Mask mandate to be relaxed in hospitals, nursing homes: What you need to know

Dr. Ken Saul is ready to bare his face.

The California Department of Public Health announced it will lift mandatory mask requirements in hospitals, nursing homes, jails and other settings previously identified as high-risk for COVID-19. The change comes April 3 and Saul, a Thousand Oaks pediatrician, is ready after three years of covering up.

“I think COVID has mutated into a virus that is milder than most any other virus we’ve seen, especially in kids. Even in adults, it’s not what we saw before,” he said, explaining why masks will be encouraged but no longer mandated in his office. “I think it’s time to let it go.”

Others worry the changes are coming too soon. Dr. Jeffrey Allan, a Camarillo geriatrician who visits more than 20 long-term care facilities, said he had two patients test positive for the virus in a 24-hour period. He pointed at the cases as proof of still-present transmission risks.

Relaxing the mandate takes away a line of defense that proved its worth long before vaccines were available, he said.

"I'm uncomfortable with the decision," he said. “What protected us for the first year were masks.”

What is changing?

Masks should be considered but will no longer required by the state in hospitals, doctor’s offices, dental offices, other health care settings, long-term care facilities, jails and emergency shelters. Individual sites can still opt to require masks but are not mandated by the California Department of Public Health to do so.

State officials said that if COVID risks rise in Ventura County from "low" to "medium" or high in a weekly assessment by the U.S. Centers for Disease Control and Prevention, they would recommend but not mandate masks be used in high-risk settings.

The changes reflect the transition to an endemic stage of the virus where risks have diminished but have not disappeared.

“Our communities did a lot of the hard work by getting vaccinated and boosted, staying home and testing when sick, requesting treatments when positive and masking to slow the spread,” said Dr. Tomás Aragón, California Department of Public Health director, in announcing the April end of the mandate. “We have now reached a point where we can update some of the COVID-19 guidance to continue to balance prevention and adapting to living with COVID-19.”

Will hospitals still require masks?

Representatives from some area hospitals said they are still figuring out what their masking rules will be as of April 3. Some are awaiting more input from the state Department of Public Health and other agencies.

“We haven’t figured it out from a policy perspective,” said Jennifer Swenson, CEO of Adventist Health Simi Valley. She asserted that protecting staff from exposure to COVID is top priority and said it’s likely masking requirements will change as transmission risks rise or fall.

“It will ebb and flow as we make our way through the pandemic,” she said.

Others offered definitive answers. The mandate will be removed at Dignity Health St. John's Hospitals in Oxnard and Camarillo. Patients and employees will be able to choose whether to mask in most instances, said spokeswoman Christina Zicklin. Masks will still be required in the operating room, patient-isolation rooms and areas where invasive procedures are performed.

Some hospitals cited the possibility of direction from the Ventura County Public Health Department but Health Officer Dr. Robert Levin said the office does not anticipate local guidance that differs from the state.

“We do not plan on weighing in individually,” he said.

Saul, the Thousand Oaks pediatrician, predicted policies in some hospitals will be guided by concerns about whether removing mask requirements increases liability.

“Hospitals act with abundance of caution and just always think in a legalistic way,” he said.

What will nursing homes do?

At long-term care facilities, staff and visitors wear masks to protect residents who are not required to use coverings. A spokesman for the California Association of Health Facilities said many sites are waiting for more guidance from the state. Sister Yesenia Perea, executive director for the Mary Health of the Sick skilled nursing facility in Newbury Park, said their policies are still being formulated.

“I can’t give you a definitive answer,” she said.

Representatives of some area long-term care sites can't wait for the change.

"We're thrilled to drop our masks and see everyone's smiling faces again. It's such a simple thing but can have a profound impact on care delivery," said Constance Sablan, spokeswoman for The Reserve at Thousand Oaks independent and assisted living community.

At the University Village senior living community and OakView Health Center, both in Thousand Oaks, the new state directive means masks will be optional as of April 3, said co-owner Warren Spieker. The change also means the facilities will no longer issue notices to all residents every time a person contracts COVID.

What are the reactions?

The state masking mandate for nursing homes and other residential facilities hindered communication and contributed to isolation, said Sylvia Taylor-Stein, executive director of the watchdog group, Long Term Care Ombudsman Services of Ventura County.

"We're happy about it," she said of the April changes. "I think socially the masks definitely crippled our residents.”

Others condemn the changes and worry removing masks will increase transmission.

“Abandoning these standards is a counterproductive and unscientific approach to curbing the spread and evolution of COVID-19," said Bonnie Castillo, executive director of the California Nurses Association union, in a news release. "This decision endangers the health and safety of nurses and other health care workers, hurts their ability to access personal protective equipment from employers and ultimately exacerbates the health care staffing crisis that political leaders have vowed to tackle.”

Some doctors want to take off their masks. Others, like Oxnard pulmonologist Dr. Raj Bhatia, see no reason to remove the mandate in high-risk hospital settings.

"This is crazy. It’s like, ‘What the hell? Why do you take the masks away?’ It makes no sense to me,” Bhatia said.

Saul said a group of 50 pediatricians and family doctors from Ventura and Los Angeles counties discussed the change during a virtual meeting Wednesday night. About half said they will make masks optional as of April 3 and the others said they would likely continue to require mask coverings. Some argued the coverings are a line of defense not only for COVID but for respiratory illnesses like flu and respiratory syncytial virus.

Some people said the end of the state requirement will change little in their lives. Josie Serrano's daughter and son-in-law both live in an Oxnard nursing home. Serrano, 89, visits every week and said she was told recently she doesn’t have to wear a mask. She still does most of the time and will continue the practice.

“Just to be safe,” she said.

State public health officials said people should still wear masks around people if they have a cough, runny nose or other respiratory symptoms. People exposed to someone who tested positive for COVID should wear a mask for 10 days. Masks should also be considered by high-risk people indoors and by travelers in airplanes and other indoor transportation settings.

What else is changing?

Other changes are coming too. The state will no longer require health care workers to be vaccinated for COVID as of April 3.

Beginning March 13, someone who tests positive for COVID-19 can end isolation after five days if they feel well, have improving symptoms and are fever-free for 24 hours even if they still test positive, state officials said. The change is in sync with recommendations from the CDC.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

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This article originally appeared on Ventura County Star: State mask mandate for Ventura County hospitals ends in April