Face masks are now required in Maryland hospitals as Covid cases soar and vaccination levels remain low, officials say.
Patients who attend Johns Hopkins hospitals and doctor offices in Maryland must once again wear a face covering.
It follows LifeBridge Health and the University of Maryland Medical System, which have also directed visitors to mask up.
In a statement, Hopkins officials wrote: "We anticipate this requirement to be in effect on a short-term basis while influenza-like illness rates are high.
Masks are now required in Maryland hospitals and doctors as Covid cases soar and vaccination levels remain low
PA"We will continue to monitor the situation and adjust the requirement as needed."
Last December, the Maryland Department of Health issued an alert to health providers after the combined virus-associated hospitalisation rate exceeded 10 hospitalisations per 100,000 residents.
The government agency specifically highlighted Covid and influenza cases.
According to the latest figures, during the week ending December 16, the state’s rate was 11.4.
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The department urged institutions to introduce "broad facility-wide" infection control measures.
Recommendations also included universal masking and vaccinating eligible patients and health care workers against Covid, flu and RSV.
The precautions are likely to continue until two weeks after the virus-associated hospitalisation rate reduced below 10 hospitalisations per 100,000 residents for two consecutive weeks.
It comes as hospitals largely stopped testing every patient for Covid when cases decreased and more people had been vaccinated.
Recommendations by Maryland hospital trust also included universal masking and vaccinating eligible patients and health care workers against Covid, flu and RSV
PA“LifeBridge Health has been closely monitoring the steady increase of respiratory viruses, including COVID, RSV and the flu," the system said in a statement.
"In an effort to protect our team members, patients and communities, LifeBridge Health will be requiring masks in patient care areas, effective January 8."
The University of Maryland Medical System also returned to masks on January 8.
The University of Maryland Medical System said: “Similar to what other health care institutions across the state are experiencing, hospitals across the University of Maryland Medical System are seeing an increase in patients presenting with respiratory illnesses.
"In response to increased hospitalisations for respiratory virus infections such as influenza, COVID-19 and respiratory syncytial virus, and following guidance from MDH, UMMS has made changes to both team member and visitor masking to reduce the spread of these viruses."