by Park MacDougald
Tuesday, 12
April 2022
Analysis
16:15

Philadelphia moves towards a perma-Covid regime

It has become the first city to reinstate an indoor mask mandate
by Park MacDougald
Commuters exit a subway stop at City Hall in Philadelphia. Credit: Getty

Yesterday, Philadelphia announced it would be reinstating its indoor mask mandate amid a moderate rise in coronavirus cases, making it the first American city to do so in response to the spread of the Omicron subvariant BA.2. In making this decision, Philadelphia went beyond the recommendations of the CDC — which still considers the city to have a “low” level of community spread, meaning that masking should be an individual decision — and relied instead on its own Covid response plan, which calls for heightened mitigation measures whenever new cases rise by more than 50% over a 10-day period. 

While much remains unknown about BA.2, the city’s return to mask mandates, which echoes recent decisions by elite universities such as Georgetown and Johns Hopkins, raises uncomfortable questions about the future of Covid policy in America’s liberal cities.

Masking is, above all else, a symbolic policy. Although it is generally favoured by U.S. public health authorities and supported by some studies, the evidence for its effectiveness in curbing the spread of the virus is sketchy, especially now, when the vast majority of Americans have some combination of vaccine-induced and natural immunity to the virus. Indeed, last week, the Children’s Hospital of Philadelphia, the source of the above-linked study in support of mask mandates, recommended against the city reimposing a mandate, given the currently low level of strain on the hospital system. 

To the extent that Covid remains a problem in cities like Philadelphia, it is due to relatively low booster uptake among the elderly — only about half of Philadalphians over 65 have received a third shot. But of course, booster campaigns do not publicly signal concern about the virus in the same way as mandates, and they are far more difficult for governments to implement. If the city can’t force its elderly residents to get boosted, it can at least force everyone to wear ineffective cloth masks while shopping for groceries — just to show that it is doing something.

After two years of living with coronavirus, the public conversation in the US is finally taking seriously the damage that has been done by the isolation and social disruption of the pandemic, often to people who are at low risk from the virus itself. Drug overdoses, homicides, and traffic deaths are all up significantly. In 2020, slightly more Americans under the age of 65 died from alcohol-related health problems than from the virus. Mental health among teenagers has taken a nosedive

Americans desperately need a return to normal. Yet Philadelphia’s eagerness to return to mandates, even in the face of CDC guidance and the recommendations of local experts, suggests a future in which alienating mitigation measures remain in place indefinitely, ready to snap back whenever case counts rise, even if they are disconnected from more serious measures like hospitalisations and deaths. It is precisely because mask mandates are more symbolic than practical — because they signal that we cannot leave the virus behind us — that they should be resisted except as a measure of last resort.

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Stephen Walshe
Stephen Walshe
2 months ago

Covid comes in waves. If mask mandates are introduced every time cases are on an upward trajectory, they will always get the credit when cases inevitably begin to fall again. But its still hocus pocus. The real damage is to physical retail as customers are much less inclined to browse, to workers who cannot WFH and who therefore must wear masks on their commutes to and from work as well as all day in work, to the hard of hearing and those not very fluent in English, to asthma suffers and people who wear glasses, and to those of us who value an occasional smile during the working day.

Last edited 2 months ago by Stephen Walshe
Lesley van Reenen
Lesley van Reenen
2 months ago

We still have indoor masking in South Africa, although the state of emergency/disaster has ended. Effectively they have no basis in law to enforce this, but are trying to pass a national health bill that ensures the state can continue to pass draconian laws. We continue to flout these fools more or less en masse to a greater or lesser degree …except for a chunk of the middle class who are still terrified of… Covid? Anyway, those folk who have money, but no real empathy, imagination or logic.

laurence scaduto
laurence scaduto
2 months ago

Years ago, pre-Covid, I heard an archeaologist answer the question “When was the Black Death over?”. She answered; “The Black Death was over when enough people decided that they had to get on with their lives.”
We seem to be at that point now. All that’s left is for us to ignore the experts and get on with our lives. I imagine it will be a gradual process; some people will continue wearing masks for years. That’s their own choice.
I just hope the people of Philadelphia aren’t overly well behaved, for their own sakes.

