States, Counties Consider Mask Mandates as Delta Variant Spreads

Carolyn Crist

July 20, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

States and counties are beginning to consider mask mandates again as the contagious Delta variant spreads, according to USA Today.

Los Angeles County announced this weekend that masks would be required indoors, though the sheriff said he wouldn't enforce it. California counties around the Bay Area are recommending masks indoors, and states with major Delta variant outbreaks — such as Arkansas and Missouri — are weighing the idea as well.

"Instead of vax it OR mask it, the emerging data suggests CDC should be advising to vax it AND mask it in areas with (rising) cases and positivity — until we see numbers going back down again," Jerome Adams, MD, the former U.S. surgeon general, wrote on Twitter on Saturday.

The seven-day average for daily COVID-19 cases has nearly tripled in the U.S. during the past month, USA Today reported. Hospitalizations and deaths have also increased sharply in the past two weeks.

Kentucky Gov. Andy Beshear issued new mask recommendations on Monday, asking unvaccinated people to wear face coverings when they're indoors and not in their homes, according to Newsweek.

After months of declining cases and hospitalizations, Beshear said, Kentucky is seeing an increase again due to the Delta variant. He cited concerns about breakthrough cases in vaccinated people as well.

"The Delta variant is serious, and it is even a deadly threat to non-vaccinated Kentuckians," he said during a press conference.

"Vaccines are still offering significant protection again serious illness and death, including against the Delta variant," he said. "But we are seeing more cases among vaccinated Kentuckians because of the Delta variant."

Beshear also recommended that people with pre-existing conditions wear masks, regardless of vaccination status. Employees who interact with a large number of customers each day — particularly those in hospitality, restaurants and retail — should also wear a mask, he said.

"I'm not picking on any industry," he added. "Just where the individuals come in contact with a lot of people, we are recommending at this point that you wear a mask."

Looking ahead to the fall, the American Academy of Pediatrics issued new COVID-19 guidelines for schools on Monday, including a recommendation that everyone over age 2 should wear masks, even if they have been vaccinated.

The group also promoted a variety of tactics to prevent the spread of COVID-19 at schools, including vaccination, ventilation, testing, quarantines and disinfection. However, universal masking could reduce overall transmission of the virus, the group said, especially because students under age 12 aren't yet eligible for a vaccine.

"There are many children and others who cannot be vaccinated," Sara Bode, MD, chairperson elect of the group's Council on School Health Executive Committee, said in a statement.

"This is why it's important to use every tool in our toolkit to safeguard children from COVID-19," she said. "Universal masking is one of those tools and has been proven effective in protecting people against other respiratory diseases as well."


USA Today: "States, counties consider mask mandates."

Twitter: @JeromeAdamsMD, July 17, 2021

Newsweek: "Kentucky Gov. Pushes for Masks After Fully-Vaxxed Lawmakers Catch COVID Amid Delta Surge."

YouTube: Governor Andy Beshear, July 19, 2021

American Academy of Pediatrics: "COVID-19 Guidance for Safe Schools."

American Academy of Pediatrics: "American Academy of Pediatrics Updates Recommendations for Opening Schools in Fall 2021."


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.