Even in the Bay Area, mask fatigue is increasing rapidly

Colfax couldn’t say when the mask warrants might be lifted, although he and his peers are now expected to offer advice on Thursday. During the meeting, Colfax admitted that masks may be present in some high-risk environments for the foreseeable future. Yekutiel said he understood, but after nearly two years living in fear and uncertainty of a pandemic and dealing with four outbreaks, he was exhausted.

“Not being able to plan what the future will be like… not being able to walk into a store because I forgot my mask, not knowing – it weighs me down,” Yekutiel said. “I’m proud of San Francisco, I’m proud to be here. And then I’m sick of it all.

Even in the Bay Area, where people have widely supported, and even celebrated, public health restrictions that have likely saved thousands of lives, the masks have become the target of more than 18 months of cumulative collective frustration.

Bay Area health officials are expected to reveal criteria counties must meet before they can lift, or at least relax, indoor mask mandates on Thursday. Criteria will likely include case, hospitalization and vaccination rates. It is not yet clear whether any counties will immediately comply with these measures and immediately lift the warrants.

Colfax and others have hinted that the mandates would be relaxed in phases – perhaps dropped in places where people have to prove vaccinations. They can stay in places where vaccinated and unvaccinated mix. Due to state orders, unvaccinated people will still need to wear masks even if the local mandate is lifted, although this requirement is often poorly enforced.

Goal setting should help alleviate some of the public reactions to the masks that have intensified in recent weeks, public health experts have said.

“I don’t know what criteria they’re going to come up with, but I’ll say it’s the right thing. You always have to be clear, ”said Dr Monica Gandhi, infectious disease expert at UCSF. If health officials can’t set goals for people, if they can’t explain the decisions they make, “people get frustrated and at some point it will spill over,” he said. she declared.

It’s already the case. At a public meeting in late August, a Santa Clara County supervisor urged Dr. Sara Cody, the hugely popular health worker, to know when the warrants could be lifted there, arguing that goal setting is essential to maintain public confidence. In mid-September, the Mayor of London Breed – who has been a notable supporter of his public health service – came under scrutiny when she was spotted in a club without a mask, and she was is unleashed in response; this week, she said the mandate review was “overdue”.

Santa Cruz County last week became the first county in the Grande Baie region to abandon its indoor mask mandate after reaching “moderate” transmission levels as defined by the Centers for Disease Control and Prevention . While the county still urges all residents to wear masks indoors, most businesses immediately stopped requiring them.

When the county health department reinstated the mask’s mandate on August 19, it included criteria to end the mandate. It was deliberate, said Dr David Ghilarducci, the assistant health worker.

“We thought it was important to communicate to the community that there was an off switch, that it was not perpetual,” he said. “We thought it was important to give the audience a break, to give them some credit for their collective action which made things better. And, of course, if things go wrong again, we always have this tool in our back pocket. “

The masks have come under intense scrutiny lately, in part because they are part of the latest universal pandemic protocols in effect in the Bay Area. There is no longer any social distancing or capacity limits. Vaccination mandates apply, but only affect those who have not been vaccinated.

And the masks are also the most visible sign that the region is still under attack in this pandemic.

“We’ve had relatively little of this libertarian idea of ​​’liberty’ and ‘liberation’ with masks in the Bay Area,” said Dr Robert Wachter, chief of medicine at UCSF. “But the psychological part of ‘I want my life back’ is a powerful human instinct. It all sucks and we’ve been going for a long time. Masks have assumed a symbolic role as the most visible everyday sign that we are still in.

Bay Area counties were among the first in California to reinstate mask warrants in early August, when cases began to skyrocket in the delta surge. The California Department of Public Health has never reinstated universal masking, although state orders requiring masks in schools and healthcare facilities are expected to remain in place for the foreseeable future.

Like the rest of the state, the Bay Area had largely abandoned its mandates when California reopened on June 15. Health officials have been encouraged by the first reports that highly effective vaccines could prevent infections and stop the spread of disease.

But delta quickly undermined the state’s reopening and forced many health experts to reassess their understanding of vaccine effectiveness. Vaccines continue to provide strong protection against serious illness and death, but are not as successful in stopping infection or transmission. This meant that everyone had to hide again.

In some ways, figuring out when masks can pull off again is a much more complicated challenge. Masks are attractive for pandemic control because of their cost-benefit ratio – asking people to wear masks is not that difficult, and they are clearly helping to slow the spread of the disease.

“The moment you give up a mask mandate, you are giving up one of your key interventions,” said Dr Abraar Karan, an infectious disease expert at Stanford. The return of the masks this summer likely played a significant role in crushing the delta’s surge before it overwhelmed hospitals, he said. “It worked, and I understand why a lot of health departments are reluctant to revisit it. “

The Bay Area currently averages about 10 cases of coronavirus per 100,000 people per day – less than half of the summer peak in August, but still three or four times the rate when the state reopens in June. Likewise, hospitalizations have dropped rapidly from the summer peak – from around 1,100 in mid-August to less than 500 this week – and are still three times higher than in June.

And the region is heading into another fall and winter, as most experts predict another swell in cases. Declining immunity can also present challenges, with boosters just starting – and children under 12 are still not eligible for the vaccine. “Now might not be the best time to take off the masks in a hurry,” Karan said.

For many people who suffer from mask fatigue, the frustration is less about wanting to remove their face covering immediately than it is about not understanding how warrant decisions are made.

When Yekutiel asked Colfax at the Mission District event when the warrant could be lifted, Colfax was vague in his response. At one point he hinted that he might wait until children aged 5-11 are eligible for vaccination, which could happen as early as this month – but those kids won’t be fully vaccinated until November or December at the earliest.

“It feels like the goalposts keep moving,” Yekutiel said in an interview this week. “I don’t envy the public health folks because their job is to keep everyone safe and use the best information they have. But there is that feeling of ‘you all told us to get vaccinated, and we did’. You asked us to restrict our spaces to vaccines only, and we are doing it. But we are running out of things to do on our part.

Even those who support masks in general say they have a hard time not knowing how long the warrants will be in place. Terry Asten Bennett, co-owner of Cliff’s Variety, a gift shop in the Castro district, said the San Francisco mask tenure has helped her stay open and keep her staff and customers safe. Maintaining the mandate over the winter would help give it stability during the critical holiday shopping season.

“There is already a lot of uncertainty about this winter,” said Bennett, who is facing Halloween stock shortages and preparing for a chaotic Christmas. “Financially, we need this winter to be successful. We need to keep our economy open and healthy. And masks are the easiest way to do it. “

Erin Allday is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday