Post by Nadica (She/Her) on Sept 9, 2024 21:40:39 GMT
Controversy Over Cancer Center Masking Policies as COVID Surge Looms? - Published Aug 27, 2024
By: Marcia Frellick
Although oncologists broadly agree that people with cancer have an elevated risk for COVID-19 infection, long COVID, breakthrough infections, and hospitalization, the nation’s top cancer centers are sharply divided on masking policies, even when the virus is surging, new data show.
Michael Hoerger, PhD, MSCR, a clinical health psychologist at Tulane Cancer Center in New Orleans, Louisiana, who models COVID transmissions, said that he and colleagues were concerned about the lack of protections in public places three years after the start of the pandemic. They looked to National Cancer Institute–designated cancer centers to gauge what top institutions were doing to protect immunocompromised patients in the winter of 2023–2024, when the United States experienced its second-highest COVID transmission peak. The highest peak was in the winter of 2021–2022, with the surge of the BA.1 Omicron subvariant, Dr. Hoerger said.
The researchers analyzed each center’s policies on Jan. 15, 2024, the day they had estimated to be the midpoint of the surge. They found that all 67 of the patient-serving centers had COVID-19 policies. However, only 28 centers (41.8%) required universal masking for all visitors and staff in at least some clinical areas, and only 12 centers (17.9%) required universal masking in all areas. The findings were published in JAMA Network Open.
Compared with what the rest of the country was doing at the time, Dr. Hoerger said, the results from the select cancer centers were “encouraging.” Although no national study has compared all masking policies, “I would guess less than 5% of hospitals had any sort of masking requirement,” he said.
“I would encourage people to view universal masking as an indicator of healthcare quality when there’s a COVID wave. This shows that many of the top cancer centers in the country are aware of that.”
Centers with strict masking guidelines signal to patients that COVID is still a serious disease and that people with cancer should take extra precautions, Dr. Hoerger said. Those guidelines should also signal to other cancer centers that they may want to rethink their policies, he added.
Although many people refer to COVID in the past tense, spikes in incidence keep coming. “We’re experiencing a wave right now,” Dr. Hoerger noted. “Right now, the South and West are having the highest transmission, and probably the peak will happen for the Midwest and Northeast a little bit later, like early September. Our model, based on wastewater, is that over a million Americans are getting infected each day.”
Dana-Farber Cancer Institute confirmed that it was one of the 12 centers that required universal masking in all areas on the Jan. 15 date. “This policy not only helped to protect our patients but also the visitors and the workforce,” said Meghan A. Baker, MD, ScD, the hospital epidemiologist at the institute.
As for the near future, she said Dana-Farber will follow state guidance and monitor local viral respiratory illness, “and will consider reinstating a mask requirement to coincide with the peak of the viral respiratory season.”
At the University of Texas MD Anderson Cancer Center in Houston, Chief Infection Control Officer Amy Spallone, MD, said that during the past winter surge, the institution required staff, visitors, and patients to wear masks in designated areas and required masking in all locations for symptomatic people. “The institution will continue these practices this coming respiratory viral season and adjust as needed, based on the available evidence,” she said.
Leo David Wang, MD, PhD, associate professor of pediatrics and immuno-oncology at City of Hope National Medical Center in Duarte, California, said that he was not surprised by the widely varying masking policies in the study, given the rapidly changing nature of the virus. He added that it would be important to know the COVID prevalence rates in a particular area on the designated date to better understand the individual policies at work. City of Hope had a universal masking policy until very recently, and still requires masking in some spaces, he said.
Dr. Wang, who performs stem cell transplants, has always masked when interacting with patients, even before COVID. “It doesn’t bother me, and I don’t think it bothers my patients.” He said that oncologists are well aware of the vulnerability of their patients and that part of an oncologist’s responsibility is to maximize patients’ safety.
“At the same time,” he says, “It’s also our responsibility to incorporate evidence-based practices so our patients aren’t facing undue restrictions.”
