In My Own Words

by Flora Bessey, PharmD, BCGP

In a “Back to the Future” surreal moment, several San Francisco Bay Area counties are reintroducing mask mandates in health care facilities starting Nov 1. The plan is to continue these mandates through the end of the flu season, which is traditionally March 31 or early April depending upon the severity of the season.

Each county will be responsible for instituting its own mandates, as this is not statewide guidance, which would be administered by the CDPH.

This brings up a significant question:  what are the benefits of a mask often (or usually) used incorrectly versus the downsides associated with obscuring the faces of health care workers who take care of patients and residents?

As it is, nursing home admissions are in decline, and many older patients are choosing to age at home.  Archaic, unproven guidelines like mask mandates will accelerate this trend, and further the reluctance for those who could most benefit from professional, residential long term care.

The greater question is: why are professional organizations not speaking out against these mandates?

At this time it appears the mandates are only for caregivers and not patients, but as we all know, in long term care “guidelines” are often misconstrued and practiced more conservatively.

In fact, in the article announcing the mask mandates in the “San Francisco Chronicle” (October 10, 2024) a healthcare worker is shown putting a mask on a bedbound patient.

No counties outside of the Bay Area are instituting such mandates, so clearly the rest of California (and the nation) is cognizant that this is an extreme position.

Putting a mask on a frail, elderly patient, as well as presenting as their caregiver while masked, is contrary to everything we know about evolutionary biology and anthropology. Human beings since the beginning of time have assessed risk and developed social relationships based on facial expressions. Denying our residents this courtesy (especially for those who may be suffering from dementia) is bad medicine, and in many ways, cruel. Patients will be more agitated when they cannot see the faces of their caregivers, and saddened when they are denied seeing the faces of their loved ones.

We owe it to those we serve to speak out against ludicrous policies like this.

Note:  This opinion piece represents the position of the author and is not the official position of CALTCM.