Why We Should Support the LA County Indoor Mask Mandate

By Daniel Lichtenstein-Boris, MPH

For the past year and a half, I have helped tabulate daily COVID-19 case counts. Every morning in L.A. County’s Acute Communicable Disease Control unit we get the latest numbers on COVID-19 cases, tests, hospitalizations, and deaths. We track outbreaks at worksites, nursing homes, and schools and record the percent of emergency room visits that are COVID related. These statistics go on the LA County Public Health website and are distributed to news outlets through regular press briefings. I am proud of the work that my colleagues and I perform as frontline public health workers

Unfortunately, things are not looking good.

It’s true that vaccines are widely available, including for young children. Eighty percent of LA County residents have received one dose, 72% are fully vaccinated, and 40% have received at least one booster. There is a high likelihood that another booster dose will be available this fall. In addition, there are anti-viral medications like Paxlovid that one can take up to five days after first experiencing COVID symptoms. All this greatly reduces the chance that patients will be hospitalized or die, and way fewer people are getting seriously ill. But cases once again are rising, hospitalizations are up, outbreaks are spreading, and for the medically vulnerable and immune compromised, the pandemic is still a nightmare.

At the height of the Omicron surge last winter, there were 40,000 cases a day. By March that had dropped sharply, to less than 800 each day. By then most people had either gotten Covid or they were barely going out. Mask wearing was widespread. At one point this Spring fewer than two hundred people were hospitalized in all of Los Angeles County.

But not anymore.

Some days more than 8,000 people test positive for COVID-19. There are over 1,200 people in the hospital with COVID, and whereas earlier this Spring five people a day were dying of COVID, today it is fifteen to twenty. Outbreaks at nursing homes and in workplaces are rising fast.

Cases are severely undercounted. Not only do we not count the at-home tests that are now readily available at pharmacies and free by mail from the federal government, but with so many asymptomatic and barely sick people, many infected individuals don’t get tested. This frustrates our work of recording accurate statistics and prevents my colleagues from helping patients isolate and inform their close contacts to limit the spread of disease.

The new B.A.5 variant has swept through the country, and it’s only mid-summer! Thankfully school is still out, because COVID spreads easily among children, who then infect their families. If we don’t get this pandemic under control now, imagine what will happen in the winter where cases have spiked in each of the last two years.

We need an indoor mask mandate now to reduce the number of cases, hospitalizations, and deaths. Vaccines and medication alone cannot stop COVID-19. It is a small price to pay for a disease that has killed over a million Americans. Many Americans believe masks are bothersome, itchy, and limit their freedom. But my colleagues stand behind LA County Public Health Director Barbara Ferrer in implementing policies supported by evidenced based science. Though unpopular, it is time to take a stand to save lives.

We need another indoor mask mandate to reduce the strain on emergency rooms and hospitals. Even when COVID patients are not hooked up to ventilators and in the ICU, their care puts a burden on hospitals and staff. Hospitals must find ways to isolate these patients, so they don’t spread COVID to others. By diverting resources to care for COVID patients, hospitals put off necessary elective surgeries and can’t care for patients with other conditions. With high COVID hospitalizations, patients with other critical and necessary healthcare needs suffer.

Further, doctors, nurses, and healthcare staff are burned out and understaffed as it is. Many got COVID earlier in the pandemic and have experienced the heartache of isolating themselves and spreading the disease to loved ones. In the winter hospitals forced healthcare professionals to work while sick because there weren’t enough staff. Another wave of hospitalizations will devastate an already battered profession.

We need an indoor mask mandate now as a sign for respect for each other, and for the doctors and nurses we will burden if and when we get sick.

We need an indoor mask mandate now in memory of the million Americans who have died of COVID-19, and the millions more suffering with long-COVID, a debilitating illness we are only beginning to understand. With COVID cases are now in the Center for Disease Control’s red zone—red for high transmission—we honor those Americans who have died by wearing masks and refusing to spread a virus that may kill others. What kind of society are we that becomes desensitized to mass death where healthy people don’t care about the elderly and medically fragile? We should wear masks indoors to honor the memory of the million Americans who have died of COVID-19, and the millions more who have passed around the world.

Finally, we need an indoor mask mandate because we should value human life. Patients’ lives matter. Even if businesses will have to check customers and remind them to wear masks, it is a small price to pay. We should put people over profits, and human life over comfort and consumption.

Los Angeles County Department of Public Health Director Barbara Ferrer faces a difficult decision. No jurisdiction in the entire country has a reinstated an indoor mask mandate. (The bay area’s Alameda County reimplemented an indoor mask mandate for three weeks then dropped it.  

It’s true, the country wants to move on from the pandemic and put the pain and hardship behind us. But the public should support the courage and conviction of public health officials with the foresight to save lives even if their policies are unpopular. Together we can do better, reduce cases now, so tomorrow we can live healthy, happy, and free.

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