To mask or not to mask? That is the question.

Just in time for the holidays, three highly contagious viruses have joined forces to create new health hazards. As a result, many healthcare facilities are struggling with whether to enforce mask-wearing mandates.

As if it wasn’t bad enough that providers have been battling COVID-19 for nearly three years now, it seems we’re on the cusp of flu season. And for good measure, respiratory syncytial virus (commonly known as RSV) has joined the fray.

And as the carnage escalates, health experts are renewing recommendations to wear medical masks in public and at work.

From their perspective, the rationale is clear: Masks are one of the most effective tools for preventing the spread of the virus. They can literally mean the difference between life and death for those with compromised health conditions, such as most nursing home residents.

Still, to say that the long-term care field is less than enthusiastic about the demand for universal masks would be a gross understatement. There are probably several reasons for such disobedience.

Staff burnout is a good place to start. COVID-19 has forced operators to adapt unprecedented infection control protocols. They included masks and other protective gear that was anything but comfortable to wear. Let’s face it, who wants to breathe through a filter all day (which is essentially a mask) or wear uncomfortable gear that makes you itchy and sweaty? Especially if additional wearables are not considered useful.

Which brings us to another point. In many places, COVID-19 is as much a political issue as a health issue. At least 40% of this nation thinks that masks don’t really help. I am not here to debate the merits of this view. I’m just pointing out that it really exists.

There’s also this: what may be good from a public health perspective can cause significant economic problems. I hardly need to explain how this is relevant to long-term care. It is a rare institution that has not experienced a drop in revenue and an increase in costs during the current pandemic. Preventive measures such as masks and isolation certainly help limit the spread of the disease. But they can take a huge toll on businesses. And trigger other unexpected negative outcomes.

Almost every day we hear more about the mental toll the pandemic has taken. Millions of us are experiencing more stress, anxiety, fear, loneliness and depression.

To be sure, there will be risks associated with a facility’s decision to require or not mandate the wearing of masks. There will be related consequences. Both known and unknown.

John O’Connor is editorial director for McKnight’s.

The opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.