Home COVID-19 How a medical journal navigates the mask wars

How a medical journal navigates the mask wars

A look at Annals of Internal Medicine's foray into the debate over the necessity for masks in health care settings.

May 2023

THE MASK WARS continued to rage on in the pages of Annals of Internal Medicine this week, with the journal publishing a new editorial on the topic in its most recent issue.

On April 18, Annals published a commentary that got attention on social media. The headline of that opinion piece was fairly clear: “Universal Masking in Health Care Settings: A Pandemic Strategy Whose Time Has Come and Gone, For Now.”

The editorial argued that with the pandemic receding, hospitals should be allowed to make the call on masking, based on local factors. It wasn’t exactly an anti-mask stance, but the blowback on social media was swift.

Many comments argued to continue universal masking to protect patient safety. On the Twitter page of Eric Topol, MD, for example, some commenters criticized the journal for publishing only one side of a contentious issue.

In their defense, the Annals editors noted that they hadn’t solicited the editorial. But commenters said that given the importance of the subject matter, the editors should have considered reaching out for an alternative point of view. By not inviting a counterargument, their thinking went, the journal appeared to be favoring one point of view.

This week, Annals leveled the playing field when it published a second editorial. The headline on this piece is also unambiguous: “For Patient Safety, It is Not Time to Take Off Masks in Health Care Settings.”

“Although gold-standard evidence is not available, we argue that, despite the lack of clinical efficacy trials (as with the widely accepted practice of hand hygiene), masking in interactions between patients and health care personnel should continue to receive serious consideration as a patient safety measure.,” the authors write.

One interesting piece of information to come out of the social media comments about the Annals editorials: Covid hospitalizations were about 25% higher in April 2023 than a year earlier. One post cited CDC data that found 10,362 covid hospitalizations in the U.S. on April 13, 2022, compared to 12,950 on April 12, 2023.

In the month since those data were flagged, however, covid hospitalizations have dropped sharply. Over the past month, CDC data show that hospitalizations from the virus were at much lower levels than in May 2022.

At the same time, longitudinal data from the CDC indicate that the pandemic produces huge peaks and valleys in trends like hospitalizations. The question is whether the current drop in hospitalizations is a blip that could change course. (A chart with activity through May 6, 2023, is on the CDC Web site.)

Getting the answer to that question—an important data point in making decisions about masking going forward—will be difficult. When the federal government ended the public health emergency surrounding covid earlier this month, the CDC stopped tracking covid data. The agency’s charts end on May 7, 2023.

While health care professionals continue to wring their hands about issues like universal masking, much of the rest of the world appears to have moved on.

For a history on how Covid-19 affected the industry, read Covid news updates: At war with no ammo.

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