Philadelphia reversed its decision to bring back indoor masking on Friday after just three days, and at the same time scrapped a new public health department COVID-19 response system that made it the only large U.S. city to bring back a mask mandate this spring.
Health officials and Mayor Jim Kenney offered differing reasons. While the health commissioner framed the decision as one driven by data and science, Kenney cited politics and logistics. The day the mandate went into effect, a Florida judge struck down a federal rule requiring masking on public transit. Regional transit agency SEPTA lifted its requirement that people wear masks on its vehicles later that day.
That left Philadelphia with rules that came into conflict inside bustling locations like Philadelphia’s main airport terminal, where the city mandate required that passengers mask up even though they could remove their facial coverings onboard airplanes. Business owners and some residents cried foul over the mandate’s return, and a group sued the city arguing the mask requirement was illegal.
“Clearly this has become such a huge issue, such a political issue, it was hard to get people to do it,” Kenney said, noting that the city’s COVID case counts had also started trending in a more favorable direction. “Our hospitalizations are going down. It seemed like the time to reverse it now.”
Without the federal opinion, the mask mandate might have stayed in place for “a couple more weeks to get the numbers down even further,” he said.
The move marked the end of a two-month-old risk assessment system designed by the Philadelphia Department of Public Health to create clear markers for when to impose precautions to counter COVID’s spread. A new system likely won’t take its place, health commissioner Cheryl Bettigole said.
The withdrawn restriction, though, was not an indication that the risk from COVID is gone, she said.
“We’re going to have to continue to be careful,” Bettigole said. “This is not a time when we should say ‘woo-hoo!’ and throw our masks off and go to parties.”
The number of people hospitalized in the city with COVID had declined for two consecutive days to 65 people on Thursday, which health officials cited as evidence that the BA.2 subvariant circulating this month wasn’t going to lead to a significant surge in hospitalizations.
By Friday, hospitalizations had ticked back up to 71 people, but the health department said such fluctuations were to be expected. The city’s hospitalization rates have stayed largely flat over the past two weeks while other big cities, as well as Pennsylvania and New Jersey, have reported increases.
Case counts have fluctuated this week, with the most recent count at 221, a decline from Thursday, although they are now considered less reliable markers due to the rise in at-home testing.
The Philadelphia Board of Health voted unanimously on Thursday night to end the mask requirement, which also ended mandatory masking at Philadelphia International Airport.
Bettigole warned the public about rising COVID case counts starting the first week of April, before it announced the renewal of the mask mandate on April 11. Businesses had a one-week grace period to prepare before mandatory masking took effect this week. Public health warnings were heeded, she said, and people masking before the mandate officially went into effect played a role in reducing hospitalizations.
“This isn’t because of enforcement starting three days ago,” said Bettigole. “It’s the response earlier than that of people being aware of something going on that they need to take action.”
Bettigole has previously said recommendations were less effective than mandates in getting people to follow safety precautions, but revised her stance during a news conference on Friday.
“I still think that letting people know that early warning sign of an increase in cases is very useful, I just don’t think we need to do that with a mandate at this point,” she said.
Seeing hospitalizations begin to drop shortly after cases increased indicated a break from earlier pandemic patterns, Bettigole said. This prompted the end of the tiered system of benchmarks that the city had introduced to decide when safety precautions were needed.
“The idea of building a different system on updated metrics doesn’t really make a lot of sense,” Bettigole said.
The city would continue issuing warnings as needed, and watching the percent increase in cases would continue to be valuable, Bettigole said.
Brian Zikmund-Fisher, a professor and expert in health risk communication at the University of Michigan School of Public Health, said abrupt reversals in guidance can backfire, and that a better approach with masks might be education and encouragement, rather than mandates.
“The back-and-forth about guidance has clearly undermined people’s trust in public health authority,” he said, noting that he was not specifically criticizing Philadelphia. “People are saying ‘They can’t make up their minds, so why should I believe them, whatever they say?’ ”
It’s unclear how much masks can be credited for the latest COVID numbers. People being outdoors and opening windows due to warm weather could be just as likely to hinder the virus’ spread, said Michael LeVasseur, a Drexel University epidemiologist.
“We may never truly know how much of an impact this has on case counts,” he said of masking, “but at the very least it serves as a signal to say to people ‘hey, be more alert.’ ”
Bettigole said the quick reversal on masking doesn’t hurt the health department’s credibility. She also did not completely rule out the mask mandate’s return. If a more severe or contagious variant reared its head, the city would likely reconsider, she told reporters.
“It really is consistent. We’re doing what we promised to do. We announced these metrics back in mid-February based on the existing data that we had then and we’ve said we would reevaluate them based on data in future waves.”
The change of direction created local confusion, just as the mask mandate itself did. Several members of City Council questioned why just a few days earlier the city felt a mandate was warranted. In comments last week, health officials had said it would likely take weeks to determine whether the mask requirement should be withdrawn again.
“If the reason [Bettigole] made the mandate is a spike in the numbers, I can believe that,” said Councilmember David Oh. “But the sudden ‘oh, it’s OK, forget it now?’ That seems to be suspect.”
City Councilmember Mark Squilla said the disconnect between having a city mask mandate that contradicted with federal guidelines led to confusion for businesses and residents.
“I was hearing frustration from a lot of folks, not just businesses, on what policies are they following,” Squilla said. “And then seeing a mask mandate, but nobody really enforcing it, it was troublesome for everyone, so maybe the administration saw that and moved forward.”
Asked by reporters on Friday about whether health officials felt pressure to rescind their rule after SEPTA lifted its mask requirement, Bettigole credited Kenney with trusting the science.
But Kenney complained that his administration “didn’t expect SEPTA to do what they did” and wasn’t consulted by SEPTA, a regional authority governed by a board with representatives from the city and surrounding counties.
“Wearing a mask is not a burden,” he said, “but it’s become a political and cultural burden for some reason I can’t explain.”
Staff writers Sean Collins Walsh, Sarah Gantz, and Tom Avril contributed to this report.