rate (less than 70 percent) among our team members has allowed us to remove masks in meetings where everybody is vaccinated; however, unvaccinated team members are directed to continue to wear masks during meetings and other non-patient-care activities. Due to indi- vidual circumstances and comfort levels, we will always honor those vaccinated team members who would like to continue to wear masks even when they are not required. Lastly, we have attempted to instill vaccine confidence in all of our team members as we recognize that herd immunity is the best strategy to eventually eliminate the need for universal masking. David Verinder. CEO of Sarasota (Fla.) Memorial Health Care System: As a safety-net hospital and tertiary referral center caring for the sickest, most vulnerable people in our region, we remain cautious about relaxing our compliance with recommendations for the use of masks in healthcare settings. We follow the science and adhere to the latest guidance from the CDCl and Florida Department of Health, taking into consideration the state of the epidemic in our community, and the recommendations of our hospital epidemiologist and infection prevention & control team. So, while we continue to ease visitor policies and other protocols put in place during the pandemic, we will continue to mandate universal mask-wearing in clinical and nonclinical settings where our staff inter- act with patients, visitors and members of the public. Whether we continue to require masking in nonclinical areas that are not frequented by patients or visitors depends on a range of factors, including whether employees have been vaccinated and whether they have enough space to remain distanced from unvaccinated staff. Although cases of COVID-19 are predicted to continue decreas- ing in the weeks ahead, we have no immediate plans to adjust our mask mandate. As we have throughout the pandemic, we will continue to monitor the prevalence of the virus around the state and region and adjust our practices to respond to the changing conditions, always being careful to guard against any potential spikes or outbreaks this summer. James Hunter, MD. Senior Vice President and CMO of Atrium Health (Charlotte, N.C.): Atrium Health requires all teammates, patients and visitors to wear masks inside all of our locations. Atrium "We have attempted to instill vaccine confidence in all of our team mem- bers as we recognize that herd immunity is the best strategy to eventually eliminate the need for universal masking." -Allison Baroco, MD, infectious disease specialist, Augusta Health

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