WASHINGTON – Coronavirus infection rates rose steadily through the first half of November across Los Angeles County, then began to climb sharply around the long Thanksgiving weekend.
As a result, on December 1, the director of public health of the county, Dr. Barbara Ferrer, made an announcement that some had hoped for and others feared: A mandate of indoor masks could return for the 10 million residents of the county.
“LA County will follow CDC guidance for communities designated at ‘high community level,’ including universal indoor masking,” Ferrer saidin reference to the Centers for Disease Control and Prevention, which official local and state guidelines tend to use when making decisions about the mask.
In stating his case, Ferrer cited not only COVID-19, but also influenza and the respiratory syncytial virus, or RSV, which are creating a viral storm that some are calling a “tripledemia”.
Three weeks later, Los Angeles remains without a warrant.
To be sure, many people continue to mask. But like other public health officials across the country, Ferrer chose not to impose a mandate, leaving the mask as a matter of personal choice.
The reluctance to impose new mandates has frustrated some public health experts, who believe the anti-mask rhetoric has also made many Democrats fear a measure that could stop the spread of the coronavirus, as well as other diseases. And with hundreds of people still dying from COVID-19 every day, they argue, not making masks mandatory in crowded spaces only puts people at risk.
“The science of universal masking hasn’t changed — COVID spreads through the air, and masks reduce the spread,” Boston University public health expert Julia Raifman he told Yahoo News. “Rational, data-driven approaches to masking and policies when and where there are local outbreaks could help mitigate the transmission of COVID and other respiratory diseases that currently overwhelm pediatric hospitals.”
The nation is now recording 48,000 new coronavirus infections and 450 new COVID-19 deaths per day. Those numbers are far below what they were during the darkest days of the pandemic, before the advent of vaccines and therapies, but they suggest the pandemic is not over.
Mask advocates say that with heavy travel expected in the coming weeks, and with people gathering for indoor meetings, the mask makes the most sense now, especially with the capacity of the hospital is destroyed in part of the country.
“It’s a small price to pay,” Dr. Vin Gupta said during a recent MSNBC appearance.
So far, however, few municipalities or districts have been willing to pay. Philadelphia will send masks to schools when students return from their winter break. School officials in Sacramento, California, he considered returning the mask before December, but they haven’t done it yet.
Oakland, Calif., imposed a mask mandate in government buildings – but not in other indoor areas. Private companies, of course, are free to mandate masks, but many may hesitate to do so without the force of a government edict backing up their decision.
In New York City, Mayor Eric Adams appeared at a press conference related to the pandemic on Wednesday in a mask. He and the city’s health commissioner, Dr. Ashwin Vasan, have asked New Yorkers to put their masks back on — but have not mandated that they do so.
Restaurants in Manhattan were packed during the previous weekend, as were other entertainment venues. The subways were crowded. The bars were full. And while masks weren’t uncommon, they weren’t nearly universal, especially if there was eating and drinking involved.
Public fatigue with the pandemic would likely make it difficult to enforce a new mandate, potentially forcing bus drivers, fast food workers and others into the unwelcome position of trying to get those willing to wear masks again.
“The data on the mask to reduce transmission is pretty abysmal,” says Dr. Lucy McBride, a Washington, D.C. physician who write a newsletter about medicine. “And even if the data showed that masks work perfectly all the time (which they don’t), we should consider the potential downsides of covering faces,” he told Yahoo News.
“I tell my patients that they want to protect themselves with masks if they want because the one-way mask has been shown to protect the wearer,” McBride said.
Studies on masks are a matter of dispute (Raifman, the health expert at Boston University, points out data showing that masking policies are effective). For one thing, it is notoriously difficult to reproduce real-life conditions in a laboratory. Some people wear masks incorrectly, without completely covering the nose and mouth. Others wear cloth masks that are ineffective. Even the ubiquitous surgical masks offer far less protection than the bowl-shaped N-95 respirators that—if properly fitted and worn consistently—offer the best kind of protection.
“Politics aside, mask mandates help prevent Covid if people wear the right masks, correctly. If not, they don’t work,” Dr. Bob Wachter, president of medicine at the University of California, San Francisco , wrote recently on Twitter.
Supporters of the mask point to the possibility of prolonged COVID – a debilitating and poorly understood condition – and also to vaccination rates that have been largely stagnant in recent months, with only modest adoption for the bivalent booster. The mask, they say, is the safest way to protect vulnerable people, including the immunocompromised and the elderly.
“Officials often like to blame the public for being too tired of masks, but the data tells us that this is not true. Even almost three years after the pandemic, polls consistently show the majority of people in the United States supports mask mandates, especially in communities of color,” Dr. Lucky Tranan outspoken advocate for a cautious approach to the pandemic, he told Yahoo News in an email.
Boston parents recently called on education officials to reinstate a mandate. Just making a masking choice, they argue, is not enough. “It should be something like a mandate for people to follow,” one of those parents said.
So far, however, neither they nor similar Americans elsewhere have had much success in persuading public officials. White House officials say they fully support the mask as an important tool in the fight against COVID-19, but maintain that vaccination is the superior weapon against the virus.
In a recent interview with NPRCDC director Rochelle Walensky said communities with high levels of virus spread should “wear masks.”
But, he added, “we certainly have always said that the mask is a personal choice.”
That is not quite true. Walensky and other officials in the Biden administration assiduously masked themselves – and urged Americans to do so – throughout 2021. But in early 2022, even some Democratic governors were tired of pandemic restrictions.
They wanted to see schools reopened, stadiums packed – and masks off.
In late February, the CDC released new guidelines that, in effect, it made it much easier for officials to justify going without masks. Then, just weeks later, a court decision knocked down mask mandates on airplanes and other forms of travel.
Since then, Biden administration officials have said little about the masks. West Wing officers now wear them only sporadically, if at all. This includes President Biden, who has traveled extensively in recent months and held holiday receptions at the White House. At those receptions, even masks were a rarity.
To a recent White House press briefingDr. Anthony Fauci, the president’s top pandemic adviser, was asked why the administration didn’t do more to emphasize the mask before the holiday season.
“We have many interventions and many actions that we can take to protect ourselves. So there is a whole spectrum,” Fauci answered. “The mask is one of them.”