Dear Wisconsin CEO Dr. Alan Kaplan, Illinois CEO Travis Anderson, and UW Health Leadership,

As community members, patients, parents, caregivers, and healthcare workers, we urge UW Health to require masking in all healthcare settings, and to provide masks (ideally N95 respirators) for everyone in those settings.

As of the publication of this petition on May 1, 2023, UW Health requires universal masking but has not committed to ongoing universal masking policies. Nearby healthcare system SSM Health, including SSM-St. Mary’s Hospital in Madison, has dropped masking as of March 15, 2023 [1], as have many healthcare systems regionally and nationally. We urge you to show leadership in maintaining universal masking requirements at UW Health to ensure safe access to healthcare for all people. Universal masking is now a minimum standard of infection control in healthcare settings [2, 3]. Incorporation of universal masking is expected in healthcare just as we expect good practices in handwashing, wearing gloves, and sterile technique in surgical procedures to prevent healthcare-acquired infections.

UW Health provides a vast array of essential healthcare services in Wisconsin and Illinois, including a Level 1 trauma center, the UW Carbone Cancer Center (the only National Cancer Institute-designated comprehensive cancer center in Wisconsin), primary care, and subspecialty care. Our communities need safe access to these services in all healthcare settings.

MASKING IN HEALTHCARE PROTECTS PATIENTS AND WORKERS
Clinics and hospitals are sites for COVID patient care, so even if transmission rates are low, they will remain among the most likely locations to encounter people infected with COVID, and also people who are vulnerable to severe disease or death from COVID. COVID protections are a justice issue due to disproportionate impacts on marginalized communities, including stark racial disparities [4]. Contagion in healthcare settings is already a problem even in well-equipped US academic medical centers [5]. Removing masks in healthcare puts both patients and healthcare workers at risk, which could place even more strain on the healthcare system amid severe staffing shortages [6].

HEALTHCARE SYSTEMS HAVE A DUTY TO PREVENT VIRAL TRANSMISSION
Failing to require masks in healthcare settings violates medical ethical principles. Patients come to clinics and hospitals to improve their health. Healthcare providers have an ethical responsibility to DO NO HARM and ensure that they do not expose patients to COVID. Children and babies who cannot or may not wear masks, and people in clinical situations that do not permit mask-wearing (such as in post operative units) need others to protect them by wearing masks. Vaccines alone are insufficient to prevent COVID-19 spread. Although being up-to-date on vaccinations lowers the risk of both short-term severe disease and long-term damage from COVID infection, even vaccinated people can die from COVID-19 infection or develop Long COVID following an infection [7]. Discontinuing universal masking policies in healthcare settings puts both patients and healthcare workers in danger and risks liability [8].

HEALTHCARE PROTECTIONS SHOULD BE BASED ON SCIENCE, NOT POLITICS
The decision to end the federal public health emergency (PHE) is based on political rather than scientific factors. The CDC’s Community Transmission map, which already underestimates COVID-19 infection rates, will likely be discontinued as the end of PHE will lead to reduced reporting requirements [9]. Under these circumstances, it will not be possible for patients to make informed decisions about the risks they face in seeking medical care if universal masking is not required. We urge healthcare systems to follow the precautionary principle and use appropriate science-based infection control practices. Healthcare protections should not be removed as a result of political decisions.

In many contexts, a single hospital-acquired infection is considered to be unacceptable. Given the significant risks of COVID infection for all people, COVID should be handled in a similar manner with appropriate universal airborne precautions. We should not lose the ground that has been gained in improving infection control practices and protecting patients in the ongoing pandemic.

We urge you, as leaders in healthcare, to act in the best interests of patients and healthcare workers by keeping universal masking requirements in your healthcare settings.

Sincerely,

Members of the informal UW Workers’ COVID Response Working Group:
Kaitlin Sundling, MD, PhD, Assistant Professor, UWSMPH and UW Health physician
Barbara Smith, UW-Madison ‘97
Karl Broman, PhD, Professor, UWSMPH
Fiona Abbott, Wisconsin Foundation & Alumni Association
Susan Nossal, Academic Staff UW Madison, patient at UW Health
Steve Burns, Madison College, son of UW Health patient Jean Burns, age 93
Yasmin Schamiloglu, UW Health Long COVID patient
Melissa Marver, MS & PhD from UWSMPH, high-risk community member

And petition signees

References:
1. https://www.nbc15.com/2023/03/13/ssm-health-no-longer-require-universal-mask-wearing/
2. https://peoplescdc.org/2023/02/23/masks-in-healthcare/
3. Kalu IC, Henderson DK, Weber DJ, Haessler S. Back to the future: Redefining “universal precautions” to include masking for all patient encounters. Infect Control Hosp Epidemiol. Published online February 10, 2023:1-2. doi:10.1017/ice.2023.2 https://www.cambridge.org/core/product/identifier/S0899823X23000028/type/journal_article
4. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html
5. Karan A, Klompas M, Tucker R, et al. The Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission from Patients With Undiagnosed Coronavirus Disease 2019 (COVID-19) to Roommates in a Large Academic Medical Center. Clinical Infectious Diseases. 2022;74(6):1097-1100. doi:10.1093/cid/ciab564 https://academic.oup.com/cid/article/74/6/1097/6305137?login=true
6. https://www.wpr.org/wisconsin-nursing-schools-struggle-graduate-enough-students-amid-nurse-shortage
7. Marra AR, Kobayashi T, Suzuki H, et al. The effectiveness of coronavirus disease 2019 (COVID-19) vaccine in the prevention of post–COVID-19 conditions: A systematic literature review and meta-analysis. Antimicrobial Stewardship & Healthcare Epidemiology. 2022;2(1):e192. doi:10.1017/ash.2022.336 https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/effectiveness-of-coronavirus-disease-2019-covid19-vaccine-in-the-prevention-of-postcovid19-conditions-a-systematic-literature-review-and-metaanalysis/0AD0EDEC8C9CC9DF455752E32D73147B
8. https://blog.petrieflom.law.harvard.edu/2023/02/20/hospital-liability-covid-infection/
9. https://www.naccho.org/uploads/downloadable-resources/CDC-PHE-Talking-Points-Final-4.13.2023.pdf