Masks or not? Without state mandates, local leaders debate next steps amid COVID surge

Update: NY requiring masks indoors unless businesses require vaccine for entry. What to know.

With COVID-19 cases climbing across New York, local leaders are deliberating over whether to implement indoor masking or other measures after Gov. Kathy Hochul’s administration made clear that, for now, no sweeping statewide mandates are coming.

COVID cases and hospitalizations have been steadily rising as New Yorkers head into the holidays with the statewide 7-day rolling average of positive tests nearly doubling over the past month and reaching levels not seen since nearly a year ago.

While Hochul stressed last week that she is prepared to install COVID safety measures if the virus' spread worsens, she said she doesn’t want to stymie local decision making, which was a common complaint about former Gov. Andrew Cuomo’s policies.

"Ignoring local health departments is not a strategy I’m going to be engaging in," Hochul told reporters last week. "We don’t need that one size fits all approach, but I’m prepared to make everything statewide if necessary.”

Hochul, who continues to urge vaccinations and encourage mask wearing among residents, faced political pressure to take a stronger statewide stance as she run for a full term next year.

“This cannot be done municipality by municipality,” said Attorney General Letitia James in a statement Monday. “New York state must finally lead.”

James was, until Thursday, one of several Democratic candidates in the 2022 gubernatorial race, and was viewed as a formidable challenger to Hochul's bid for the seat. James ended her run Thursday, saying she would instead run for reelection as attorney general.

Without statewide mandates in place, only a few counties have taken steps toward countywide restrictions, some of which have drawn the ire of residents and other leaders who say things like masking should be matters of personal choice.

Meanwhile, in New York City, outgoing Mayor Bill de Blasio further limited access to many indoor activities for unvaccinated people, imposing some of the most expansive vaccine mandates for workers in the country.

With the two-year anniversary of COVID’s arrival in New York approaching, leaders are fighting fatigue and political opposition from their constituents, with almost any COVID decision drawing criticism that it is too much or not enough, some of them said.

“There’s a fervor,” Chautauqua County Executive Paul M. Wendel Jr. said.

“Two days ago, I probably had two dozen letters questioning my research…We’ve been told we’re committing crimes against humanity for encouraging people to get the vaccine. And I’m not the only one. This is every county leader,” he said.

No COVID mandates in NY: No new statewide mandates immediately planned, Hochul says

More: NYC to impose vaccine mandate on private sector employers. When it starts

Local leaders split on next steps

In western New York, where the 7-day average of positive tests stood at more than 11% as of Monday, Erie County Executive Mark Poloncarz last month implemented an indoor mask mandate, requiring residents to wear masks in grocery stores, restaurants, gyms and other spaces.

Erie County was the first county to take that step, with Poloncarz pointing to evidence that masks work to curb the spread of the disease. Hundreds of people marched in downtown Buffalo this week to protest the measure.

Hochul expressed support for the mandate and encouraged other county leaders facing similar surges to consider the same.

Oneida County announced Friday that it would implement a similar indoor mask mandate, to take effect on Mon., Dec 13.

“Elected officials are entitled to their own opinions, but they are not entitled to their own facts,” Poloncarz said on Twitter Tuesday. “Masks work. We need to work collaboratively, not combatively. Please think of others and realize this is a public health crisis that needs us all to cooperate and work together.”

Others have no immediate plans to do so.

For example, Dutchess County Executive Marc Molinaro's office told the USA TODAY Network New York this week that Dutchess has no plans to implement a mask mandate, saying “New York state has historically issued mandates of this nature.”

Counties, including Monroe, Ulster and Westchester, have declared states of emergency but have stopped short of mandates for now.

"We are now across to a level of emergency," said Westchester County Executive George Latimer this week, stressing that no other mandates were put into place at the time.

"And it requires each of us to determine what can we do on our own...before we have to take government action on behalf of the whole society."

In Chautauqua County, Wendel questioned what implementing a state of emergency would mean for a county where many residents have already made up their minds on masking and vaccines.

The rural western New York county has among the lowest vaccinations in the state with about 58% of its population having received one shot; the statewide average is 75%, state data shows.

“We’ve been asked, ‘Will you declare a state of emergency?’ We will consider that, but what will that get us?” he said, adding that the county continues to conduct outreach on the safety and effectiveness of vaccines.

“At the end of the day, we’re going to continue to care for the health and well-being of our residents.”

Enforcing a mask mandate would be difficult, Wendell said: “There are those who do it, and those who don’t.”

County leaders called on the state to reopen mass vaccination clinics and provide more rapid testing.

“Our chief elected officials must make decisions in real time and these decisions can be unpopular but necessary to protect the public,” Stephen Acquario, executive director of the state Association of Counties, said in a recent statement.

