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18 percent of Alabamians must wear masks, more cities could soon follow - AL.com

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Alabama elected officials and health professionals are redoubling their efforts to encourage, or require, people to wear cloth face masks in public as the number of new coronavirus cases per day has gone up sharply over the past seven days and hospitals begin to fill with COVID-19 patients.

The cities of Birmingham, Montgomery and Selma already require people to wear masks in public. Jefferson County, which contains Birmingham and many of its outlying suburbs, has announced a county-wide mask order that will go into effect on Monday.

Combined, those areas are home to about 18 percent of Alabama’s population.

Mayors across the state, regardless of party, have promoted mask wearing to their citizens as local hospitals feel the strain of COVID. And some say they are looking at passing ordinances this week.

Birmingham Mayor Randall Woodfin released a video Friday about the use of masks in the city, urging Birmingham residents to abandon a “I, me” mentality and wear masks for the good of the community as a whole.

“Face coverings are for the health and well-being of not just you, not just ourselves, but for those around us, especially those communities who are at risk,” Woodfin said.

Mobile Mayor Sandy Stimpson is sponsoring a local mask ordinance for his city that will go before the city council next week. Stimpson posted appeals on Twitter to Mobile city councilors to support the ordinance.

Tuscaloosa Mayor Walt Maddox said on Twitter Friday that he believes the city council will pass a mask ordinance as well.

The city of Huntsville has not implemented a mask ordinance yet, but the city promoted a video clip on Friday in which David Spillers, CEO of Huntsville Hospital urges everyone to wear a mask.

“I’m not trying to make a political statement, I think it’s just logical that if people have on masks, they’re going to be less likely to transmit or receive the virus,” Spillers said. “I think that’s the single most important thing we could do to try to limit the spread of coronavirus.

“And I think it’s an inconvenience, but I think it’s a small price to pay if it keeps your loved ones or your friends or other people in the population from getting COVID.”

Madison Mayor Paul Finley told reporters Friday that his city of 50,000 west of Huntsville will require masks to enter public buildings, but that he would not support a broader mask order at this time.

Alabama COVID cases surge in June

Alabama saw three consecutive days of more than 950 new COVID-19 cases in late June and hospital ICUs have filled to more than 80 percent of their capacity, according to Don Williamson, head of the Alabama Hospital Association.

Of Alabama’s more than 34,500 total cases of COVID-19, more than 11,000 were reported after June 12, the first day the state reported more than 1,000 new cases in a day. Since that day, the state has exceeded that threshold three more times, all in the past week. The seven-day average of new cases per day is almost 800.

That increase casts an ominous shadow over Alabama’s already stressed hospital system. In the coming days, many of those people who recently tested positive will get sicker and some will require hospitalization, filling more of the dwindling supply of available hospital beds.

Dr. Jeanne Marrazzo, an infectious disease expert at the University of Alabama at Birmingham, said there is often a delay between large increases in case numbers and an increase in hospitalizations. She said Children’s Hospital in Houston began taking adult patients this week because the city’s regular ICUs were full.

“If we are seeing this very big peak in cases right now, the hospitalizations and death rates as we know, typically lag two to two and a half to three weeks behind those case reports,” Marrazzo said. “So could we be seeing a situation in the middle of July, particularly with the July 4th weekend, people getting out and about, where we are in a situation like Houston is facing right now or New York City, New Jersey, Boston, some of the other cities that have sustained really large burdens of in-patient demand, have experienced in the past? That is entirely possible.”

Dr. Beth Lewis, chair of the Department of Epidemiology at UAB’s School of Public Health, said masks are one of the few tools, aside from total closures of businesses and restrictions on social gatherings, that local governments have to fight the disease and avoid the kind of dangerous hospital surges.

“We don’t have a lot of tools to fight this,” Lewis said. “And so we all need to be responsible and do our part. Because if the hospitals become overwhelmed, like they were in New York, people died who wouldn’t normally have died, and we really don’t want that to happen here.”

'Very political, very divisive'

Jefferson County Health Officer Dr. Mark Wilson, who announced Jefferson County’s policy Friday, said he decided to require masks because too many people were ignoring recommendations.

“Frankly I’ve found that we’re losing the support of the public,” Wilson said. “People are getting careless. I’ve been very reluctant to issue an order because orders are not popular.

“Unfortunately this particular topic has become very political, very divisive, which is rather bewildering, frankly.”

Wilson said he would like to see a mask order in place for the entire state.

“I think it would be great if this could be done statewide,” Wilson said. “The entire state of Alabama is in trouble.”

Alabama’s Safer at Home order, which recommends all Alabamians wear masks in public and requires masks for employees and/or customers at certain businesses, expires on July 3. Gov. Kay Ivey has not yet announced whether she will extend or modify that order going forward.

U.S. Sen. Doug Jones in a press conference Thursday that the economic toll from the virus would only get worse the continued spread of the virus, citing Alabama restaurants that have had to close again after staff members became infected.

“As we open back up, if we don’t control this virus, our economy is going to go back down,” Jones said. “There is no question about that.”

Jones also asked local leaders, elected and otherwise, to step up and set a good example by wearing masks themselves and encouraging others to do so.

“If we want to get our economy rolling again, I think it’s so important that businesses step up also, churches, everyone step up on this mask-wearing and let’s get everybody used to this and it not be such a political issue, it doesn’t [need to] be such a social stigma issue,” Jones said. “It’s just something we do, like buckling a seatbelt when we get in a car.”

Dr. Lewis, the chair of the UAB Epidemiology Department, said that one key difference is that a seatbelt primarily only protects the person wearing it, while facemasks can protect everyone else.

Because people can spread COVID-19 before they develop symptoms, and young, healthy people especially may only experience mild symptoms over the course of their infection, people may be infected and spreading the virus without realizing they have it.

Marrazzo said that recent virus data, particularly in Florida, shows people in their 20s and 30s are making up a higher percentage of recent COVID cases, and may be spreading the disease to more vulnerable populations without realizing it.

“Many of the infections that people are transmitting are coming from people before they develop their symptoms or when their symptoms are really, really mild,” Marrazzo said. “Or maybe they never get symptoms, but they still can transmit the virus.

“Younger people tend to have milder cases, less symptoms, they’re not as likely to stay home, they may feel relatively okay, like they can go out and do their usual thing. That puts them at great risk for serving as an intense focus of transmission in the community.”

Fighting COVID, Lewis said, has to be a team effort, with everyone in the community doing their part.

“I certainly wouldn’t want to be responsible for bringing something home and infecting your grandmother,” Lewis said. “And that could very well happen. People can infect their family members and their friends. They can cause a business to shut down because they went to their favorite restaurant and breathed on a bunch of people and gave them COVID-19.

“I certainly wouldn’t want to be responsible for that, but it could happen if you don’t play on the team.”

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