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Fears of a “quad-emic” are pushing some states in America to bring back mask mandates for hospitals.

Four viral infections are on the rise, with a whopping 15 million cases and 30,000 deaths already this winter. The viruses, flu, COVID, the cold-like virus RSV, and norovirus, have been dubbed the “quad-emic” and are prompting healthcare facilities like Duke Health in North Carolina and Mass General Brigham in Massachusetts to update their masking guidelines.

Mass General, which is composed of 12 locations in Massachusetts, treats about 2.5 million patients and is sounding the alarm over respiratory infections, however, masks are not yet a requirement.

Duke Health’s clinics and hospitals released a statement on their decision to update visitor guidelines in response to the surge in viral cases.

“Due to increased respiratory illness in our communities, we are updating our visitation restrictions after consultation with our Infectious Disease and Infection Prevention experts,” they said. They are also “strongly” recommending wearing masks in areas with patients, and have actually required it in “select patient care areas based on their medical condition.”

Hospitals also located in Wisconsin, California, Illinois, Indiana, New Jersey, and New York are strongly urging masking while indoors.

Aurora Healthcare in Wisconsin told local news station WISN that those who “congregate in patient areas” will be subject to mandatory masking temporarily.

According to the CDC, Wisconsin currently has the third most cases nationally of whooping cough, behind Pennsylvania and New York.

State health officials also said norovirus cases are currently surging, affecting kids, seniors, and those with health issues,” the outlet reported. “The CDC reported 91 cases of norovirus across the country over a single week in early December, the highest number of cases reported in several years.”

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