COVID-19 cases are on the rise and the traditional flu and RSV seasons are coming. But when it comes to masking at the hospital or doctors’ office — where you may know someone who is sick or you may be sick ― there is little in the way of masking requirements.

Many facilities’ official policies recommend, even strongly recommend, visitors and staff wear masks. And certainly, “Patients: Please wear a mask if you have upper respiratory symptoms or fever,” reads the Johns Hopkins Medicine policy.

But mask mandates that were universal during much of the coronavirus pandemic are now few and far between.

There’s just “no longer any appetite” for mandates, said Dr. Eric Toner, an emergency department physician and senior scientist in the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security.

But these health facilities are filled with people who are unwell, prompting many area hospitals and doctor offices to officially require a face covering when a patient is at high risk for infection, for example, or when patients request their providers wear them.

Toner also notes that there is nothing stopping people from wearing masks to protect themselves or others. And in fact, he encourages them to do so.

He and other public health experts consider masks — especially the high-quality N95 or KN95 types — a key measure against respiratory infections, along with vaccinations, hand hygiene and good air circulation.

“The problem is that most people have had one or more bouts of COVID and recovered without problems so they no longer see COVID as a significant risk,” Toner said. “They don’t see the thousands of people being hospitalized.”

He said seeing family and friends with an infection could change their calculus. Already with this rise in cases, Toner said he’s seen more masks in public in recent days, but, “I do wish that hospitals would take a stronger stand.”

Officials from the Maryland Hospital Association say health systems are keeping tabs on the coronavirus, and following policies set by state and federal authorities.

“Maryland hospitals regularly evaluate and adjust policies to ensure the safety and well-being of staff, patients, and visitors,” said Meghan McClelland, the group’s chief operating officer.

“Currently hospitals are masking based on their community and patient population’s needs,” she said. “Throughout the pandemic, hospitals have complied with the latest guidance from the state, the Maryland Department of Health and the federal Centers for Disease Control and Prevention, including on masking, and will continue to do so.”

The CDC says at low hospital admission levels, “People may choose to mask at any time.”

It’s unclear how many cases of COVID-19 are out there given the reduced level of testing and reporting. That leaves other measures, particularly hospitalizations, to assess the level of the virus.

There were 278 people hospitalized who had COVID-19 in Maryland as of Oct. 2, according to state health data that mirrors national trends. That’s nearly five times the summer-time low at the beginning of July but well below the more than 900 recorded in January. The pandemic peak of 3,462 was in January 2022, when officials were still testing every patient.

As for other seasonal infections, flu and RSV cases are ticking up but remain minimal, according to state data. The season typically doesn’t begin in earnest for several more weeks. RSV cases peaked in November last year, though infections began earlier and were particularly high compared to previous years, when experts said mask wearing stemmed the spread.

The CDC recommends everyone age 6 months and older get the flu vaccine plus the newly approved COVID-19 vaccine to match circulating strains. Though, the COVID-19 vaccine, the first on the commercial market and not government funded, has been slow to trickle out.

Seniors and pregnant women also now can get a new RSV vaccine.

Hospital officials say mask policies could still change as the season progresses.

“Infection prevention teams are always closely monitoring the number of COVID cases, as well as the spread of other illnesses, particularly with the approaching fall-winter virus season,” said Sharon Boston, spokeswoman for LifeBridge Health, which includes Sinai Hospital in North Baltimore.

But, Boston said: “Masking is currently not required while working in or visiting a LifeBridge Health facility.”

At MedStar Health, which operates several hospitals and urgent care centers in the region, masks are required when a patient is deemed at high risk for infection. And like other health systems: “Providers are also mandated to mask if any patient, regardless of risk level, requests masking throughout their care.”

Same in the University of Maryland Medical System, according to its online policy. Officials there do request people with COVID-like respiratory symptoms and their escorts to voluntarily wear masks.

“Most of the time, masks are not required for patients, visitors and staff in our facilities,” the policy says. “Of course, patients, visitors and staff members may always choose to wear masks in situations where one is not required.”

meredith@thebaltimorebanner.com