Study link: jamanetwork.com/journals/jamanetworkopen/fullarticle/2821699
By: Marcia Frellick
Although oncologists broadly agree that people with cancer have an elevated risk for COVID-19 infection, long COVID, breakthrough infections, and hospitalization, the nation’s top cancer centers are sharply divided on masking policies, even when the virus is surging, new data show.
Michael Hoerger, PhD, MSCR, a clinical health psychologist at Tulane Cancer Center in New Orleans, Louisiana, who models COVID transmissions, said that he and colleagues were concerned about the lack of protections in public places three years after the start of the pandemic. They looked to National Cancer Institute–designated cancer centers to gauge what top institutions were doing to protect immunocompromised patients in the winter of 2023–2024, when the United States experienced its second-highest COVID transmission peak. The highest peak was in the winter of 2021–2022, with the surge of the BA.1 Omicron subvariant, Dr. Hoerger said.
The researchers analyzed each center’s policies on Jan. 15, 2024, the day they had estimated to be the midpoint of the surge. They found that all 67 of the patient-serving centers had COVID-19 policies. However, only 28 centers (41.8%) required universal masking for all visitors and staff in at least some clinical areas, and only 12 centers (17.9%) required universal masking in all areas. The findings were published in JAMA Network Open.
Compared with what the rest of the country was doing at the time, Dr. Hoerger said, the results from the select cancer centers were “encouraging.” Although no national study has compared all masking policies, “I would guess less than 5% of hospitals had any sort of masking requirement,” he said.
“I would encourage people to view universal masking as an indicator of healthcare quality when there’s a COVID wave. This shows that many of the top cancer centers in the country are aware of that.”
Centers with strict masking guidelines signal to patients that COVID is still a serious disease and that people with cancer should take extra precautions, Dr. Hoerger said. Those guidelines should also signal to other cancer centers that they may want to rethink their policies, he added.
Although many people refer to COVID in the past tense, spikes in incidence keep coming. “We’re experiencing a wave right now,” Dr. Hoerger noted. “Right now, the South and West are having the highest transmission, and probably the peak will happen for the Midwest and Northeast a little bit later, like early September. Our model, based on wastewater, is that over a million Americans are getting infected each day.”
Dana-Farber Cancer Institute confirmed that it was one of the 12 centers that required universal masking in all areas on the Jan. 15 date. “This policy not only helped to protect our patients but also the visitors and the workforce,” said Meghan A. Baker, MD, ScD, the hospital epidemiologist at the institute.
As for the near future, she said Dana-Farber will follow state guidance and monitor local viral respiratory illness, “and will consider reinstating a mask requirement to coincide with the peak of the viral respiratory season.”
At the University of Texas MD Anderson Cancer Center in Houston, Chief Infection Control Officer Amy Spallone, MD, said that during the past winter surge, the institution required staff, visitors, and patients to wear masks in designated areas and required masking in all locations for symptomatic people. “The institution will continue these practices this coming respiratory viral season and adjust as needed, based on the available evidence,” she said.
Leo David Wang, MD, PhD, associate professor of pediatrics and immuno-oncology at City of Hope National Medical Center in Duarte, California, said that he was not surprised by the widely varying masking policies in the study, given the rapidly changing nature of the virus. He added that it would be important to know the COVID prevalence rates in a particular area on the designated date to better understand the individual policies at work. City of Hope had a universal masking policy until very recently, and still requires masking in some spaces, he said.
Dr. Wang, who performs stem cell transplants, has always masked when interacting with patients, even before COVID. “It doesn’t bother me, and I don’t think it bothers my patients.” He said that oncologists are well aware of the vulnerability of their patients and that part of an oncologist’s responsibility is to maximize patients’ safety.
“At the same time,” he says, “It’s also our responsibility to incorporate evidence-based practices so our patients aren’t facing undue restrictions.”
Study link: jamanetwork.com/journals/jamanetworkopen/fullarticle/2821699