The Montgomery County Council, acting as the Board of Health, unanimously voted on Tuesday to relax the coronavirus metrics that dictate when mask mandates in the Maryland county can snap back into effect.
The county will now reinstate a public indoor mask mandate only if it sees seven consecutive days of what the Centers for Disease Control and Prevention calls “substantial” transmission.
Before, the mask mandate was automatically triggered as soon as the county crossed the substantial transmission threshold.
This led to widespread confusion when the county lifted its indoor mask mandate last Thursday in the wake of improving COVID-19 case numbers — only to have the county fall back into substantial transmission status two days later.
That in turn meant the county would have had to reimpose the mask mandate this Wednesday — because it still had to give four days’ notice of the move — unless the council acted to amend the emergency health regulations, which is what it did Tuesday.
The council also unanimously approved an amendment that would do away with indoor mask mandates altogether once 85% of the total population in the county is fully vaccinated.
The council will rely on CDC data to determine when the county hits that benchmark; currently, 77.5% of the population is fully vaccinated.
In the meantime, lengthening the transmission snapback period will avoid what council members called “flip-flopping” on mask mandates, which apply only to indoor public settings — not to schools or to private businesses, which can decide their own mask policies.
By the numbers
The CDC defines substantial transmission as 50 to 100 cases per 100,000 residents over the past seven days (or a positivity test rate of 8% to 10% over seven days).
On July 27, in the wake of the rapidly spreading Delta variant, the agency recommended that people living in communities of substantial or high COVID-19 transmission wear masks in indoor public spaces.
In response to the guidance, the Montgomery County Council adopted a resolution on Aug. 5 to automatically trigger a mask mandate when the county fell into substantial transmission.
Last Thursday, when Montgomery County achieved “moderate” transmission — less than 50 cases per 100,000 residents for seven days straight — the mask mandate was lifted. But the respite was brief because the county went above 50 cases by Saturday, leaving open the prospect that the mask mandate would come right back.
Now, the county needs to be in the substantial category for seven consecutive days before the mandate goes back into effect. There’s also a four-day notification period that gets tacked on to those seven days.
So what does that mean at the moment? If coronavirus case numbers don’t improve, Friday will mark the seventh straight day of substantial transmission. At that point, the county will have four days to reinstate the mask mandate.
So by next Tuesday morning, residents could again be required to wear masks indoors unless the county dips out of the substantial range between now and then. If that happens, the clock starts over.
Sticking to the science
Confused much? County Council President Tom Hucker acknowledged the frustration among residents, but he pointed out that officials are dealing with an unprecedented, and unpredictable, global pandemic.
He noted that when the council passed the original mask order in August, boosters for the elderly and immunocompromised weren’t yet available, and it was unclear if vaccines for children would be approved.
Hucker also said that by following the science, Montgomery County has become a national vaccination leader.
“We all wish the CDC had clearer guidance on this topic for local governments, but they don’t,” he said during the virtual council meeting. “I want to reassure the public that we are doing the best we can with the information we have, following the guidance of our nonpartisan professional public health team.
“In a county of 1 million people, we don’t expect everyone to agree,” Hucker acknowledged, but he said that among all of the medical professionals he has consulted, none recommended removing mask mandates in the short term.
“So I’m proud of this board of health. We’ve received a lot of criticism, and even threats at times, because we’ve taken a cautious approach,” he said. “We follow the advice of our professional public health teams throughout the pandemic, and I think because of that, we’re performing better than the great majority of jurisdictions in this nation.”
Doing away with masks altogether
That didn’t sway the handful of residents who spoke during the public comment period. Five of the six residents supported doing away with mask mandates altogether, citing the county’s high vaccination rate.
Margery Smelkinson, an infectious disease scientist, said that relying on COVID-19 case numbers is a flawed metric because many cases nowadays are mild or asymptomatic — not severe or fatal. And, as many experts have pointed out, we will be living with COVID for years to come.
“Given our amazing vaccination rate, counting infections is simply the wrong metric to determine restrictions,” she said, adding that because the county’s asymptomatic surveillance testing system is so effective, “it may be years before we consistently meet the CDC standard for unmasking.”
Smelkinson said a more accurate way to guide mandates would be hospitalization rates.
“For comparison, we don’t implement restrictions during a typical flu season, which often has five times as many hospitalizations as we have now for COVID. Perspective has been warped and we need to regain it,” she said. “A low hospitalization rate means that the disease is well managed and presents low risk to county residents. Many of us are frustrated and want normalcy for ourselves and our children.”
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Paul Meyer, the parent of a 2-year-old, agreed, saying, “The best thing that we can do to protect young children is for the people around them to be vaccinated. And in a county with a 99% vaccination rate, we’ve taken care of that.”
He added that “we can’t pretend there aren’t any harms to children from long-term mask-wearing when the conditions don’t warrant it.”
Another parent, Bradley Jensen, said the county’s “insistence on mass mandates has required my family and others to remove our children from Montgomery County schools, and to take the bulk of our business to counties where masks [aren’t] required so that we can enjoy the freedoms that come with unmasking.”
‘We’re almost there’
But as Council Member Hans Riemer pointed out, the debate over masks in schools was a moot point because it’s the county’s Board of Education — not the council — that determines mask policy for students.
As for masking up in other indoor public spaces, several council members said the county is in the enviable position it is in now precisely because it’s been following the science.
“From the very beginning, we were making sure that we made decisions based on CDC guidance. That’s how we led this effort, and that’s why we’re at the high percentage of vaccinations and low percentage of hospitalizations,” said Council Member Craig Rice.
And while the county boasts a high vaccination rate overall, Rice said that many pockets remain unvaccinated, especially young people. Even with CDC approval of vaccines for younger children, it will take time to vaccinate everyone.
Rice also pointed out that while the residents who spoke at the meeting opposed mask mandates, he has spoken to many constituents who worry about mandates being lifted too early.
He urged everyone to be a little more patient.
“We’re almost there, and so there’s no reason now to throw caution into the wind. We need to make sure that we remain committed and vigilant, like we have been, protecting our most youngest and vulnerable. And then once we get there in terms of a percentage of those vaccinated, we can move forward.”
All nine members of the council agreed the county can move forward with dropping mask mandates once 85% of the population is vaccinated.
Council Vice President Gabe Albornoz said this new goal might even incentivize vaccine holdouts to get the shot.
“As we’ve known for quite some time now, all roads to getting on the other side of this lead through vaccinations,” he said. “So once we hit that threshold, I think it will be not just great news in our fight against this virus, but it will also … trigger yet another important milestone as we try to get on the other side of this.”