WASHINGTON — The number of coronavirus infections rose steadily in Los Angeles County during the first half of November, then began a sharp rise around the long Thanksgiving weekend.
As a result, on Dec. 1, the county’s public health director, Dr. Barbara Ferrer, made an announcement that some had hoped for and others had feared: There could be a mandate for indoor masks for the county’s 10 million residents.
“LA County will follow CDC guidelines for communities designated at the ‘high community level,’ including universal indoor masking,” Ferrer said, citing the Centers for Disease Control and Prevention, whose guidelines local and state officials often use when taking masking decisions.
In setting out her case, Ferrer cited not only COVID-19, but also flu and the respiratory syncytial virus, or RSV, which caused a viral blizzard that some are calling a “tripleemia.”
Three weeks later, Los Angeles remains mandate-free.
Certainly, many people continue to mask. But like other public health officials across the country, Ferrer chose not to mandate, leaving masking a matter of personal choice.
The reluctance to impose new mandates has frustrated some public health experts, who believe anti-mask rhetoric has even left many Democrats fearful of a measure that could stop the spread of the coronavirus and other diseases. And with hundreds of people still dying from COVID-19 every day, they argue, not mandating masks 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 told Yahoo News. “Rational, data-driven approaches to masking policies when and where there are state or local spikes can help reduce the transmission of COVID and other respiratory illnesses currently overwhelming children’s hospitals.”
The country is now recording 48,000 new coronavirus infections and 450 new COVID-19 deaths per day. Those numbers are well 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 proponents say that with the expectation of a lot of travel in the coming weeks and with people gathering for indoor gatherings, masking makes as much sense now as it ever did, especially with hospital capacity under pressure in parts of the country.
“It’s a small price to pay,” said Dr. Vin Gupta during a recent MSNBC appearance.
So far, however, few municipalities or city districts have been willing to pay for it. Philadelphia will make masks mandatory in schools when students return from their winter break. School officials in Sacramento, California, considered bringing back masks earlier in December, but have so far failed to do so.
Oakland, California, has enforced a mask mandate in government buildings, but not other indoor spaces. Private companies are of course free to mandate masks, but many may be hesitant to do so without the strength of a government order backing their decision.
In New York City, Mayor Eric Adams appeared in a mask at a pandemic-related press conference on Wednesday. He and the city’s health commissioner, Dr. Ashwin Vasan, both have asked New Yorkers to put their masks back on — but they have not given a mandate to do so.
Restaurants in Manhattan were packed over the weekend, as were other entertainment venues. The subways were overcrowded. Bars were full. And while masks were not uncommon, they were hardly universal, especially when it came to food and drink.
Public fatigue from the pandemic would likely make enforcement of a new mandate more difficult, potentially forcing bus drivers, fast food workers and others into the unwelcome position of trying to mask the unwilling again.
“The data on masking to reduce transmission is pretty appalling,” says Dr. Lucy McBride, a Washington, D.C., physician who writes a drug newsletter. “And even if the data shows that masks always work perfectly (which they don’t), we have to consider the potential downsides of covering faces,” she told Yahoo News.
“I tell my patients who want to protect themselves to mask if they want to because unidirectional masking has been shown to protect the wearer,” McBride said.
Studies on masks are a matter of debate (Raifman, the Boston University health expert, points to data showing that mask policies are effective). For starters, it’s notoriously difficult to reproduce real-life conditions in a lab. Some people mistakenly wear masks without completely covering their 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 which, when fitted properly and worn consistently, provide the best protection.
“Politics aside, mask mandates would help prevent Covid if people wore the right masks, correctly. If not, they won’t work,” says Dr. Bob Wachter, president of medicine at the University of California, San Francisco, recently wrote on Twitter.
Proponents of masking point to the possibility of long-term COVID — a debilitating and little understood condition — as well as vaccination coverage that has largely stagnated in recent months, with only modest uptake of the bivalent booster. Masking, they say, is the surest 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 this is simply not true. Even nearly three years into the pandemic, polls consistently show a majority of people in the US support mask mandates, especially in communities of color. Dr Lucky Tranan outspoken advocate for a prudent approach to the pandemic, told Yahoo News in an email.
Parents in Boston recently petitioned education officials to reinstate a mandate. Simply making a choice for masking, they argued, is not enough. “It has to be something like a mandate for people to follow it,” said one parent.
So far, neither she nor like-minded Americans elsewhere have had much success convincing government officials. White House officials say they fully support masking as an important tool in the fight against COVID-19, but they argue that vaccination is the superior weapon against the virus.
In a recent interview with NPR, CDC Director Rochelle Walensky said communities with high rates of virus spread “should wear masks.”
But, she added, “we’ve certainly always said masking is a personal choice.”
That is not entirely true. Walensky and other Biden administration officials diligently masked — and urged Americans to do so — throughout 2021. But by early 2022, even some Democratic governors were becoming exhausted by pandemic restrictions.
They wanted schools reopened, stadiums packed – and masks off.
In late February, the CDC issued new guidelines that actually made it much easier for officials to go mask-free. Just weeks later, a court ruling scrapped mask mandates on airplanes and other forms of travel.
Since then, Biden administration officials have said little about masks. West Wing officials now wear them only sporadically, if at all. So does President Biden, who has traveled extensively in recent months and held holiday receptions at the White House. Masks were also a rarity at those receptions.
At a recent White House press briefing, Dr. Anthony Fauci, the president’s top pandemic adviser, was asked why the administration was not doing more to emphasize masking ahead of the holiday season.
“We have multiple interventions and multiple actions we can take to protect ourselves. So there’s a whole spectrum,’ Fauci replied. “Masking is one of them.”