More: Westchester to declare state of emergency over COVID concern; no immediate action planned

More: Monroe County declares state of emergency over rising COVID cases, hospitalizations

What public health experts say about NY mask mandate

Dr. Mary Bassett, who took over last week as state health commissioner, praised Hochul’s pandemic response for being a collaboration with local officials, rather than a top-down governmental edict.

Hochul has noted that she has adopted COVID safety measures since taking office in August, such as enforcing a vaccine mandate for health-care workers and requiring hospitals to curtail elective surgeries when they reach bed capacity.

Bassett, a former New York City health commissioner, also alluded to criticism of Cuomo’s administration excluding local officials from many pandemic-related decisions.

“There’s a difference between having a coherent statewide strategy and having a cookie-cutter top down strategy,” Bassett said.

The latter, she added, “loses the capacity in the local health departments and loses the trusting relationships that they’ve built with the people who live in their (communities).”

The comments came after a former state health official, Dr. Elizabeth Dufort, accused Cuomo’s administration of hindering the pandemic response by blocking the state Department of Health from collaborating with local health officials.

That accusation was revealed as part of transcripts released last month by James as part of her investigation into the Cuomo administration., who is also running for governor.

Amid the debate, public health experts suggested that local officials could lack the resources, expertise and political will to implement pandemic-related mandates — a point that Cuomo would allude to when he would make unilateral decisions.

The current conditions, including the looming omicron variant threat and rising COVID cases, support imposing an indoor mask mandate across upstate, if not statewide, experts said.

“As a health provider and person in public health, we would certainly welcome clear directives from the state,” said Dr. Dial Hewlett, an Infectious Diseases Society of America expert.

Looking back, a lot of the friction or opposition to Cuomo’s pandemic mandates didn’t come from a disagreement over policy, Hewlett said.

“The opposition and pushback were because there was a lack of communication,” Hewlett said.

But Erika Martin, a University at Albany associate professor specializing in public health policy, asserted Hochul faces a much different mix of political and public health challenges than Cuomo.

Pandemic fatigue and the divisive political climate complicates efforts to impose mandates, she said.

“Politicians are not in an enviable position right now,” Martin said.

Local law enforcement has also been reluctant to enforce mask mandates, which further complicates efforts to boost compliance, experts said.

Martin also contrasted the political factors facing Hochul and her predecessor.

Before Cuomo resigned in August under the weight of sexual harassment allegations, he operated as a three-term governor known for running Albany with a firm grip on all levers of state government, Martin said.

Hochul, in contrast, was thrust into power and now faces a contentious election battle next year.

“She’s in a very vulnerable position” Martin said, adding imposing a mask mandate “can create a lot of public backlash, and she can jeopardize any chance she has at winning the election.”

More on hospital capacity: NY reveals list of 32 hospitals halting elective care. What to know

What to know about mask mandate debate

While New York debates its pandemic response, some other states like Tennessee and Florida are seeing lawmakers effectively ban local officials from imposing mask mandates.

On the other end of the spectrum, some European countries are passing policies that all but exclude unvaccinated people from many aspects of society.

Dr. William Schaffner, an infectious diseases professor at Vanderbilt University School of Medicine, asserted the diverse mix of global pandemic responses stems from the complexity of combating a virus prone to mutation and unpredictability.

“There is no agreed upon set of metrics…that will permit you to throw those into a formula and tell you when you’ve got to impose a mask mandate on folks,” he said, referring to efforts to track COVID cases, deaths and stress on the health care system.

For example, the most recent Centers for Disease Control and Prevention guidance recommending indoor mask wearing, regardless of vaccination status, came over the summer.

It recommended indoor mask-wearing in public counties with substantial or high COVID transmission or test positivity rates —places with at least 50 new cases per 100,000 population over the past seven days or a COVID test positivity rate of 8% and above.

Many New York counties outside New York City currently far exceed that threshold, with the Mohawk Valley and Finger Lakes reporting about 80 new cases per 100,000 population and positivity rates of 8% and 10%, respectively.

But the absence of updated federal guidance on mask use amid shifting factors, such as the omicron variant and rollout of booster shots, complicates local policy decisions, Schaffner said.

“I do think some elements of the CDC’s response – early on suppressed politically now freer – have been slow,” he said, adding the agency has “a difficult time revising recommendations or communicating why they have not.”

As a result, people are left, in many ways, to decipher mixed pandemic messaging when policy decisions are left to local officials.

“It does then become very confusing to the average person because they don’t just stay in one political jurisdiction; they travel and move around,” Schaffner said.

More: NY reveals list of 32 hospitals halting elective care. What to know

Sarah Taddeo is an enterprise reporter for USA Today Network's New York State Team. Got a story tip or comment? Contact Sarah at STADDEO@Gannett.com or (585) 258-2774. Follow her on Twitter @Sjtaddeo. This coverage is only possible with support from our readers. Please consider becoming a digital subscriber.

This article originally appeared on New York State Team: Will more NY counties implement mask mandates or new COVID restrictions?