In Paris, hospitals are returning to a measure that many thought was over. Faced with the rapid increase in respiratory infections, several establishments in Île-de-France have decided to reinstate the compulsory wearing of masks for caregivers, visitors and patients over six years old. But what pushed hospital authorities to take this step again, and is it really necessary? Dr Gérald Kierzek, emergency doctor and medical director of True Medical, gives his insight on the situation.
Why have masks become compulsory again in hospitals?
According to Dr. Gérald Kierzek, “Wearing a mask in hospital during epidemics of influenza, Covid-19, and respiratory syncytial virus (RSV) is a measure to limit the spread of viruses. It acts as a simple barrier that would reduce the transmission of viral particles emitted by a sick person or asymptomatic carrier. This protects in particular the most vulnerable patients (elderly, immunocompromised, infants) as well as healthcare staff and visitors.“.
In the corridors of hospitals, posters recalling the obligation to wear masks reappear. The medical teams insist on the temporary but essential nature of this return to barrier gestures. “In hospitals, the mask must be worn upon entering areas where patients circulate, including in consultations, in the waiting room, or in the corridors. This obligation is put in place during epidemic peaks for all health professionals, patients and visitors over the age of six.
Perceived by many as a first alert to a more serious epidemic, wearing a mask nevertheless remains a simple way to protect yourself and others: “This collective gesture complements other measures such as regular hand washing and ventilation of premises. Wearing a mask helps reduce the risk of outbreaks and protects all those present, particularly those who are most vulnerable.“.
A useful gesture but not enough
This precaution, however, remains a partial response to a deeper crisis, according to the emergency doctor. “Unfortunately, the mask does not replace the beds closed over the years and making the hospital vulnerable to regular epidemics with fragile populations who will need, in all cases, masks or not, to be hospitalized… The crisis is therefore structural and the single response “wear a mask” a little simplistic, probably necessary but not sufficient!“.
A bitter observation, which illustrates the exhaustion of a hospital system forced to compensate for its structural shortcomings through barrier gestures that have become reflex since the 2020 pandemic.
Is the mask really enough to slow down RSV?
If the mask has proven effective against the flu and Covid-19, its effectiveness against RSV raises more questions. This virus, often perceived as benign in adults, can cause serious forms in infants and the elderly. “Respiratory syncytial virus (RSV) can affect everyone, but it is of particular concern in infants, young children under 2-3 years old, the elderly and those with a weakened immune system or chronic illnesses (heart disease, pulmonary pathologies). In children, it is the main cause of bronchiolitis and may require hospitalization. In healthy adults, it usually causes a cold, but can cause serious respiratory illnesses in frail people. More than 90% of children are infected with RSV before age 2, but immune protection is temporary and reinfections are common“.
The current bronchiolitis epidemic, which is hitting pediatric services hard, illustrates the danger of the virus among young people. Pediatric emergencies in Paris and the inner suburbs have recorded a marked increase in admissions since mid-October.
Good reflexes to protect yourself from RSV
Dr Kierzek points out that prevention remains the best defense against these infections. They give some advice to best protect yourself from RSV:
- Respect barrier gestures: frequent hand washing, wearing a mask, particularly in hospitals or in contact with vulnerable people;
- Avoid close contact with sick people;
- Ventilate the rooms regularly;
- Clean and disinfect frequently touched objects and surfaces;
- Limit attendance at busy places during the epidemic season (fall-winter);
- In populations at risk (infants at risk, elderly), vaccination and the administration of monoclonal antibodies are beginning to be recommended.
These simple gestures, already familiar since the Covid-19 crisis, become essential again as winter approaches. While the cold season has only just begun, health authorities fear a triple wave of flu, Covid and RSV. These simple measures complement the efforts of hospitals to avoid further tensions on intensive care beds and pediatric emergencies. In this context, the mask once again imposes itself as a symbol of caution and collective responsibility.