Pima COVID mask mandate will end Feb 28 after supervisors nix extension

Despite recommendations from county staff, a December measure requiring the use of masks in indoor public places will expire on Feb. 28 after the Pima County Board of Supervisors refused to extend the mandate for another month.

As the county was wracked by a rising wave of COVID-19 cases driven by the Omicron variant, the Board of Supervisors voted on Dec. 21 to reinstate a requirement that people wear masks in all indoor establishments where continuous physical distancing of at least six feet is not possible, allowing for few exceptions. Last week, Acting Administrator Jan Lesher recommended the board extend the measure for another month, keeping it in place until March 28.

In a Feb. 8 memo, Lesher asked to extend the mandate, noting that the measure allowed the supervisors to reconsider their choice "depending on the progress of the pandemic," and she said that county experienced more COVID-19 cases, more deaths, and had a higher positivity rate from COVID-19 tests than when the supervisors voted for the mandate.

"Although it is clear that the Omicron surge is beginning to recede, community transmission continues to occur at a concerning level and schools, workplaces and hospitals continue to be substantially impacted," Lesher wrote.

However, while the original measure passed in a 3-2 vote with Board Chair Sharon Bronson casting the deciding vote, Bronson switched sides Tuesday, joining with Supervisors Rex Scott and Steve Christy in slapping down the extension.

While Christy complained that it was "painfully obvious" the measure had to end, Scott argued the lack of enforcement made the county a "paper tiger" that could be unable to enforce future health measures.

The change will not affect the mandate for mask wearing in county buildings, but will add pressure to local school districts that have maintained mask mandates since the school year began in August.

As case numbers continue to drop following a historic surge in COVID-19 cases driven by the Omicron variant, governors and local government officials across the country have begun to drop mask mandates — despite the recommendations from the CDC and their own health departments.  Over the last week, officials in California, Connecticut, Delaware, Illinois, Massachusetts, Nevada, New Jersey, New York, Oregon and Rhode Island announced end dates for masking requirements in indoor public spaces.

Last Friday, the county reported 381 cases of COVID-19, far from the massive peak of cases on Jan. 19 when Pima County reported 3,500 cases in a single day. Similarly, on Tuesday, the Arizona Department of Health Services reported another 1,740 cases and five new deaths.

Since the pandemic began, there have been more than 1.9 million COVID-19 cases in Arizona, and 27,186 people have died from the disease. This includes over 539,000 cases reported in Arizona after New Year’s Day, as the number of cases accelerated because of the Omicron variant.

On Jan. 10, 2022 the pandemic peaked with 26,179 cases in a single day, and on average there were 12,539 cases per day in Arizona. This far exceeds the pandemic's previous record when there were 12,460 cases in a single day on Jan. 4, 2021.

And, since New Year's Day, another 1,800 people have died, according to ADHS.

Dr. Francisco Garcia, the county's chief medical officer, said that since Lesher's memo was written, it was "clear the Omicron surge is beginning to resolve," however, while cases show a clear sign of declining, the county still reported more cases than it had when the mandate was implemented in December.

Garcia told the board that there were 3,375 new cases of COVID-19 last week—down from 5,443 reported a week earlier. Additionally, the rate of positive COVID-19 tests has declined over the last week, going from 19 percent on Feb. 8 to around 15 percent this week, Garcia said. Despite this decline, the county's positivity rate remains 66 percent higher than it was in December.

In fact, by every metric but hospitalizations, the county's current figures are higher than they were when the board voted for December's mandate, or the original mandate made during the early days of the pandemic.

In June 2020, the Board of Supervisors voted for the first mask mandate, requiring masks throughout the county. At the time, the county reported 2,115 cases per week and endured 55 deaths. Similarly, the number of cases per 100,000 people was around 201, and overall test positivity was at 12 percent. A year later, the board decided to remove the mandate in July 2021, when cases waned over the summer.

When the board agreed to remove the first mandate in July 2021, there were around 369 cases per week, and overall testing positivity was at four percent.

While masks—especially N95/K95 and surgical masks—appear to be effective at limiting the spread of COVID-19, mask mandate have been controversial. During the call to the audience at the beginning of the meeting, several people attacked the mandate, especially because the county-wide mandate extended to school districts like Vail Unified School District, Marana Unified and the Tanque Verde Unified School District where mandates are unpopular.

During a meeting two weeks ago, Garcia told the Board that the pandemic has been "particularly tough on schools," adding that there were 6,633 cases reported by school districts just in January. "That's a staggering amount by any judgement," he said, noting that around 44 percent of children who were infected by COVID-19 were under the age of 11, and around 39 percent were 12 to 19.

"Masks continue to make sense," he said, adding that they "are very effective at reducing COVID-19 transmission." He added that while the CDC has recommended people upgrade to N95/KN95 masks and surgical masks over cloth masks, "any mask is better than no mask."

