Philly’s return of masks gets both eyerolls and support from residents. Can health officials bridge this divide?

Under warm blue skies that seemed at odds with the recent rise of COVID-19, shoppers at Roosevelt Mall seemed united on Tuesday in a quest to finish errands quickly and get back outside in the sun.

But as for opinions on the return of Philadelphia’s mask mandate — which takes effect in businesses including those very same stores on Monday — errand-runners were sharply divided.

Harold Phillips, 50, of Germantown, said the restriction made sense, given that one-third of Philadelphians are not fully vaccinated.

“They should’ve never stopped it,” he said of the mask mandate, as he headed into a Snipes shoe store. “I did the research. I got the shots.”

But Angie Gonzalez, 35, thinks the mandate is a waste of time. After two years of restrictions being imposed, lifted, then imposed again, the latest message from the city Department of Public Health will be ignored by many, she predicted.

“I feel like people are not going to wear them. They don’t even care,” she said, pushing her toddler in a stroller near an electronic sign flashing the words Wear PPE and Stay 6′ Apart. “I feel like people know the risks.”

Therein lies the latest chapter of a challenge that has bedeviled public health agencies since the start of the pandemic: How to implement precautions in such a way that people will pay attention.

At this stage of the pandemic, masking is a matter of communal health more than individual safety, said Kathleen Hall Jamieson, a professor at the University of Pennsylvania’s Annenberg School for Communication.

“Philadelphia prides itself of being a city of neighborhoods,” she said. “Part of what you’re asking is, let’s protect our neighborhoods.”

In announcing the renewed mask mandate on Monday, a week ahead of when it takes effect, Philadelphia was alone among major U.S. cities, despite having lower numbers of COVID cases than some. City health officials acknowledged bringing back masking could be divisive.

“The pandemic doesn’t care about our wishes. When cases are rising, the danger to everyone rises,” said Matthew Rankin, a spokesperson for the Philadelphia Department of Public Health, in a statement Tuesday. “We believe that Philadelphians understand that this wave of cases will likely take the lives of some of our most vulnerable neighbors and we will take the appropriate measures to protect their community.”

The need for masks, Rankin said, will hopefully be brief. He noted European case surges associated with the BA.2 subvariant of omicron subsided relatively quickly.

“If people take this seriously and work to protect their communities,” he said, “we can get through it more quickly.”

The pandemic has been a communications nightmare for public health officials. Conditions keep changing along with new variants and interventions like vaccines or treatments. The hope that vaccination would end the pandemic has been tamped down as time has shown vaccinated people can spread the virus asymptomatically.

“What’s challenging about this from a recommendation standpoint is it doesn’t stand still,” Jamieson said. “Things that are true at point A are not true at point B.”

Several local health experts lauded the city health department for providing standards that make clear to the public when safety interventions would be triggered.

“It’s good for consistency and it’s good for transparency in the process,” said Neal Goldstein, a Drexel University epidemiologist, “and that’s very important to establish the credibility of public health.”

The city could provide even more information to bolster public trust, Jamieson said, including the availability of COVID treatments and parts of the city where, due to age or other factors, people are particularly vulnerable.

Though the city’s decision was consistent with its stated metrics, opinions varied over whether those metrics reflect the realities of BA.2.

The BA.2 subvariant appears more transmissible than the original omicron, but not more likely to cause serious illness.

“The outcomes don’t appear to be getting worse,” Goldstein said. “Slightly more infectious, meaning more people will get sick with this variant, but it’s not equating to the really severe outcomes.”

The case rate in Philadelphia is up 74% over the past two weeks, but it is still far below the level of viral spread seen just a few months ago. At the beginning of March, the city was averaging almost twice as many new daily cases as it is now, and on Jan. 12, in the midst of an omicron surge, the city averaged 3,909 new cases, more than 27 times the daily average this week.

Further complicating messaging, the Centers for Disease Control and Prevention’s metrics indicate Philadelphia is still an area at low risk from COVID.

That’s because the CDC emphasizes hospitalizations, but city health officials believe its better to take action before a lot of people get that sick. Local experts are more attuned to the demographics and risks of is area than federal counterparts would be, Jamieson said.

“The best way to assess the situation on the ground is to task the local health experts,” she said. “It’s not to ask the CDC.”

The most effective intervention to prevent COVID transmission and serious illness is vaccination, Goldstein said. Masks reduce the transmission of the coronavirus, but how much depends on a range of variables: the type of mask, the way it is worn, even the strain of virus that is circulating.

As we’ve all heard, the N95 and KN95 varieties are designed to stop the transmission of most virus particles. A surgical mask is not as effective, while a cloth mask may be even less so — particularly if it’s just draped loosely across the wearer’s face. Goldstein also noted that a significant amount of COVID transmission happens in homes, where people may not be wearing masks.

Determining exactly how much the various face-coverings help can be a challenge in the real world. In one recent study in the journal Pediatrics, Duke University researchers found that cases of in-school transmission were 72% lower in districts with mandatory masking during the late summer and fall of 2021, compared to those where masks were optional.

But other precautions and demographic characteristics may have played a role as well, the authors wrote. And that was before the rise of the omicron variant, which is more transmissible than earlier strains.

Carmen Arroyo, 58, wore a black mask Monday at Roosevelt Mall, but only because she was headed to a doctor’s appointment, where it was required. The Northeast Philadelphia woman predicted that the renewed mandate will backfire.

“People will be more depressed than before,” she said, contending that the decision is best left up to the individual. “We have choices.”

Jim Licaretz, 72, on the other hand, said he had no problem with the return of masks. Fully vaccinated and boosted, the Tacony resident has continued to wear a mask indoors even when not required. Yet he shares pandemic fatigue with us all. He said the KN95 masks, in particular, take a toll.

“I get tired of it after a while,” he said. “I really don’t like them.”