Before the pandemic, Dr. David Alpern, like many health care workers at the time, didn’t think twice about going to work with a runny nose or cough.

But since symptoms of COVID-19 are indistinguishable from the common cold, the retired Cooley Dickinson Hospital internist is concerned hospital employees with these mild symptoms could spread coronavirus to patients.

Alpern’s desire for Cooley Dickinson Hospital and other hospitals to take stronger precautions this holiday season inspired him to speak at a virtual press conference organized by the Massachusetts Coalition for Health Equity on Monday, at which health care experts advocated for the return to universal mask protections in health care settings and pre-admission testing during the winter, when viral infections are more prevalent.

The health equity coalition raised three other policy recommendations for the Healey-Driscoll administration to consider during this holiday season, including general disability rights, public education about long COVID, and free access to PCR and rapid tests, high-quality respirators and COVID vaccines.

“Even asymptomatic or mildly symptomatic COVID-19 cases can result in over 200 long-term health issues, including an elevated risk of heart attacks, strokes and neurological problems,” Alpern, a Florence resident, said in a press release and reiterated during the press conference. “Prevention of virus transmission in health care settings is critical, which would include implementing comprehensive precautions to prevent the spread of aerosolized viruses and conducting mandatory COVID-19 testing for all incoming patients.”

In his experience, many of Alpern’s past patients tended to be older, which the Centers for Disease Control and Prevention has identified as a vulnerable population for long COVID. As the holidays approach, young family members with a low risk for long COVID can expose their elderly relatives to the virus, especially since half of all COVID-19 transmissions occur from asymptomatic cases or before symptoms develop.

“COVID is still here. It’s our eighth wave,” Alpern said. “People can choose to do what they want to, but you can’t choose when you get sick and go to the hospital.”

The CDC reported that about 3.5% of Americans were dealing with long COVID in 2022, and more adults from ages 18 to 44 report increased difficulty in thinking and remembering after the start the pandemic.

“Just as there is never going to be a good time to stop wearing gloves in hospitals, I can’t understand why we oughtn’t just continue using a basic simple intervention that results in the patients being safer,” said Colin Killick, executive director of the Disability Policy Consortium.

Patients who require coronavirus precautions have a difficult time acquiring them, according to those who spoke at Monday’s press conference. Coalition for Health Equity member Jayda Jones said she’s helped dozens of people submit reasonable accommodations requests, asking doctors and nurses to wear masks during treatment. Most of these requests are denied because the patients are not considered vulnerable enough to require precautions. Jones noted that patients with disabilities are choosing between delaying care or continuing treatment.

“Patients should not have to consider their likelihood of becoming exposed or infected with the hospital-acquired infection, and if so, we know that it’s due to the lack of protections that we have in place to control infectious disease,” she said.

Currently, Cooley Dickinson Hospital does not require masks for staff members, but encourages employees to mask during cold and flu season. Baystate Health also doesn’t require masks for health care staff, but requires testing for a number of high-risk units such as oncology.

“COVID-19 testing is not performed on patients prior to surgeries or procedures, but if they are coming in with symptoms, we do test,” said Keith O’Connor, a Baystate Health spokesperson.

Theodore Pak, an infectious disease fellow at Massachusetts General Hospital, stresses the importance of patients wearing masks in hospitals as well. According to another study from Brigham and Women’s Hospital, a patient with an unknown case of COVID who receives treatment in a shared patient room, which are common in Massachusetts, increases the risk of transmission up to 39%, he said.

Pak notes that COVID case numbers in the United States are underreported and underrepresented because of the lack of pre-admittance testing in hospitals. In the United Kingdom, data has shown one in seven patients contracted COVID while in the hospital during the height of the pandemic. The mortality rate for hospital-acquired COVID is between 5% and 10%.

“For instance, in doing genome sequencing on a Brigham Hospital outbreak, it’s discovered that infections occur between workers and patients, even with both parties wearing surgical masks,” Pak said. “So imagine, without that layer of protection, what would happen.”

Dr. Lara Jirmanus, a physician and instructor at Harvard Medical School, noted that 50% of the public is concerned about a local outbreak despite messaging that the pandemic is over. Yet without proper education and prevention, many people still hold these concerns without a way to express them.

“We are here to make sure that our health systems are safe and healthy for everybody,” Jirmanus said, “and that starts with making sure that it is safe and healthy for the most vulnerable.”

Emilee Klein can be reached at eklein@gazettenet.com.