The Maryland Department of Health is urging medical centers, hospitals, clinics, outpatient facilities and long-term care homes to implement universal masking after respiratory hospitalizations exceeded 10 people per 100,000 residents in the state last month.

MDH guidelines state that medical facilities should switch to universal masking and other protective measures like optimized ventilation when hospitalizations get that high. However, according to Johns Hopkins, University of Maryland Medical System, Mercy Medical System and other organizations’ websites, the policies have yet to change.

That is concerning to some groups like COVID Safe Maryland, an organization focused on immune safety in the state.

“If you get COVID, while you're in the hospital, you're twice as likely to die of it than if you got it somewhere else, or came in with it,” said Roselie Bright, an epidemiologist with COVID Safe Maryland. “That's why we think it's especially important to protect vulnerable people because they are there in the healthcare space.”

MDH sent a letter to clinicians on Dec. 28 informing them of the increased numbers. The health department says universal masking should stay in effect until two weeks after the numbers have decreased below 10 hospitalizations per 100,000.

“The Centers for Disease Control and Prevention data through December 21 shows the Maryland combined hospitalization rate for the week ending on December 16 was 11.4, in large part to increasing COVID and flu infections,” David McCallister, a spokesperson for MDH told WYPR. “The Department recommends implementing broad facility-wide source control in all patient care areas and patient-facing healthcare settings, including outpatient and long-term care.”

Maryland, like most of the nation, is in its second year of dealing with what many clinicians have called a “triple-demic,” where RSV, the flu and COVID hit populations hard in the winter.

“We have seen an increase in these diseases after the holidays,” Dr. Leana Wen, a former health commissioner of Baltimore and a scholar at George Washington University and the Brookings Institution, said on WYPR’s Tom Hall show.

The CDC recommends everyone get vaccinated for COVID and the flu. The agency also suggests that people over 65 get the RSV vaccination.