Why are healthcare venues persisting with masks?

The triumph of culture over rationality

The evidence that masking healthy people in community settings reduces viral transmission is – at best – weak and contradictory. In light of this lack of empirical support for the effectiveness of face coverings, together with the multiple harms associated with them, HART welcomes the lifting of all mask mandates in the UK. The manifest reduction in the prevalence of face coverings in retail settings, hospitality venues and public transport is something to celebrate. Yet, the stark outliers to this return to a mask-free society are NHS facilities and venues allied to health, with widespread masking of both staff and patrons persisting in all hospitals, health centres and GP practices, and most dentists, opticians and pharmacies. This persistence of masks in healthcare settings is both irrational and to the detriment of the people who use these services.

Several of the generally recognised harms of wearing face coverings are likely to be additionally problematic for the users of health services. Impaired communication in the form of muffled speech and the hiding of non-verbal signals will impair both the professional’s understanding of a clinical problem and a patient’s understanding of the recommended therapeutic intervention, a phenomenon that will disproportionately impact the one-in-six people with existing hearing deficits. Elderly people – frequent users of healthcare – will also unduly suffer the consequences of this communication barrier, as well as being especially vulnerable to the increased risk of falls associated with wearing a mask.

Patients seeking help for ongoing respiratory difficulties will be more likely to suffer as a result of the requirement to cover their airways. Long waits – such as those typical within Accident & Emergency departments – might be especially challenging given the breathing difficulties associated with extended wear, together with the increased risk of bacterial infection and the largely unknown danger of inhaling micro-plastics.

Another group of frequent attenders at hospitals and GP practices, those with existing emotional difficulties, will be additionally compromised by the healthcare sector’s insistence on masks. Victims of historical physical and/or sexual abuse will be at risk of re-traumatisation, triggered by either the somatic sensations of cloth or plastic over their airways or simply the sight of masked faces. Furthermore, people suffering recurrent panic attacks – often characterised by catastrophic thoughts of suffocation and feelings of breathlessness – will find face coverings difficult to tolerate. And it is a misconception that masks will reassure the anxious; on the contrary, habitual wearing will prolong fears.    

It is intriguing that a sphere of society where one might reasonably expect a reliance upon evidence-based practice is now the outlier in persisting with the unscientific and pervasively damaging mass-masking phenomenon. After all, a piece of ill-fitting cloth or plastic does not transform into an impermeable viral barrier, or shed its associated harms, by virtue of crossing the threshold of a hospital or health centre. It seems that doctors, nurses and allied-health professionals are becoming culturally wedded to masks, a symbolic gesture to demonstrate a united team – patient and staff – fighting against a virus. It is hugely concerning that this ideological trend ignores a fundamental tenet: a positive relationship between professional and patient is a necessary ingredient of a healing environment, and such a therapeutic alliance is much more difficult to achieve when access to facial expressions is denied.

Healthcare’s persistence with masks will mean that many service users will experience sub-optimal care, from the cancer patient nervously awaiting test results to the frightened child in acute pain. Healing services, delivered with demonstrable warmth and compassion, will always be more effective than a robotic version delivered by a faceless professional hidden behind a veneer of sterility. As proposed by one free-thinking GP, it’s time to ‘put the patient first again’ by ditching the mask in healthcare settings.       

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