L.A. County’s Public Health Chief Discusses the Mask Mandate

Good morning.

Last week, exactly a month after Californians exalted in the state’s grand reopening, Los Angeles County officials announced that masks would be required, once again, in indoor public settings.

The move, which came in response to the explosive spread of the Delta variant of the coronavirus, was an emotional setback for Angelenos, who lived with stringent pandemic restrictions for more than a year.

Case rates have been climbing at an alarming pace, and there are millions of Los Angeles County residents who have yet to be vaccinated.

I spoke with Barbara Ferrer, the county’s public health director, about what’s ahead and why her office decided to return to mandatory indoor masking. Here’s our conversation, lightly edited and condensed.

First, Dr. Ferrer, can you explain why it was necessary to put in place the mandate rather than continuing with mask guidance? You told my colleague a couple of weeks ago that you didn’t intend to “return to lockdown or more disruptive mandates.” What changed?

I guess I would start by saying we don’t consider wearing masks a disruptive mandate at all. Some people might be inconvenienced by it, but it doesn’t disrupt customary business processes.

We were hopeful that more people would mask indoors with the recommendation. With the Delta variant, the situation has changed. I don’t think we’d see a surge in cases without the Delta variant.

All along, this department has been very clear we’re recommending masking indoors because of what we’ve been seeing in other countries with this variant.

Now that we know more, it’s time to mandate masks indoors. This is in line with how we’ve been approaching mitigating the devastating effects of this virus with the evidence at hand.

We had more than 2,500 new cases today. Test positivity is 5.2 percent. All of these numbers reflect behaviors and actions people took two weeks ago.

We were just urging people to wear masks indoors to avoid these big surges. But it will take us another couple of weeks at least to start seeing the benefits.

What are you looking for in terms of being in a place where it’s safe to lift the mandate, if not the masking guidance? How long do you think that will take?

It’s a great question. We made the decision when community transmission moved from a moderate level to a substantial level of transmission. We’re about to move to widespread transmission.

We’d like to get back to a more moderate threshold of community transmission, at which point we’ll be comfortable.

It will indicate that a lot of people adhered to the masking mandate. But getting more people vaccinated is still the most effective way of reducing transmission. So it will take both.

Do you think it’ll be weeks? A month? Months?

It’s hard to say. It’s by far the most infectious variant we’ve ever seen; you end up with more breakthrough cases because it’s a more infectious variant.

I want to commend everyone here who’s gotten vaccinated. That’s 69 percent of people 12 and older.

But that still leaves us with about 4 million people, including around 1.3 million because they’re under the age of 12. The number of people susceptible is huge in L.A. County.

How much is the indoor masking mandate meant to prevent the virus from spreading among unvaccinated Angelenos versus preventing those who’ve been vaccinated from getting sick?

I think it’s both. You don’t want a lot of community transmission because it leads to more mutations. As we’ve seen with the Delta variant, while vaccines are super powerful, they’re reduced. But the loss of life and the most severe health consequences are experienced by far by unvaccinated people.

Many of them are really scared. These aren’t crazy people who are just being obstinate. Before we dismiss people as being completely irresponsible, many actually can’t get vaccinated for health reasons. We all have to commit ourselves to helping people who have concerns in order to make progress.

I do think it will help once the F.D.A. fully approves this vaccine. It will help more private businesses to require vaccines, particularly if they’re serving high-risk people.

Are you concerned at all about undermining trust in the vaccine or trust in public health officials if people have been told they’re much safer and can return to some kind of normal once they’re vaccinated?

I appreciate that question. I wish life were simpler. Everybody would love for us to say one thing and stick to it for five months, but the information we have constantly changes. We all have to acknowledge the reality we’re living in.

This is a new virus. Every time we have a new explosion attributed to the new variant, we’re kind of starting over in the sense that we have to assess how it’s interacting with human beings.

A lot of folks hang onto the optics: Take off your mask, to show we’re really safe again. That was never true. Absolutely, people who are fully vaccinated have much more protection, but we’re going to continue to have variants. That is our reality.

The best we can do is get good information out that’s really transparent about what the data is telling us when things start changing.

I will say for the record, as well, L.A. County has always thought people should continue to wear masks indoors.

Most of us who got vaccinated, we didn’t get vaccinated to take off our masks. We got vaccinated to keep healthy and to get back to doing the things we love.

I’m very open to figuring out if there are alternatives.

Science has to guide some of these decisions. If you’re indoors in a room with fully vaccinated people, your risk of getting sick or passing on infection to others is very, very small — much smaller than if you’re in a room and you’re vaccinated but not everybody is.

In your house, in your own social settings, you have much less risk because you know people. But public places we haven’t figured out. Ultimately, though, we want to wear these masks now, get community transmission low and take a mask mandate off the table.

Should this continue longer than we’d like, we talk to businesses and we’re open to doing what makes sense.

Is there a point where you might need to close down, say, concert venues that are reopening?

I hope not. We can’t definitively take anything off the table. But there would have to be extraordinary circumstances.

More likely, we’d work with venues on requiring folks to either get tested or show vaccination.

I don’t see us going back to lockdowns, hopefully. We have vaccines now. Last time we had no vaccines.

Can you talk a bit about how you’re trying to get more people vaccinated?

This week we have 329 mobile teams out there. We continue to increase that mobile capacity. If you’re a business, if you’re a community provider, if you say, “We’ve got 10 people who might want it,” we’ll show up.

We’ve got people going door to door. We have a huge initiative with houses of worship. We’re working with solo practice medical providers on getting them through the vaccine approval process. It’s much easier to take your child or young teen to your provider to get vaccinated.

We’re working really hard with businesses that employ hourly wage workers to get them to release employees to come get vaccinated. We’ve incentivized it with programs for making up for lost wages if that’s the kind of employment you have. We have a community ambassador program for people to talk to their own friends and family, a student ambassador program, a parent ambassador program.

We’re trying to make sure people have access to good information. I think at this point, for many people, it is about relationships with the people they’re getting information from. One of the worst things can do is trash people who haven’t come in for vaccination.

Social media hasn’t been a friend in many ways. We talk to people and hear so much misinformation. These are myths that have taken on a life of their own.

I appreciate the frustrations some fully vaccinated people have. But I think we need to move forward with kindness, with appreciation, with understanding. I think it’s a strategy question at this point.

For more:

• See coronavirus case rates and vaccination rates across California.

• From anger to acceptance, here’s how Los Angeles County reacted to the new indoor mask mandate.

• If you missed it, read about the Delta variant’s early spread in California and L.A. County’s initial guidance to return to masking up indoors.

• California school districts received a collective $4.6 billion from the state in early March to prepare students for their return to school in the fall and address several issues exposed during the coronavirus pandemic. The Los Angeles Times reports that the size and scope of these programs have been limited by teacher and staffing shortages and other challenges.

• South County schools returned to full capacity for the first time since the start of the pandemic on Wednesday, reports The San Diego Union Tribune.

• Larry Elder, the conservative talk show host, will be on the recall ballot after a Sacramento judge ruled in his favor. The secretary of state’s office had said he had failed to properly submit tax returns. The ruling throws the final list of contenders into some confusion.

• Across the country, local officials — including in Los Angeles County — have looked nervously to their own skylines after the devastating building collapse in Surfside, Fla., and wondered whether a catastrophe might be looming.

• Aiming to curb wildfire risk, Pacific Gas & Electric said it would bury about 10,000 miles of power lines, a process that will cost tens of billions of dollars.

• A couple in California, Refugio Manuel Jimenez Jr. and Angela Renee Jimenez, were indicted by a grand jury on one count each of involuntary manslaughter. Prosecutors are charging them in connection with a deadly wildfire last September that was started by a smoke bomb during a gender reveal.

• The 2022 class of Jazz Masters has been announced by the National Endowment for the Arts. They will be honored at a ceremony at the SFJAZZ Center in San Francisco in April 2022.

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Jill Cowan grew up in Orange County, graduated from U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.