Dramatic decline in the number of viruses begs the question: masks forever?


Masks and physical distancing have great benefits in preventing people from getting all kinds of diseases – not just Covid-19. However, it is unclear whether the protocols are worth the pain in the long run.

The teachers at New Hope Academy in Franklin, Tennessee, had a chat the other day. The private Christian school has met face-to-face during much of the pandemic – it needs masks and tries to keep kids apart as much as possible with young children. And Nicole Grayson, who teaches fourth grade, said they recognized something special.

“We don’t know anyone who’s got the flu,” she said. “I don’t know any student who has a sore throat.”

It’s not just an anecdote.

A study published this month in the Journal of Hospital Medicine, led by researchers at Vanderbilt University Medical Center, found that 44 children’s hospitals have reduced the number of pediatric patients hospitalized for respiratory problems by 62%. The number of children in the United States who died from the flu this season remains in the single digits. Deaths have also fallen dramatically compared to the last 10 years: the number of child flu deaths is typically between 100 and 200 per year, but so far only one child has died of the disease in the US during the 2020-21 flu season.

Adults don’t get sick either. U.S. flu deaths this season are measured in the hundreds rather than thousands. In 2018-19, a moderate flu season, an estimated 34,200 Americans died.

Effective combination

It’s not just the masks and physical distance that contain communicable diseases, said Dr. Amy Vehec, a pediatrician at Mercy Community Healthcare, a Tennessee clinic that receives federal funding. Going anywhere with a fever has become a serious social faux pas – so parents don’t send their sick children to school, she said.

“You’d better stay home when you’re sick,” Vehec said. This includes adults who may be feeling sick.

Isolating when feeling bad could be sustained after the pandemic. But the isolation, the distance and the masks don’t work for many children, Vehec said.

For example, children with language problems do not see their teacher’s mouth to learn how to speak properly.

“I think it was a necessary evil because of the pandemic and I fully supported it, but it had prices. It had consequences, ”she said. “Raising children suffers among other things.”

And since covid vaccines for kids aren’t available for a while, it may be another year of masks in schools.

Some experts, like researchers trying to improve masks, argue that more societies should accept masking – as some Asian countries have done. But experts in infectious diseases such as Dr. Ricardo Franco of the University of Alabama-Birmingham doubt this is practical.

“I am a little skeptical that this crisis will be enough for a comprehensive cultural change, as it has been difficult to achieve a reasonable cultural change in the past few months,” said Franco.

The most realistic framework for lasting change can be in the healthcare sector itself.

Doctors and nurses usually didn’t wear masks until they were eager. Dr. Duane Harrison, who runs an emergency department for an HCA hospital outside of Nashville, mentioned a fellow doctor who has worn a mask since graduating from medical school.

“We joked and played around with him about it,” Harrison said. “Until then.”

Now that everyone is wearing masks, Harrison’s department has found the same thing that many other jobs have: employees don’t call sick unless it’s normal.

“When Covid is done, this is a practice that most of us are likely to continue,” Harrison said. “Because we don’t worry about running children and the elderly who don’t know they are sneezing in your face.”

Some hospital systems, including Nebraska Medicine, have begun relaxing the universal masking requirements for their staff. But vaccinated employees also have to wear a mask when visiting a patient. Intermountain Healthcare in Utah has signaled that masks will continue to be required if a statewide mandate is lifted in April.

“Does everyone need a break?”

But even believers who believe in the effectiveness of masks have doubts that the medical community will carry on like this.

“The bigger question is, does everyone need a break?” asked Dr. Joshua Barocas, who studies Infectious Diseases at Boston University.

Whatever the future holds, public health officials say it is not yet time to drop mask requirements as the US waits for more people to get a covid vaccine. But at some point even doctors and nurses are ready to see smiling faces again.

“I know I’ll have to take my masks off at some point in the future,” said Barocas, “for a little.”

This story is part of a partnership that includes Nashville Public Radio, NPR, and KHN.

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