Masks remain a 'recommendation' even as Cincinnati's COVID-19 hospitalizations rise

Masks are now recommended to be worn indoors in Hamilton County and other parts of the Cincinnati region due to the high risk of COVID-19 spead. But many local agencies are leaving guidance up to the Centers for Disease Control and Prevention – forgoing strong community enforcement in place of the automatic federal suggestion.

Last Thursday, the CDC updated its community levels map, which assesses the risk of COVID-19 in every county in the United States based on the number of hospital beds being used, hospital admissions, and the total number of new COVID-19 cases per population in an area. Eight local counties were deemed to have "high" risk, a designation that triggers an automatic indoor mask recommendation in those locations regardless of vaccination status.

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In some cities like Columbus, the upgrade to high risk prompted a mask advisory by the city for residents. The Columbus advisory released last Friday urges residents to mask indoors and in crowded areas but is a recommendation, unlike an official mandate that was issued in March by the city's mayor, Andrew J. Ginther.

In Kentucky's largest school district, Louisville's Jefferson County Public Schools, a mask mandate is back in effect following the high-risk upgrade, two weeks before school resumes.

Other counties across the nation, such as Seattle's King County, are discussing imposing a mask mandate. Los Angeles County in California is expected to re-issue a mandate sometime this week.

Recommendations, not rules, as cases rise around Cincinnati

Cincinnati hasn't issued its own advisory for the public. Instead, it is recommending city employees wear a mask while indoors, a softer approach than in January when it imposed a mask mandate on the public while in government buildings during the fast-spreading omicron surge.

“We have seen a sharp rise in COVID-19 infection and hospitalization rates, and in accordance with the CDC’s current recommendations for Hamilton County, we as a city are making a formal recommendation for employees in all departments to begin wearing a mask while indoors,” Cincinnati Mayor Aftab Pureval said Monday in a release announcing the recommendation. The new guidance makes no mention of visitors to city facilities.

Cincinnati Public Schools will remain mask-optional too, a spokesperson said, noting that any changes would require action from the school board.

The city intends to follow the CDC's "general recommendation" to mask indoors and while using public transportation during high community levels, said Maryse Amin, assistant health commissioner of the Cincinnati Health Department.

"We are aligning this with the CDC recommendation," she said about the city electing to issue a recommendation rather than enforce a mandate on city employees.

Amin wouldn't say whether there was a level of community spread or hospitalizations that would spur any kind of mandate from the city. While agencies have deemed case counts as unreliable due to widespread use of at-home tests, hospitalizations are closely monitored as the best gauge of risk in a community.

Amin said the city is monitoring levels, particularly as the summer winds down.

"I think it's always a concern," Amin said. "We do look at hospital admissions, bed capacity, and while the numbers have increased in recent weeks, they're not where they were during omicron. But we have seen a bit of an uptick."

Hospitalizations hovered around 1,000 in the Cincinnati region in January during the omicron surge, sparking a massive undertaking on the system. As of Wednesday, 205 individuals were hospitalized with COVID-19, according to data compiled for the Health Collaborative.

The current case level is a much smaller number compared to where things were eight months ago, but the current increase is something health experts are closely watching. From the beginning of July to the end of the month, hospitalizations have increased by roughly 100 COVID-19 patients.

During the omicron spread, Gov. Mike DeWine elected not to reimpose mask mandates, instead opting to send the Ohio National Guard to assist overwhelmed health systems. With that precedent, Tiffany Mattingly, vice president of clinical strategies for the Health Collaborative, the coordinating group for the region's 40 hospitals, said a statewide mandate for a much lower spread is unlikely to surface.

But vigilance during a small summer spike, she said, is important.

"It helps keep us down (hospitalization levels) and it helps keep us safe," she said.

What Hamilton County Health says

Hamilton County Public Health does not have the authority to issue a mask mandate. The Ohio Department of Health's ability to issue an order or mandate became much more difficult after the passage of Senate Bill 22 last year, which grants state lawmakers authority to strike down public health orders without approval from the governor.

The county is recommending masks in accordance with the CDC and monitoring hospital levels, but any further action would have to come from other agencies, spokesman Mike Samet said.

"We are basing our recommendations on the CDC," he said. "As a county health agency we don't have the ability to legislate any mandates, implement any mandates, but we see it as a good practice to wear a mask indoors."

What health officials in Northern Kentucky and Southwest Ohio say

In Northern Kentucky, an area where four counties are currently at high levels according to the CDC, officials are following the federal recommendation and asking individuals to "take appropriate measures to protect themselves."

"COVID-19 continues to be a concern and we have seen a steady increase in case numbers over the last several weeks," said Robin Feltner, a spokeswoman for the Northern Kentucky Health Department. "The actual case numbers locally are likely significantly higher than known due to the use of at-home test kits whose results do not get reported. Fortunately, COVID hospitalizations have not climbed at the same pace in Northern Kentucky and ICU and ventilator use are relatively low."

Feltner added that those in particular who are vulnerable to COVID-19 should take measures to stay safe from the disease.

Masking is also recommended in Butler, Warren, and Clermont Counties, areas that also have high community levels, according to the CDC.

Some local groups, companies are requiring masks

Some organizations, both public and private, have moved to require masks for employees or guests.

In accordance with the upgraded community levels, Procter & Gamble, one of the largest employers in the region, is currently implementing masking and social distancing, spokesman Patrick Blair said. The company automatically implements masks when the CDC level rises too high and adjusts to not require masks when it falls to medium or low.

The Cincinnati Parks Board this week implemented masking indoors and "enhanced" its sanitation efforts due to the rising levels.

Miami University in Butler County is requiring masks on campus after the county jumped from low to high-risk last Thursday, the Miami Student reported.

This article originally appeared on Cincinnati Enquirer: COVID-19: Masks a 'recommendation' as Cincinnati cases rise