Public Health: Mask mandate now uncertain amid drop-off in hospitalizations

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L.A. County may be able to avoid an indoor mask mandate if case rates and COVID-related hospitalizations continue to decline.  

The county is still in the Centers for Disease Control’s “high” tier for both of these metrics, but it is possible they could dip back down into the “medium” tier at the last minute, which would be on Thursday.  

Barbara Ferrer, director of the Los Angeles County Department of Public Health, briefed the L.A. County Board of Supervisors on Tuesday about the current situation and expressed cautious optimism about the next two days.  

“While we’re really glad to see this decrease and, should it continue, we may be positioned to pause the implementation of universal indoor masking, it’s important to note that we had three instances, earlier this spring and summer, where we saw dips in cases that were followed shortly by increases, ” said Ferrer. “So it’s important for us to continue to be cautious and prepared for layering and additional protections.” 

Ferrer said a reassessment on Thursday will most likely occur if the downward trend continues or is “on the threshold” between “medium” and “high.” It is unknown what steps Public Health will take if this were to occur, but this will most likely be disclosed at Thursday’s press briefing.  

Thursday is expected to mark the second consecutive week L.A. County has been in the CDC’s “high” tier for hospitalizations, which Ferrer has said will trigger a universal indoor-mask mandate.  

With the increased chance of a mandate returning, the debate over masks, their effectiveness, and the county’s ability to enforce a mandate have resurfaced.  

On Monday, L.A. County Supervisor Kathryn Barger, whose 5th District includes the Santa Clarita Valley, wrote an open letter in opposition to a proposed mandate, saying that existing and alternative measures can be used to combat the current spike.  

“What I have seen, time and time again, is that masking mandates actually distract our collective efforts to decrease COVID-19 infection rates. I believe masking mandates are polarizing and are unenforceable,” wrote Barger. “I also believe we have not fully examined nor understand the costs associated with imposing masking mandates among our children and youth.” 

Barger said that she does support masking for those “who want or need an extra layer of protection” and that she supports Public Health’s current mandates for hospitals, jails, public transportation and homeless shelters, but opposes a “one-size fits all” mandate.   

“As I’ve said countless times, to effectively fight the COVID-19 pandemic and mitigate its effects, we need clarity and consistency,” said Barger. “This means trusting the public to make personal COVID-19 prevention decisions to keep themselves and their loved ones safe, promoting the efficacy of vaccines and boosters, and investing in equitable access to COVID-19 treatments.” 

A large section of Ferrer’s briefing was aimed at what she said were misstatements and myths about both COVID-19 and masks. Ferrer cited several studies in an effort to argue that masks do work, including a study from the University of Pennsylvania that showed, in 2020, counties that had a mask mandate had case rates that were 35% lower than counties that didn’t have one. She also cited a 2021 study in California that found that people who regularly use an N-95 or KN-95 mask had 83% lower odds of testing positive than people who never wore masks.  

“No one is suggesting that we need to wear masks forever, rather that they are likely to be short periods of time when it makes sense because of the high transmissibility of new variants that are evading vaccine protections,” said Ferrer. “There is broad consensus among respected and skilled public health practitioners that indoor masking is a time-tested safety tool for reducing the risk of COVID.” 

Following Ferrer’s briefing, Barger wanted to clarify her open letter and again said that she supports masking and that she was “not an anti-masker” but believes there are conditions in which masking is most effective, such as in large groups. She also had concerns regarding the effectiveness of masking on a community-based level, how a mandate would be enforced, and how a mandate could polarize the county. 

“I also want to say that when you talk about the effectiveness of government masking, your own abstract that you sent to us, starts off with evidence for the effectiveness of masking on SARS CoV-2 to transmission at the individual level, as accumulated, but the additional benefit of community-level mandates is less certain,” said Barger. “So we really don’t have empirical data that will support the fact that mandating is more effective than encouraging doing what we’re doing now.” 

Supervisor Janice Hahn, 4th district, echoed Barger’s statements by saying that she does believe masks work, but convincing people to wear them — or how to enforce a mandate — is a concern of hers.  

“My office has received thousands of phone calls, emails, letters from people who are vehemently against us reinstating the indoor mask mandate on July 29,” said Hahn. “I know I’m one of those folks that was hoping that we wouldn’t be here again contemplating the need for masks ,for more masking requirements. And I honestly believe there are a significant number of our population who are not willing to accept mask mandates at this point.” 

Ferrer responded by asking the supervisors how much death L.A. County could tolerate before a mandate would convince the public.  

“When you have this high rate of transmission, it will lead to tragically more deaths,” said Ferrer. “I think the question everyone has to ask themselves, is how much death do you want to tolerate before you ask people, during these extraordinary times of high transmission, to put their masks back on.”  

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