Necessary or excessive? Debate intensifies over potential mask rule for L.A. County

California is suffering through another intense coronavirus wave.
(Irfan Khan / Los Angeles Times)

The idea of a new indoor mask mandate, which could come in days, sparks a growing debate, with some L.A. communities saying they won’t enforce it.

Will Los Angeles County impose a new mask mandate this week in response to a summer coronavirus surge fueled by ultra-contagious Omicron subvariants?

The county appeared set to take that step this week, but recent declines in case numbers could prompt a delay. Still, the idea has sparked debate, with some L.A. communities saying they won’t enforce a mask mandate if it comes.

Here’s a breakdown of the health issues and politics involving the potential public health order:

Why are we here?

Public Health Director Barbara Ferrer has said L.A. County would reimpose an indoor mask mandate if it reached the high COVID-19 community level, as defined by the U.S. Centers for Disease Control and Prevention, and remained there for two consecutive weeks. Placement in that category means a county is recording both a significant amount of coronavirus cases and at least 10 new weekly COVID-19 hospitalizations for every 100,000 residents.

L.A. County entered the high level July 14 and remained there last week. County officials make the determination every Thursday, using criteria established by the CDC.

If implemented, the mandate would apply indoors to anyone 2 or older at an array of establishments and venues, including shared office space, manufacturing and retail settings, event spaces, restaurants and bars, gyms and yoga studios, educational settings and children’s programs.

Cases

However, Ferrer has said the county could hold off on a mask mandate if transmission shows pronounced signs of slowing.

And case rates have been dropping. As of Tuesday afternoon, L.A. County was averaging about 6,000 coronavirus cases a day over the previous week, down 11% from the prior week’s average of 6,700. On a per-capita basis, the latest rate is 417 cases a week for every 100,000 residents. A rate of 100 or more is considered high.

Cases are also falling statewide. California reported an average of 17,000 a day over the last week, down 17% from a week ago.

The decline could be attributable to a number of factors.

As coronavirus cases climbed in recent weeks, and hospitalizations worsened, a number of businesses in L.A. County have tightened up on COVID-19 restrictions. Some decided to cancel or postpone gatherings or move them outside.

About a month ago, hospitalization levels passed a threshold that triggered the TV and film industry to resume certain indoor masking requirements. In shifting its in-person summer tour to virtual sessions, the Television Critics Assn. cited growing concerns about the surge, fueled by the hyper-contagious BA.5 subvariant, and the potential mask mandate in L.A. County as a reason why “shows in production cannot or do not want to break COVID bubbles” and “producers, writers, talent and publicists are not willing to appear in person.”

It’s also possible that BA.5 is starting to run out of people to infect. For the week that ended Saturday, 82% of estimated coronavirus cases nationwide were of the BA.5 subvariant, a stunning pace of growth; just two months ago, BA.5 comprised less than 3% of estimated cases. And unlike the national wave dominated by the BA.2 and BA.2.12.1 subvariants, which transitioned directly into the BA.5-fueled wave, there appears to be no readily visible successor to BA.5, at least for now.

Hospitalizations

Improvement in its hospital metrics also could make the county reconsider the timing of a mask order.

“Should we see sustained decreases in cases, or the rate of hospital admissions moves closer to the threshold for medium, we will pause implementation of universal indoor masking as we closely monitor our transmission rates,” Ferrer said Tuesday.

On July 20, 1,329 coronavirus-positive patients were hospitalized countywide. That total plunged to 1,200 by Friday before creeping up again over the weekend, to 1,286 as of Monday.

Dr. Christina Ghaly, the county’s health services director, said she’s not concerned that any of the county’s four public hospitals are at risk of being overwhelmed. But, because of the high level of community transmission, she said a number of staffers are being infected and unable to work.

“In hospitals, that means that beds are closed or that it might take longer to be seen in an emergency department,” she said. “It has several ways in which there’s an impact on facilities.”

Deaths

L.A. County’s weekly coronavirus death rate is starting to climb again.

As of Tuesday, L.A. County was recording 106 COVID-19 deaths a week, a 23% week-over-week increase. A month ago, there were 50 deaths a week.

The weekly per capita death rate for L.A. County — 105 deaths a week for every 10 million residents — is 67% worse than that of the San Francisco Bay Area, which reports 63 deaths a week for every 10 million residents.

The case for mask rules

Public health officials largely characterize face coverings as a low-impact way to help tamp down transmission in indoor settings, where the risk of coronavirus spread is generally higher. Both the L.A. County and California departments of public health strongly recommend residents mask up while indoors in public.

But during periods of high transmission, Ferrer has said it makes sense to consider a requirement — which in her mind would protect not only clients and patrons but also the county’s workforce and more vulnerable residents.

Ferrer has said she is hopeful that, should a mask order be reinstated, many residents would adhere to it. She said the rules would require businesses to post signs informing the public of the mask-wearing requirement but the health department would not ask employees to enforce the rules.

Some officials are not sure what all the fuss is about. Supervisor Sheila Kuehl said she’s struck by “the blowback from a number — though not a really significant number — of sort of snowflake weepies about how oppressive it is to wear a mask.”

The case against mask rules

But other supervisors said L.A. should avoid another mandate.

Supervisor Kathryn Barger said Tuesday she’s adamantly opposed to a new mask order “because I truly do believe it’s going to have the opposite effect.”

In an open letter Monday, Barger wrote that she believes such orders are polarizing, unenforceable and “actually distract our collective efforts to decrease COVID-19 infection rates.”

Supervisor Janice Hahn said her preference would be to stay aligned with the state, which strongly recommends — but does not require — masking indoors while in public.

If a mandate were implemented, she suggested it initially be more limited, perhaps covering only places such as grocery stores and pharmacies.

“Local businesses I know have been telling my office that they’re concerned about having to enforce this mask mandate when such a large portion of the population is against it,” Hahn said. “They just don’t feel like that’s why they went into small business was to, sort of, get in fights with their customers.”

Maria Salinas, president and chief executive of the Los Angeles Area Chamber of Commerce, and Jessica Lall, president and CEO of the Central City Assn., a downtown business group, also recently sent a letter to Ferrer expressing their concerns.

Requiring masks, they wrote, “puts employees in the increasingly challenging position of enforcing a mandate that many customers no longer wish to — or are unwilling to — comply with.”

Officials in Beverly Hills have said they will not use city resources to enforce a mask mandate if L.A. County decides to issue one. In addition, Long Beach and Pasadena — which have their own public health departments — have said they will not immediately follow L.A. County if it imposes a mandate this week.

This story originally appeared in Los Angeles Times.