COVID-19 Roundup: Masks, Primary Care Recommendations
Universal Masking in Health Care Systems
Researchers from Brigham and Women’s Hospital in Boston, Massachusetts conducted an analysis of data from the Mass General Brigham hospital system, including over 75,000 employees, to determine the effects of a universal masking policy on COVID-19 rates among health care workers (HCWs).
Of the 9850 tested HCWs, 1271 had positive test results for SARS-CoV-2 (2.4% physicians or trainees, 26.5% nurse or physician assistants, 18.7% technologists or nursing support, and 48.3% other). Before the policy was implemented, the SARS-CoV-2 positivity rate increased from 0% to 21.32%, with a weighted mean increase of 1.16% per day. During the intervention period, positivity rates decreased from 14.65% to 11.46%, with a weighted mean decline of 0.49% per day.
“Randomized trials of universal masking of HCWs during a pandemic are likely not feasible. Nonetheless, these results support universal masking as part of a multipronged infection reduction strategy in health care settings,” the authors wrote.
Cloth Face Coverings
In the July 17, 2020 edition of Morbidity and Mortality Weekly Report, the CDC detailed changes in the rates of cloth face covering use from April to May 2020, as well as factors associated with these rates.
Their conclusions were based on surveys conducted from April 7-9 (n = 503 adults) and May 11-13, 2020, (n = 502 adults). Notably, prevalence of mask use increased from 61.9% to 76.4% between the 2 surveys among adults who reported leaving their homes in the previous week.
Rates of mask use was particularly high and increased further from April to May among non-Hispanic black persons (74.4% to 82.3%), Hispanic or Latino persons (77.3% to 76.2%), non-Hispanic persons of other race (70.8% to 77.3%), persons aged 18–29 years (70.1% to 74.9%) and 30–39 years (73.9% to 84.4%), and persons residing in the Northeast (76.9% to 87.0%). The largest differences between April and May rates were observed in non-Hispanic white persons (54.3% to 75.1%), persons aged ≥65 years (36.6% to 79.2%), and persons residing in the Midwest (43.7% to 73.8%).
Primary Care During the Pandemic
In an article published in the Annals of Family Medicine offers recommendations for how primary care practices can “rapidly and continuously reinvent themselves during a pandemic using the CDC’s pandemic framework."
These recommendations include monitoring for outbreaks, promoting physical distancing and hand washing, wearing masks, increasing virtual visits, testing for infection, identifying vulnerable patients, engaging with nursing homes and rehabilitation centers, and more.
—Michael Potts
References:
Wang X, Gerro EG, Zhou G, et al. Association between universal masking in a health care system and SARS-CoV-2 positivity among health care workers. Published online July 14, 2020. doi:10.1001/jama.2020.12897
Fisher KA, Barile JP, Guerin RJ, et al. Factors associated with cloth face covering use among adults during the COVID-19 pandemic — United States, April and May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(28):933-937
Krist AH, DeVoe JE, Cheng A, et al. redesigning primary care to address the COVID-19 pandemic in the midst of the pandemic. Ann Fam Med. 2020;18(4):349-354. https://doi.org/10.1370/afm.2557