Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers

Abstract

This study describes SARS-CoV-2 PCR test positivity among health care workers before, during, and after implementation of a policy requiring universal masking of all health care workers and patients in a large health care system in Massachusetts.

Conflict of interest statement

Conflict of Interest Disclosures: Dr Bhatt discloses the following relationships: advisory board: Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Level Ex, Medscape Cardiology, PhaseBio, PLx Pharma, Regado Biosciences; board of directors: Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; chair: American Heart Association Quality Oversight Committee, NCDR-ACTION Registry Steering Committee, VA CART Research and Publications Committee; data monitoring committees: Baim Institute for Clinical Research, Cleveland Clinic, Contego Medical, Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine, Population Health Research Institute; honoraria: American College of Cardiology, Baim Institute for Clinical Research, Belvoir Publications, Duke Clinical Research Institute, HMP Global, Journal of the American College of Cardiology, K2P, Level Ex, Medtelligence/ReachMD, MJH Life Sciences, Population Health Research Institute, Slack Publications, Society of Cardiovascular Patient Care, WebMD; deputy editorship: Clinical Cardiology; research funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Cardax, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Idorsia, Ironwood, Ischemix, Lexicon, Lilly, Medtronic, Pfizer, PhaseBio, PLx Pharma, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company; royalties: Elsevier; site coinvestigator: Biotronik, Boston Scientific, CSI, St Jude Medical, Svelte; trustee: American College of Cardiology; unfunded research: FlowCo, Merck, Novo Nordisk, Takeda. No other disclosures were reported.

Figures

Figure.. Temporal Trend in Percentage Positivity of SARS-CoV-2 Testing Among HCWs

HCW indicates health care worker; MGB, Mass General Brigham; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. All dates given are for the year 2020. The size of each data marker is proportional to the total number of SARS-CoV-2 tests performed each day over the time of the study period (x-axis), while the position of each data marker along the y-axis shows the percentage of daily test results that were positive among HCWs. The horizontal bars below the x-axis represent the timing of key interventions implemented in the state of Massachusetts and at MGB. The dotted lines represent the implementation dates of hospital policies. The study period is divided into 3 phases: a preintervention period before implementation of universal masking of HCWs (pink), which includes March 26, the day after implementation of universal masking for HCWs, to account for HCWs who became symptomatic after business hours on March 25 and were tested on March 26; a transition period until implementation of universal masking of patients (purple) plus an additional lag period (yellow); and the intervention period (green). For the preintervention and intervention periods, daily tests were fitted by weighted nonlinear regression (curves). The change in overall slope was compared between the 2 curves to determine any statistically significant changes in trend (as shown by the P value).