Philadelphia reinstates indoor mask mandate

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Philadelphia officials announced Monday that masks will once again be required in indoor spaces. This includes restaurants, gyms, retail stores and schools. It’s the first major city nationwide to reinstate a mask mandate as coronavirus cases begin to rise again in cities across the country. The change goes into effect in one week, on April 18.

The move comes as the city crossed the threshold into Response Level 2: Mask precautions. The city had been in the “All Clear” level for just over a month, since March 2, meaning there were no mask or vaccination requirements across the city, with the exception of health care settings and public transit.

To qualify for Level 2, the city must  meet two or more of the following requirements:

• Daily case levels exceed 100
• Cases increase by more than 50% over the previous ten days
• Hospitalizations exceed 50

As of Monday, the city reported an average of 142 daily new infections, and cases had increased by more than 50% over the last 10 days. Hospitalizations were at 46, still below the limit.

Still, Philadelphia Health Commissioner Cheryl Bettigole said it would be foolish to avoid the warning signs: every time so far, rising cases have been followed by rising hospitalizations and deaths.

“ I suspect that this wave will be smaller than the one we saw in January,” she said, referring to the original omicron wave. “But if we wait to find out and to put our masks back on, we’ll have lost our chance to stop the wave.” She added that if it appears hospitalizations don’t increase in response to the new BA2 variant as they have in the U.K. and elsewhere in Europe, the health department can adjust its metrics and the mandate can be dropped again.

Philadelphia’s threshold at which to reinstate the indoor mask mandate is among the strictest among other East Coast cities. New York City, for example, has considerably higher case rates than Philadelphia right now, but remains in the ‘Low” alert level, which recommends wearing a mask inside if vaccine status is unknown, but does not require it.

The CDC’s alert system, which many cities hew to, doesn’t recommend indoor mask usage until the community level is considered “high.”

But public health expert Jennifer Kolker said health officials must make decisions based on the needs of their own cities, not what others are doing.

“We’ve always been a little stricter [than New York]” said Kolker, who is a Health Management and policy professor at Drexel and Director of the Center for Public Health Practice. “Our population is poorer. Our burden of disease has been greater.”

She said it’s not necessarily a bad thing for Philadelphia to be an outlier in this regard. She pointed to the delta surge last summer, when case rates were lower in Philadelphia than the surrounding counties, which many attributed to there being an indoor mask mandate here and not other places.

The city established four COVID response levels. To reach level 3, the city would need to hit two of the following criteria:

• Case counts over 225
• Cases increasing by 50% over the last 10 days
• Hospitalizations over 100

In the event the city meets those benchmarks, the vaccine mandate in restaurants would be reinstated (or patrons would need to show proof of a negative test.)

The Pennsylvania Restaurant and Lodging Association expressed disappointment at the new mandate, calling it a ‘major blow.’

“While the rest of the Commonwealth has moved forward navigating life with COVID, Philadelphia has stepped back by imposing another mandate and expecting it to be enforced by businesses and their employees,” they wrote in a statement.

As they were when there was a mask mandate prior, restaurants are allowed to require that all patrons show proof of vaccination in lieu of masking.

The Philadelphia School District will also be subject to the mask mandate, although students are currently on Spring Break and the district had already planned to impose a mask mandate for one week upon the students’ return.

Bettigole said her department will review the data informing the metrics on a regular basis, and send updates weekly every Monday.