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Mayo Clinic will continue to monitor need for mask policy change

Hospital and clinic guidelines don't mean cloth masks need to be abandoned elsewhere

a-woman-perhaps-a-medical-hospital-worker-adjusting-the-straps-on-a-her-face-mask-16x9-1-1024x576.jpg
(Mayo Clinic News Network photo)
Contributed / Mayo Clinic News Network

A mask-policy change at Mayo Clinic isn’t likely to be the final word on which face coverings are acceptable.

“We are continually evaluating new evidence as it comes forward,” said Dr. John O’Horo, a Mayo Clinic infectious diseases expert. “New evidence includes the disease activity itself.”

Mayo Clinic announced Wednesday that it is asking all patients and visitors to switch to medical or surgical masks in an effort to add a layer of protection against the spread of COVID-19. Staff members are required to make the change, as well.

“I do not have an answer about how long this will be in place, but I can say with certainty that this will be evaluated on a weekly basis, if not more often, to determine how long this measure will be necessary,” O’Horo said.

Olmsted Medical Center hasn’t made changes to its COVID-19 mask protocol, but continues to require everyone who enters one of its buildings to wear a mask and be screened for COVID symptoms. Patients and visitors without a mask are provided one.

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Olmsted County Public Health officials continue to recommend masking for indoor public areas, as advised by state and federal officials. They also acknowledged different environments may implement more stringent masking requirements due to workers’ close contact with others, noting such decisions are made and enforced by each business or organization as they deem appropriate.

As with much COVID-19 pandemic guidance, recommendations tend to change with spread and new emerging variants.

O’Horo said Mayo Clinic’s decision to push the use of medical and surgical masks in its facilities isn’t specifically tied to the spread of the omicron variant, but a look at data regarding strain was part of the decision.

“Mayo’s been continuously looking at different studies to evaluate this,” he said. “With the impending omicron variant, we evaluated the evidence about the importance of source-control masking in the context of the potential for a surge in the coming weeks.”

During the seven-day period ending Wednesday, federal data shows 529 new COVID cases were reported in Olmsted County, a 3.5% increase over the previous week.

O’Horo said masking doesn’t have unique protection related to omicron’s characteristics, but he noted added steps to control the potential source of transmission are important in the overall effort to reduce COVID spread.

Meanwhile, the Centers for Disease Control and Prevention’s website continues to provide the green light for cloth masks with at least two layers, which is advice that matches O’Horo’s outside medical facilities.

The CDC guidance says masks should have two or more layers of washable, breathable fabric.

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Other federal recommendation for masks is that they should:

  • Completely cover your nose and mouth
  • Fit snugly against the sides of your face without gaps
  • Have a nose wire to prevent air from leaking out of the top of the mask

Bandannas, gaiters and masks with exhalation valves are not being allowed in Mayo Clinic, due to lack of an appropriate fit or limited research to show effectiveness.
“Masks with exhalation have not been permitted on campus because of concern that they might not effectively contain COVID-19, if worn by an infected individual,” O’Horo said.

That includes N95 respirator masks, which the CDC says should be prioritized for healthcare professionals needing protection from airborne diseases.

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O’Horo said a patient or visitor arriving at the clinic with a N95 respirator mask will be required to swap it for a clinic-provided mask or place a mask over the valve.

When it comes to gaiters, O’Horo said studies don’t provide enough protection for hospital nad clinic settings, but CDC’s mask guidelines point to benefits over no mask. However, the federal agency recommends using at least two of the face coverings, if used in lieu of a layered cloth mask.

A commonly suggested test of a mask’s effectiveness in preventing the spread of the COVID virus is attempting to blow out a lit candle while wearing the face covering. If the flame goes out, the mask is not offering protection.

Additionally, the less the flame flickers, the more protective the mask.

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While face shields have long been an option used by people unable to wear masks, they are not recommended as an alternative by the CDC.

“Evaluation of face shields is ongoing, but effectiveness is unknown at this time,” it states on its mask website.

When it comes to medical and surgical mask options, O’Horo pointed out some acceptable variations exist for purchase in pharmacies and local stores, but Mayo Clinic is providing patients and visitors with options that have been specifically tested to prove effective in limiting COVID spread.

While Mayo Clinic is encouraging people to replace cloth masks when visiting its hospitals and clinics, O’Horo said "good" cloth masks don’t need to be tossed out.

“Out in the general public, a high-quality cloth mask is still a very reasonable option in many settings,” he said.

The CDC notes counterfeit masks, especially those marked as N95 respirators most commonly prioritized for healthcare professionals, are circulating in the national and global marketplace.

The masks are frequently misrepresented as being approved by the National Institute for Occupational Safety & Health, but the CDC said frequent signs exist when the claims are false.

“NIOSH-approved respirators have an approval label on or within the packaging of the respirator (i.e. on the box itself and/or within the users’ instructions),” it states.

Added signs that a mask is counterfeit include:

  • A lack of markings on the filtering facepiece respirator
  • The lack of an approval number on filtering facepiece respirator or headband
  • The lack of NIOSH markings
  • NIOSH being misspelled
  • The addition of decorative fabric or add-ons, such as sequins
  • Claims of approval for children, since NIOSH does not approve any type of respiratory protection for children
  • The filtering facepiece respirator has ear loops, rather than headbands
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