Mask-wearing was new and controversial during the rise of COVID-19, but infectious disease experts are urging Minnesotans to use the practice again against an old nemesis of the flu.
Michael Osterholm has frequently criticized mask wearing during the pandemic because people were using poor quality masks and wearing them ineffectively under the nose and loosely over the mouth. But the director of the Center for Infectious Diseases Research and Policy (CIDRAP) at the University of Minnesota wore high-quality N95 masks at conferences across Europe this fall, and he stressed that proper masks worn correctly can make the difference this winter.
“I’m a loyal N95 user and fit it appropriately in the face and not under my nose. And I think that’s what we’re talking about,” he said. “Many of them [mask-wearing] the recommendations are so generic that the public has no idea what you’re talking about.”
Minnesota experts encourage effective mask wearing during the holidays — especially by and around people at high risk for severe illness — as respiratory viruses spread widely this time of year.
“It’s never a bad thing not to pass your germs on to other people. That’s why we use them extensively in health care,” said Dr. Will Nicholson, president of Minnesota Medical. Association. He is also vice president of medical affairs for M Health Fairview East Metro Hospitals, which treated patients in emergency room waiting rooms this fall due to overcrowding.
The stage is already set for an upsurge in infections due to an early start to the flu and RSV seasons. Minnesota reported another 241 flu-related hospitalizations Wednesday during the week ending Nov. 19, bringing the total to 713. Even during a harsher 2017-18 flu season, Minnesota did not reach that number before Christmas.
Respiratory viruses have consumed hospital capacity in Minnesota, especially with RSV sending infants and a few older children to pediatric hospitals. More than 8,000 inpatient beds have been used for six days so far in November — a high point for Minnesota’s hospital capacity. On November 15, the state had only two pediatric intensive care beds available.
Minnesota’s leading pediatricians held a press conference Monday to try to ease the pressure by advising parents when — and when not — to bring sick children to crowded emergency rooms. Generally, trips to the emergency room are warranted for a sick child with dehydration, difficulty breathing, or a fever of 100.4 degrees that has lasted more than four days. But they also noted that mask-wearing and prevention can reduce disease in the first place.
Public mask-wearing was an oddity in the United States, rarely seen at airports, before COVID-19. Interest exploded at the start of the pandemic, causing shortages of rubber bands, fabrics and especially high-caliber N95 masks. Minnesota imposed a mandate in the summer of 2020 after supplies stabilized, and by winter nearly 90% of residents wore them most or all of the time in public places, according to surveys.
The corresponding flu season has been historically mild and doctors believe mask-wearing and social distancing played a part. Only 35 flu-related hospitalizations have been reported in Minnesota this season, compared to 2,000 to 6,000 in a typical season. Mask-wearing levels fell below 60% the following winter – after the mandate was lifted – but flu-related hospitalizations remained below normal at 901 for the 2021-22 season.
Mask wearing declined in 2022 as COVID-19 risks declined; the latest estimates put Minnesota’s mask-wearing rate at around 5%.
The spread of the coronavirus that causes COVID-19 has remained low but steady across Minnesota all fall, according to wastewater monitoring for the virus at 40 treatment plants across the state. The state’s COVID-19 death toll has reached 13,663, but the risk is concentrated among the elderly, according to Minnesota’s weekly situation update. Of 131 COVID-19 deaths in Minnesota so far since Oct. 30, 120 have been in the elderly.
Mask fatigue and political opposition to the controversial mandate have led to a rapid decline, but people should take advantage of the protection now that there is additional evidence they protect against the flu and other viruses, said said Bloomington infectious disease expert Dr. Mark Sannes. health-partners.
“Although we are not masked for COVID purposes, we have a flu spike that we could interrupt by incorporating masks into our daily lives when we are in public,” he said. “I think it could be a tool that we use intermittently and turn on and off for times like these in the future.”
Osterholm said he was struck by the amount of ineffective masks under the nose and mouth, even at a time when people aren’t required to wear them. He urged people to take advantage of healthier supplies and use high-quality N95 or similar masks.
Early federal estimates of the pandemic suggested an unmasked person would transmit an infectious dose of the coronavirus to a face-to-face contact within 15 minutes. Osterholm’s CIDRAP made estimates based on industry data and suggested that cloth or surgical masks would only delay transmission in this scenario by an additional 5-15 minutes.
An N95 would protect someone from unmasked, infected close contact for another hour or two, depending on its fit. CIDRAP estimated that transmission of an infectious dose would take 25 hours between two close contacts both carrying tested N95s.
Wearing a mask could prove to be an extra precaution against a prolonged and severe flu season, or perhaps just a first. Fears of a severe season originated in Australia, which saw an early spike in sick children, but quickly dissipated. Other parts of the Southern Hemisphere have not reported severe flu seasons.
RSV and influenza-related hospitalizations in Minnesota last week were unusually high for the fall, but both represented slight declines from the previous week.
Health officials have pointed out that masks work best in combination with other strategies, including hand washing, practicing social distancing, staying home when sick and getting vaccinated.