A thousand medical providers affiliated with the University of Hawaii and a health care provider on Kauai will be required to wear masks in patient care areas if they decline to get flu shots.

The requirement will last through the flu season from Oct. 1 to May 1.

As of Oct. 1, a vaccination or “mask up” policy will be enforced for University Health Partners of Hawaii, made up of 200 doctors and nurse practitioners at the UH John A. Burns School of Medicine and UH School of Nursing &Dental Hygiene who practice medicine in the community.

“Most hospitals and nursing homes now require that employees receive their flu shot as a condition of employment,” said Dr. Patricia Blanchette, chief medical officer of University Health Partners of Hawaii and associate dean at JABSOM.

A similar policy will go into effect as part of a pilot program for more than 800 employees at Wilcox Medical Center and Kauai Medical Clinic on Oct. 15.

“There are no plans at this time to implement this policy at our medical centers on Oahu, but we continue to emphasize to our employees the importance of getting vaccinated, staying home from work if they have flu symptoms, as well as early identification of patients with the flu to help minimize the spread of the flu,” said Kristen Bonilla, a spokeswoman for Hawaii Pacific Health, owner of Kapiolani Medical Center for Women &Children, Pali Momi Medical Center and Straub Medical Center, as well as the Kauai facilities. “Our goal with all of these measures is to protect our patients as well as our employees and the broader community.”

Prior to the new policies, getting the flu vaccine was highly recommended, but not mandatory.

During the past flu season — from October 2017 to May 2018 — 12,239 individuals tested positive for the virus in Hawaii, compared to 9,053 the 2016-2017 flu season. During last year’s flu season there were 490 deaths attributed to pneumonia and influenza in Hawaii.

The Queen’s Medical Center said workers who decline flu shots have been required to wear masks around patients since 2013.

“We’re choosing to require it because it is highly recommended by the (Centers for Disease Control and Prevention) for health care workers,” Blanchette said. “Every year there are people who die from the flu. We as health care workers, our first directive is, ‘first do no harm.’ As a health care worker, if we go around unvaccinated and we contract the flu and then we end up giving it to our patients, that’s not right. It’s not what we should be doing.”

In certain instances, people with severe allergies to eggs choose not to take the traditional flu vaccine, as do those with Guillain-Barre syndrome, which causes the immune system to attack the nerves and can result in paralysis. Others object to flu shots for religious reasons.

The flu virus can easily be spread through coughing and sneezing for up to 72 hours, even before a person shows symptoms.

The flu and complications from the flu resulted in an estimated 80,000 deaths across the nation last winter — the highest flu mortality in at least 40 years, according to the CDC.

“One thing about the flu is that it’s so catchy, that’s what causes epidemics across the country, and it’s catchy before a person who has it knows that they’re spreading it,” Blanchette said. “Here we are as health care workers caring for patients. We should do everything that we can do to prevent ourselves form giving an infection to somebody else.”