Johann Strauss
Johann Strauss
2 months ago

The fundamental issue right now is that the public health authorities don’t seem to want to understand the very simple fact that the current Omicron variant is no more harmful than a bad cold or a very mild flu. We never masked previously during the flu season and there is absolutely no reason to mask now in the context of the community where the benefits are negligible to non-existent and where the harms (in terms of simple human to human communication, difficulties in wearing a mask all day, etc…) are significantly worse.
I’m not saying that an appropriate mask worn in the right environment such as a hospital when examining highly infectious patients isn’t a smart thing to do. Just that in the community masks have proven entirely ineffective.
Right now it would be vastly better to simply practice focussed protection with special focus on the elderly with multiple co-morbidities. Anything else reflects irrational panic at a nothing. If we had started out with Omicron instead of the original Wuhan strain, there would never have been any disruptions at all and nobody would have even noticed.

Francis MacGabhann
Francis MacGabhann
2 months ago

Political decision, which is to be expected from a 17 member city council, 14 of whom are Democrats. As at the height of the virus, there is no question of genuine concerns for public health on behalf of anyone on the political left.

Gunner Myrtle
Gunner Myrtle
2 months ago

Let’s hope the Democrats get slaughtered in the mid terms and come to realize that this is bad politics. For most of Covid I knew I was in the minority on this issue – but not any longer. Like a lot of progressive issues there is a very loud and self confident minority and an intimidated majority. The voting booth is where we will see what people really think.

Skip Simonds
Skip Simonds
2 months ago

Hidden in plain sight is the fact that this is driven not by a public health concerns, but rather by a statistical fallacy. Philadelphia’s policy is to institute “heightened mitigation measures whenever new cases rise by more than 50% over a 10-day period.” The math of this is that if the number of cases just preceding the 10 day period is X, and the number of cases in the most recent 10 day period is 1.5X, then masking is instituted. This creates a ridiculously low threshold when the number of cases, as is currently the situation, is very low. It is a poorly reasoned standard. Philadelphia’s problem is statistical, not medical. Unfortunately, because of our and the media’s addiction to “panic porn,” we are unable to see it.

polidori redux
polidori redux
2 months ago

I always thought that the USA was a bit iffy and not a society to be emulated, but even I am surprised ay the madness that is engulfing it.

Mary Bruels
Mary Bruels
2 months ago
Reply to  polidori redux

Not all of America has gone mad. The so called “Red” states (run by Republican governors) have faired far better than the “Blue” states (run by Democratic governors). Here in Florida, life goes on as normal with open businesses, in school attendance, and no masking.

Allison Barrows
Allison Barrows
2 months ago

It seems the people getting COVID are the people who have been shot and boosted. Something like 73 swells at the Gridiron Dinner – all of whom had to show their shot papers to attend – tested positive. Of course, they weren’t wearing their little obedience masks, so maybe that’s what happened. Yeah, that’s it.

Richard Hopkins
Richard Hopkins
2 months ago

Why the WHO delayed airborne warning
Throughout much of 2020, the World Health Organization (WHO) held tight to the idea that SARS-CoV-2, the virus that causes COVID-19, spreads through relatively large ‘respiratory’ droplets that contaminate nearby surfaces. It took many months for the agency to acknowledge that the virus could travel on tiny particles called aerosols that can spread widely and linger in the air. And nearly two years passed before the WHO clearly stated that the virus is airborne. That mistake and the prolonged process of correcting it sowed confusion and raises questions about what will happen in the next pandemic.

Nature | 18 min read

Nature Briefing 7th April 2022

Lizzie J
Lizzie J
2 months ago

I wasn’t sure whether to laugh or cry at the sight of a very fat woman buying cigarettes whilst wearing a mask. Why are people so convinced by advice on masks, but continue to ignore advice on weight and smoking? I suppose because wearing a mask is easy.

dphiggins.dh
dphiggins.dh
2 months ago
Reply to  Lizzie J

To paraphrase the great man himself.
“The thick you will always have with you”
©J. Christ

Lisa Nakamura
Lisa Nakamura
2 months ago

I teach at a university in the US that just dropped its mask mandate last week. Another faculty member who teaches in the School of Nursing told me that masking is generally useless unless its with a very high-quality N95 mask, and I noticed that most of my students wore low-quality and poor-fitting cloth masks. Yet our university had a very low rate of infection when on ground classes resumed even though we’re near a large metropolitan area, and my colleague thinks that was due to the vaccine mandate our university had, not masking. For him, our community’s experience reveals the best way to keep fighting covid: vaccines and encouraging those who are especially vulnerable to wear good masks. And he also thinks that getting covid, on top of being vaccinated, may be a good way to boost immunity against serious illness, as scary as that sounds, as long as these newer variants appear to be mild.