Hospitals across the United States are reviving mask mandates as a sharp rise in winter respiratory viruses threatens patients and healthcare systems. The move, led by major networks in New Jersey, signals a renewed effort to combat the simultaneous spread of Covid-19, influenza, and RSV.
New Jersey Hospitals Lead Policy Shift
Hackensack Meridian Health, New Jersey's largest hospital network with 18 sites, announced on Monday that all visitors to admitted patients must wear masks effective from 1 December. The network, which serves nearly two million patients annually, stated the 'respiratory virus season is here' and the policy aims to protect vulnerable individuals and workers.
On the same day, RWJ Barnabas Health, operating 14 hospitals, reinstated its previous mandate. It requires masks for direct-care employees, patients leaving their rooms, and all visitors in patient areas. This decision follows a steady increase in hospitalisations linked to respiratory illnesses, particularly affecting adults over 65 and young children.
The Driving Force: A 'Quad-Demic' Threat
State health officials report that the primary culprit currently is the H3N2 subtype of Influenza A. According to the latest surveillance data, while emergency visits remain relatively low, hospital admissions for both Covid and flu are climbing. RSV admissions are highest among children under four and older adults.
Experts warn this confluence of viruses—dubbed a 'quad-demic' including Covid, flu, RSV, and the common cold—is expected to worsen during the holiday season. Colder weather and indoor gatherings create ideal conditions for viral spread, and cases are anticipated to keep rising.
California County Sets Precedent
This policy shift mirrors action taken in Sonoma County, California, which reinstated an indoor mask mandate from 1 November. The order requires staff and visitors at nursing homes, long-term care facilities, and dialysis centres to wear masks.
County health officer Dr Karen Smith emphasised the significant risk to vulnerable patients, stating it 'continues to be important for face masks to be used in patient care areas' when seasonal virus exposure is high. The order is based on a pre-pandemic policy first adopted in 2017 and is designed for seasonal reapplication.
Data from the week ending 3 November shows the flu positivity rate has increased sharply over nine weeks, rising more than 13.5 times to over seven percent. Public health labs identified 348 flu viruses that week, with 341 being influenza A.
Broader Implications and Recommendations
Other hospitals and clinics in New Jersey have indicated they may follow suit, reserving the right to reinstate masking when community transmission rises. Alongside masking, health authorities are encouraging all residents aged six months and older to stay updated with vaccines for Covid, flu, and RSV.
This marks a return to the intermittent use of public health measures seen since the pandemic, as hospitals nationwide brace for the peak of the winter virus season.
