PHILADELPHIA — Amid the hodgepodge of warnings, rules and edicts on the H20 laundromat counter — “No Cash,” “Watch Your Step,” “Not Responsible” — there was a new one Monday morning , prominently displayed. “Masks required for everyone,” he said, “beginning April 18.”
The owner, Chris Lee, had it checked in there over the weekend even though the new rule wasn’t his. It was the city one. Starting Monday, Philadelphia’s health commissioner announced last week, everyone in the city would be required to wear masks in indoor public places, except in businesses where proof of vaccination has been checked at the ‘entrance.
Mr. Lee’s response was fairly representative.
“I’m for it,” he said. “I guess.”
Over the past month and a half, a number of cities, including Philadelphia, have lifted mask mandates that had been in place for some of the deadliest months of the Covid-19 pandemic, signaling that a return to normal was perhaps, once again, close. But another oddly-named subvariant soon arrived, and infections started to rise again. With a low but rapidly rising number of cases, Philadelphia this spring became the first major US city to order its residents to put the masks back on.
The decision comes at an uncertain time in the pandemic, as new variants of unknown risk emerge while the wide availability of home testing has complicated official tallies of new infections. The Omicron subvariant known as BA.2 has reversed a nationwide drop in new cases, but is spreading in a better-vaccinated country than when the Delta variant arrived last year. There are now good antiviral drug options. And so far, a spike in hospitalizations has not kept pace with the spike in infections.
At the same time, many people, even the most cautious, have lost their appetite for vigilance and the rules have become harder to follow. Seeking to forestall a further surge, the Biden administration extended the federal mask mandate on public transportation by two weeks, but a federal judge in Florida overturned the mandate on Monday. Broadway theaters recently dropped vaccination proof rules, but extended mask requirements through the end of May.
As cases mount, local and state leaders across the country will have to decide whether a time comes when recommendations are no longer enough and policies such as mask mandates are called for again.
“From a broader public health perspective, it’s a constant dance we find ourselves in, especially here in the United States, about when to get things political,” said Dr. Megan Ranney, emergency physician and academic dean of the Brown University School of Public Health.
For the Philadelphia Department of Health, that point was reached last week, when an increasing number of cases automatically triggered the mask mandate. The city of 1.6 million has generally complied with public health guidelines for the past two years, and masking was widespread even without a warrant. Yet the inversion presents a case study for other cities, a test of the thinness of patience for pandemic restrictions, even in a place where thousands have died of Covid-19.
“I think it’s overly conservative, but I see where they’re coming from,” said Mike Levay, 25, a digital properties manager in Philadelphia, as he walked through the city’s main Amtrak station Monday morning. He thought it was a bit confusing going back and forth on warrants. But, he added, “I understand and respect it.”
Most Philadelphians polled Monday accepted the mandate, with some even applauding it. But it was not unanimous. Some restaurateurs saw the mandate as yet another reason for customers to stay home during two brutal years for the restaurant industry – “another bump in a series of stops and starts,” one said. them.
Others dismissed these concerns. “In restaurants, all you have to do is carry it to the door,” said Ilene Winikur, 81, who said she was proud of her city for issuing the warrant. “As soon as they put water on your table, the mask is off.”
A group of business owners and residents filed a lawsuit on Saturday to stop the mandate. Mayor Jim Kenney defended the city’s decision-making as “clear, transparent and predictable,” while the state’s leading Democratic gubernatorial candidate, Josh Shapiro, called the mandates “against -productive”.
The range of opinions at the H20 laundromat contained multitudes.
“A lot of people thought you had to wear it anyway,” said Ashley Thurston, 31, a prison officer wearing a glittery rhinestone face mask while folding children’s clothes.
“If I am vaccinated, why do I have to wear a mask? fumed Myesha Romero, 31, whose displeasure was barely concealed under a red mask with the Temple University logo. ” What is that ? ” she asked. “Every day is a new rule.” Coretta Nesmith, 32, sitting without a mask in a row of seats at the other end of the counter laundry, smiles broadly. “You can say my point,” she said.
Statistics released by the city on Monday indicated a still small but rapidly growing epidemic. The average number of new cases reported was 224 per day, a relatively low figure for a major city, but a 240% increase over two weeks. Eighty-two people have been hospitalized with Covid-19, nearly double the number from last Monday. But the death toll, which usually lags the total number of cases and hospitalizations by several weeks, had not risen so dramatically in the weeks since hitting the horrific 5,000. .
In the low but rapidly rising numbers, city health officials saw a familiar warning.
“I remember seeing this when Delta was on the horizon,” city health commissioner Dr. Cheryl Bettigole said in an interview, describing the ominous days last year when Philadelphians were finally enjoying respite from Covid-19 as she and her colleagues watched as a new variant spread death and disease across Europe. “It was hard to get people’s attention,” she said.
When Dr. Bettigole and other health officials began piecing together a series of measures that would determine what mitigation policies should be in place by when, Delta’s experience was on her mind, she said. declared. So they decided that a 50% jump in daily infections counted over 10 days – what she called “the most reliable measure we’ve seen in previous waves” – plus an increase in the absolute number of infections. over 100 or hospitalizations over 50 would automatically trigger an indoor mask mandate.
As critics of the order are quick to point out, Philadelphia’s guidelines differ from those of the federal Centers for Disease Control and Prevention. The latest CDC guidelines place more emphasis on hospital admissions and occupied hospital beds, which are measures of strain on health care systems rather than direct gauges of infection risk; like deaths, these measures tend to lag the trend of new cases by several weeks. By the CDC’s definition, Philadelphia was still solidly in the “weak” category when the mask mandate was reinstated.
“What’s the argument for going against the CDC, for going against Dr. Fauci?” asked Allan Domb, a real estate mogul who sits on the Philadelphia City Council. “It’s hard to understand when all these other institutions say it’s not necessary.”
Dr Bettigole acknowledged the discrepancy, but insisted decisions were made based on specific conditions in Philadelphia, a city with a large population in poverty and one where black communities have been particularly hard hit by the virus.
“We need to focus on protecting the city’s residents who are the most vulnerable,” she said. With all the unknowns in epidemiology and human behavior, fighting the virus requires making the best-informed efforts, she explained, and adapting if those efforts were to fail.
“The thing is, I could be wrong – people in two weeks might laugh at me,” she said. “But if I manage to save lives because I’m right, it’s worth the risk.”