"The most important feature of the mask is the person who's wearing it, and the willingness to keep it on," he said. He also added that there are dozens of publications recommend mask wearing. In Sept., the CDC released a study evaluating Arizona schools and found that schools without mask mandates were 3.5 times more likely to experience an outbreak of COVID-19.

While this study was criticized for its methodology, data from districts in Tucson from August to December showed that mask mandates helped blunt the number of COVID cases among students.

At Tucson Unified School District, the largest district in the county, there were 2,102 cases during that first semester, with an enrollment of nearly 46,000. However, when adjusted for the number of cases per student, the district had around 4.6 cases per student, one of the lowest rates in the county, second only to Altar Valley Elementary District, which has just 639 students. Meanwhile, the Vail School District, which avoided implementing a mask mandate, had 981 cases among nearly 13,400 students, an incidence rate of 7.3, or nearly 160 percent higher.

On Feb. 4, the CDC released a new study, which found that among residents of California who reported wearing masks in indoor settings from Feb. to Dec. 2021 were less likely to be infected by COVID-19. Those who wore cloth masks were 56 percent less likely to test positive for COVID-19, those who wore surgical masks were 66 percent less likely to test positive, and those who wore N95 or KN95 masks were 83 percent less likely to test positive.

"Although consistent use of any face mask or respirator indoors was protective, the adjusted odds of infection were lowest among persons who reported typically wearing an N95/KN95 respirator, followed by wearing a surgical mask," wrote researchers from California's public health department. "These data from real-world settings reinforce the importance of consistently wearing face masks or respirators to reduce the risk of acquisition of SARS-CoV-2 infection among the general public in indoor community settings."

As Jessica Rigler, the assistant director for public health preparedness with the ADHS, wrote "Masking up and being up to date on COVID-19 vaccinations are a powerful combination when it comes to reducing the risk of testing positive."

Despite Garcia's recommendation, Christy argued that the measure should end.

"It's painfully obvious that this mask mandate needs to be allowed to expire," he said, arguing that "promises have been made" about the pandemic and the necessity of masks and vaccinations. "We've followed the rules, we've worn the masks, we've gotten the shots. We've done all the protocols," he said, adding that the new variant, Omicron, "changes everything" because it's less virulent. He added that the county had a "high rate of vaccination," and argued that there was also "a high rate of herd immunity that we don't talk about anymore."

Christy voted against the original mandate in 2020, joining then-Supervisor Ally Miller, and he voted against the mandate again in December 2021, along with Scott.

"The community is exhausted over this. There's no need to carry this mask mandate any further," he said. "It needs to expire and it needs to expire now." 

Scott argued that the measure made the county a "paper tiger" because it lacked enforcement, reiterating a complaint he made in December

"When we voted to put the current mandate in place I said at the time that I thought that the people who agree—as I do—that masks should be worn in group settings already wear them," Scott said. "But that those who were not were not more likely to do so because Pima County said they should."

"I feel even more strongly two months later that that is the case," he said. Scott argued that the lack of enforcement meant that masks were not actually mandated, and that calling the measure a mandate was "confusing and misleading."

"If we need in the future to impose any kind of public health mandate in the future, the lack of enforcement will hinder the effectiveness of that action," he said.

Christy questions quarantine orders

During Tuesday’s meeting, Christy also questioned how the county issued quarantine orders, citing one instance when a Pima County Constable delivered an order to a family home.

In documents submitted to the board by Christy, a parent complained that she was served a quarantine order by Constable Kristen Randall. The parent, April Sample, was served the order after her family ignored an order to quarantine their daughter. Sample wrote that the Vail School District told her to quarantine her daughter, but “knowing that our school cannot force us to quarantine, they can only recommend, and my daughter wasn’t sick, so I sent her back to school on Tuesday,” Sample told Christy. Following this move, the Pima County Health Department issued a quarantine order, and sent Randall to deliver the order on Nov. 3, 2021.

In her email, Sample complained to Christy that the order was left on her door by the constable, and said she would not pay a bill issued by the county for the delivery of the legal order. “I will not pay it as I was not the one that hired the Pima County Constables office to deliver said order,” Sample wrote to Christy, arguing that she didn’t know how to fight what she claimed was a violation of the Health Insurance Portability and Accountability Act.

Christy pressed on Garcia, asking how the Pima County Health was "triggered" to order the quarantine of a student. Garcia said that when Gov. Doug Ducey declared an emergency under state law during the beginning of the pandemic, it allowed local health authorities to require isolation or quarantine, "when it was in the interest of protecting the health of the public."

"We have the ability to issue a written directive to isolate or quarantine, and we do so by issuing an order," said Garcia. "To be clear, since the pandemic, we have issued 6 such orders, and they only occurred since the current school year," Garcia said. "The reason we haven't had to issue is more frequent orders is because parents and school districts are trying really hard to do the right thing. Those parents follow the recommendation of the health department."

"At the point we are notified by the school district or school that they, the parents of the student intend not to comply with the recommendations of the Health Department," the county will issue a quarantine order, Garcia said.