Whitman-Walker Health, the D.C. provider that focuses on caring for members of the LGTBQ+ community, no longer requires visitors and staff to wear masks — a move that unsettled some patients who say the new policy endangers at-risk populations the health center is meant to serve.

“Long COVID is disabling a lot of people, and a lot of people who Whitman-Walker reportedly serves: communities of color, folks who are living with HIV, people who experience homelessness,” says Emmett Patterson, a Whitman-Walker patient.

Patterson says he only realized masks were optional when he went into the 14th Street location for an urgent care appointment in November. “I was just really kind of in shock,” he says.

The lobby at the health center on 14th Street still showed signage instructing patients to “mask up” and social distance, and someone sitting at the front desk was wearing a mask, Patterson says. But when he went up a floor to his provider, no employees at the front desk were masked, and only about one or two other patients in the waiting area had face coverings on. He told DCist/WAMU that when he saw his provider, he asked about the current mask policy, and was told that the requirement was removed for patients and staff.

“I double checked my portal, my voicemails, there was no notice given to patients that this had changed. In the waiting room there were still signs to put your mask on — it felt like I was kind of in an episode of the Twilight Zone,” he says.

Whitman-Walker’s Chief Health Officer Sarah Henn says that while masking is mostly optional, the center still requires anyone with respiratory illnesses to wear a mask, and providers will match the behavior of whoever they are seeing — so if a patient comes in with a mask, their provider will put one on.

“We certainly feel really comfortable that we have systems in place that protect the health of our staff and protect the health of our patients” Henn says. “And we’ve worked really hard for the last two and a half years to achieve that.”

While mask mandates have largely fallen away in places like schools and public transit, many local healthcare settings — like Medstar, which operates numerous urgent care clinics, One Medical, and Howard University Hospital — require patients and staff to wear face coverings. In September, the Centers for Disease Control and Prevention stopped recommending universal masking in healthcare settings unless the facility is located in an area of high COVID transmission, and D.C. has no local mandate requiring mask-wearing for patients or staff in healthcare settings. An update to Mayor Muriel Bowser’s masking and PPE guidance for healthcare personnel, dated Oct. 25, clarifies that any guidelines set by the city are “best practices,” but not definitive requirements.

“There’s a reasonable anticipation that over the next several weeks and potentially months, cases will rise before they fall again, and reducing protections — especially in places where people who are medically vulnerable need to go — doesn’t seem like a decision to be interested in the public’s health,” says Neil Sehgal, a public health professor at the University of Maryland, .

While COVID-19 transmission is low in D.C., per the city’s data, Sehgal noted that the seven-day average of case count in the city has doubled in the past two weeks, mimicking the waves experienced around the fall and winter holidays in pervious years. Respiratory illnesses like the flu have also been surging early in the region this year, and according to the CDC, D.C. has some of the highest levels of flu in the country.

“I think there’s very little debate as to the effectiveness of face masks in preventing people who are infectious from transmitting [it], and protecting people who are medically vulnerable,” Sehgal says.

Whitman-Walker dropped its mask mandate in accordance with DC Health policy (which often follows decisions from the CDC), Henn says. But some say that the decisions coming from the government do not always fit the needs of the immunocompromised or particularly vulnerable who may be seeking care at Whitman-Walker.

Faith Ferber, a therapist who sees several Whitman-Walker patients and has used the center’s testing services previously, wrote in with a complaint to the center after hearing about the policy change.

“One of the biggest things that my disabled queer and trans clients are dealing with is feeling like everyone is moving on from COVID, while our immune systems have not moved on from COVID,” Ferber says. “When you have even medical professionals, who are supposed to be protecting you saying, ‘well, we’re not going to do that anymore, we’re just going to listen to this guidance’ that’s not rooted in the best health interests of the community — who’s going to look out for them, who is going to keep them safe? Who is going to make sure that they’re not shut out from society forever?”

For Patterson, a trans man and a disabled person, the lack of a mask mandate means he now needs to look for another provider — a complicated process, he says, thanks to the relatively few gender-affirming and LGBTQ+-specific clinics in the region.

“They are my primary care [provider], there are also a lot preventative services I use, like STIs, PreP, gynecology,”  Patterson says. “I’m a trans guy, so I already don’t have a lot of choices  for getting affirming care, so it just feels like I have to choose between becoming very sick or more disabled through long COVID, dying, or getting trans-affirming care. I know there are people who are going to be experiencing that issue as well.”

Patterson has filed complaints online with the provider and has shared the news with friends online and a local queer Facebook, asking others to write-in and express their concerns about the lack of a mask mandate.

Mariah Francis, a former employee of Whitman-Walker from 2018-2020, has also reached out with a complaint to Whitman-Walker but has not heard back, they told DCist. Also a former patient who still gets their prescription filled at the 14th Street location, Francis says the policy not only jeopardizes patients, but the front-facing staff as well, who are often the first faces that greet patients when they enter the building.

“Remember, the people who have to work there also are being jeopardized,” Francis says. “Not having leadership be strong enough to say, ‘yeah, we’re protecting patient safety but also that of our employees,’ who also might be immunocompromised but nonetheless have very little power.”

Henn told DCist/WAMU that they have heard some complaints from staff about the mask-optional policy, but that many do not work directly in patient-facing roles. A spokesperson also said that of the center’s roughly 20,000 patients, about 30 have filed some form of complaint with the mask mandate, and they’ve received a number of complaitns from people who are not Whitman-Walker patients.

“I think the anxiety around COVID is really real for folks,” Henn says.”But it’s disproportional, often, to the risk.”

Whitman-Walker, which originally opened in 1970, is in the midst of a large and expensive expansion; the provider plans to open a health clinic on the St. Elizabeths East campus in 2024, and last month received a $2 million federal grant to build an HIV-focused biomedical research space. To Francis, it’s “disappointing” to see a center that receives funding for its ability to meet the needs of a community decide “they’re no longer going to put basic requirements and safeguards up.”

“You’re dropping a mask requirement, which to me says you are not you’re choosing to be an ally to folks who are immunocompromised, or queer, or trans, or Black, or medically underserved,” Francis says. “This is a clinic that prided itself on being a support to those underserved communities. Part of that is realizing they have a lot of power and leverage to do something to keep them safe, bare minimum, and they are not.”