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Masking now required for all patient interactions

Published Date

Respiratory virus thresholds prompt masking to slow transmission

SOUTH PUGET SOUND – When transmission levels for RSV, influenza and COVID-19 reach a certain threshold, masking is initiated to slow transmission. We have been monitoring COVID-19, influenza and RSV closely and based on current case rates, we are currently requiring masking during patient interactions until we determine rates have dropped below the threshold. 

What is the threshold that requires masking?

For 2026, when RSV, influenza and COVID-19 combined reach 14%, masking is initiated. Our most recent data shows we are currently at 16% with an upward trend direction.

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What data is being used to track community levels to determine universal masking?

The CDC has a syndromic surveillance system that utilizes data collected nationally from chief complaints and discharge diagnosis. This new Essence Data report has well tracked prediction models based on past seasonal viruses, allowing for surge epidemic thresholds to be established.

Data can also be viewed by accessing the Washington State DOH Respiratory Illness Data Dashboard.

Masking guidance

Masks are REQUIRED for all patient interactions in:

  • Hospital inpatient rooms

  • During any direct patient care

  • Emergency departments and ED waiting rooms

  • Oncology and cancer center waiting rooms

  • Exam rooms

  • Front desks and check-in

  • Discharge Lobby

Masks are also required upon entry to outpatient clinics.

  • To make the masking practice easier to operationalize, outpatient clinics will follow universal masking. 

  • Why? Outpatient clinics have unique layouts and workflows, including: 

·         Shared waiting areas 

·         Limited space for physical distancing 

·         High volume of patients entering/exiting clinic spaces 

·         Frequent close contact between patients and caregivers in small spaces

Masks are HIGHLY ENCOURAGED but not required in public and caregiver-only spaces in:

  • Public hallways

  • Breakrooms

  • Cafeteria/coffee shop

  • Gift shops

  • Elevators

  • Hospital lobby/waiting areas

  • Offices

  • Other rooms isolated and away from patient-care spaces

  • Conference rooms 

Use these infection prevention strategies:

  • Continue to offer masks at entrances.

  • Perform infectious-risk-screening for patients in the electronic health record (EHR) on check-in, regular symptom monitoring, and utilization of transmission-based precautions.

  • Mandate caregivers to stay home if sick with viral respiratory illness and report illness to Caregiver Health Services. Caregivers must take responsibility to self-report exposures to viral respiratory illness, self-report illnesses, and mask when indicated.

  • Instruct visitors to wear a mask while in patient rooms or other direct patient care areas.

  • Obtain case-by-case approval from nursing leadership and Infection Prevention (IP) for visitors with viral respiratory illness.

  • Enforce-standard precautions-and wear personal protective equipment (PPE) if you anticipate-exposure, including splash, splatter, and exposure to aerosolized particles.

If patient or visitors refuse to mask:

  • Explain why it is important for them and others. 

  • Respect patient wishes.

  • Take additional infection prevention measures as necessary during visits with patients who refuse to mask. They can still be seen for care.

  • Offer virtual visitation as an alternative for visitors who refuse to mask. Visitors without a mask will not be allowed to enter patient rooms, unless they are an essential caretaker. Ask other visitors to return home or wait outside or in a vehicle.

  • Still mask during handoffs when transporting any of the patients described above to another department. Ensure a warm handoff and instruct fellow caregivers to mask.

  • Additional FAQ can be found here: Masking Guidelines & FAQ 2025 - 2026.

Remember, masking is always required when:

  • A patient has voluntarily masked. Out of respect for the patient, the caregiver will also don a mask. Post a Mask Required sign outside the door.

  • You are asked to mask by a patient, visitor or another caregiver, while-providing-care for a patient.

  • An outbreak/cluster-occurs-on a unit or-within a-department among patients or caregivers.

As always, follow standard and-transmission-based precautions to protect yourself from blood or body fluids.

Please note stricter masking requirements may be implemented when we have high levels of respiratory viruses circulating in our community (such as influenza, RSV or COVID) or during an outbreak.