As the highly contagious delta variant fuels COVID-19 case spikes among the unvaccinated in many parts of the country, Philadelphia health officials said Thursday they now “strongly recommend” that everyone — including the fully vaccinated — wear masks inside public places.
James Garrow, a spokesperson for the city Department of Public Health, said officials are concerned about a small increase in hospitalizations among children too young to be vaccinated. Vaccines are only approved for people 12 and older. National statistics also point to trouble ahead.
“It’s time for all of us to do what we need to do to protect our city’s kids,” acting health commissioner Cheryl Bettigole said in a written release. “That means getting fully vaccinated if you haven’t yet, and it means all of us going back to wearing masks in public.”
Overall, COVID-19 case rates are rising again in Philadelphia and the surrounding region but are still well below peak levels. For two weeks in late June and early July, the city had only about 24 cases per day. As of Thursday, the two-week average was 64. There has been on average less than one death per day in the last month.
The nation is now averaging close to 38,000 cases a day, up from just over 11,000 in mid-June, according to the U.S. Centers for Disease Control and Prevention. Hospitalizations and deaths are also starting to rise, especially in states with low vaccination rates.
“Now is the time to take action,” Garrow said. “Doing it now will help us head it off before it gets to a point where it really gets bad.”
Asked this week how close New Jersey was to re-imposing mask guidelines or other restrictions, Gov. Phil Murphy said at his regular coronavirus briefing, “We’re not there yet. We continue to be comfortable with where we are, but we watch this like a hawk. And our strong, strong, strong preference is to not go back.”
Philadelphia’s new recommendations call for everyone to wear masks indoors when they don’t know if others are vaccinated. Unvaccinated people, Garrow said, should consider double-masking when inside with others. Socializing outside is still the safest bet.
Masks are still required in healthcare settings, public transit, schools, childcare, indoor camps and congregate living facilities in Philadelphia.
This recommendation does not stop people from eating — you have to take your mask off to do that — inside in restaurants. Garrow said officials do not yet think it is “unsafe” for vaccinated people to eat in restaurants.
Because there’s currently no way to know whether the unmasked people shopping with you are vaccinated or not, the health department thinks it’s better to “normalize” mask wearing for everybody. The city considers it too burdensome to ask businesses to check vaccine status when customers enter. Plus, Garrow said, it’s not much trouble for people to put on a mask. “We’ve all been wearing masks for months and months,” he said.
Doctors said that as the COVID virus mutates and more contagious variants emerge, it’s reasonable for health officials to revisit their safety guidance.
“People need to be a little bit open to the fact that what is appropriate today may not be appropriate tomorrow,” said Jennifer Khelil, the chief medical officer of Virtua Health System. “It’s not whether it’s right or wrong to wear a mask, but what are the data telling us and what can we put in place to protect the largest number of vulnerable people. Wearing a mask is not harmful to anyone. Not wearing a mask might expose folks.”
The CDC now says fully vaccinated people don’t need masks in most settings, but the Washington Post this week reported that federal officials are debating whether to recommend stronger public health measures. The World Health Organization still encourages masking.
Eight counties in California, including Los Angeles County, have recently either recommended or required that people wear masks in indoor public spaces regardless of their vaccination status. Case counts in Los Angeles are far higher than in Philadelphia.
A spokesperson for Chester County said “its health department does not provide general guidance on masking (although summer camp guidance was given earlier in June),” but they continue to encourage vaccinations.
Montgomery, Delaware and Bucks counties have no plans to change mask guidance at this time.
“Delaware County Council and the Delaware County COVID-19 Task Force continue to monitor national trends which show an alarming increase of positivity and hospitalizations among the unimmunized,” a spokesperson said.
“I think it’s a mistake,” Bucks County Health Commissioner David Damsker, who is a doctor, said of Philadelphia’s decision to encourage indoor mask-wearing. “It completely undermines the message that the vaccine is safe and effective.”
Some people got vaccinated only because they were told they wouldn’t have to wear a mask anymore, while those who remain unvaccinated may dig their heels in even more. Health officials note that the vast majority of hospitalizations and deaths now are happening in the unvaccinated.
Damsker said he does not think it’s productive to return to mask-wearing and social isolation. Rather, he thinks people should “flip a switch” on how they think of COVID to view it as a chronic communicable disease, like influenza — there is always a risk, but with a vaccine and effective treatment, people feel safe going about their lives.
“I don’t want to be on this COVID treadmill,” he said. “It doesn’t mean we’re not taking it seriously or it’s not real or can’t kill people — it can — that’s why we tell people to get vaccinated.”
While more than half of all Americans still are not vaccinated, the number of people seeking shots has slowed considerably in recent weeks. Polls show that there is still resistance to shots among Republicans and some racial groups.
Experts say vaccines provide very good protection against the virus, including the delta variant, which is now causing more than 80% of cases. Some “breakthrough” cases are expected among vaccine recipients because the vaccines are not 100% effective. Philadelphia has been tracking breakthrough cases since January and has found that vaccines are holding up well. Fully vaccinated people have accounted for only 1.3% of new cases, 1.5% of hospitalizations and 1.4% of deaths.
At this point, about 61% of eligible Philadelphians are vaccinated. Providers have been administering 18,000 to 20,000 vaccine doses per week since June. The city’s lowest vaccination rates are in North and West Philadelphia but there are pockets of low vaccination in the lower Northeast and far Northeast. By race, the vaccination rates are 48% for African Americans, 61% for Hispanics, 62% for whites and 88% for Asians. Garrow said the vaccination rate among Hispanic residents has improved greatly in recent weeks and may soon surpass that of whites.
Gov. Murphy noted that New Jersey was “among the most vaccinated states in the country, and that’s a huge positive.” He also said thousands of shots are still being administered per day. ”Our strong hope is that we can stay as we are,” he said.
Health commissioner Judith Persichilli said health officials were closely monitoring the case numbers, particularly in children, and that although hospitalizations have risen somewhat they are still low, as are numbers of patients in the ICU. “Severe disease seems to be under control,” she said.
Staff writers Allison Steele and Erin McCarthy contributed to this story.