WASHINGTON — Confronting a drastic rise in coronavirus cases across the United States, the nation’s top public health officials urged all Americans to wear masks in order to prevent the spread of the disease. 

“At this critical juncture when COVID-19 is resurging,” wrote Centers for Disease Control and Prevention director Dr. Robert Redfield in a Journal of the American Medical Association editorial published on Tuesday, “broad adoption of cloth face coverings is a civic duty, a small sacrifice reliant on a highly effective low-tech solution that can help turn the tide favorably in national and global efforts against COVID-19.”

COVID-19 is the disease caused by the coronavirus. It has killed 138,000 Americans since February. In recent weeks, the coronavirus has swept across the Sun Belt, where states like Florida, Arizona and Texas disregarded the warnings of public health officials and reopened early, without strict mask mandates in place. California, which had been among the first to shut down, has also seen a rise in cases, leading Gov. Gavin Newsom to roll back the reopening of the state.

Some fear that other parts of the country could soon undergo renewed lockdowns, thus effectively returning the nation to the state of affairs that drove millions of people indoors and devastated the economy back in March and early April. 

CDC Director Dr Robert Redfield. (Graeme Jennings/Pool via Reuters)

The editorial acknowledges this fear, effectively depicting the discomfort and awkwardness of wearing a mask as the price for keeping a new round of lockdowns at bay. So far, however, the federal government has resisted making masks mandatory. It is not clear if a plea from the CDC — an agency the White House views with suspicion — will make any appreciable difference in that regard. 

“Like herd immunity with vaccines, the more individuals wear cloth face coverings in public places where they may be close together, the more the entire community is protected,” Redfield and his co-authors wrote. “Community-level protection afforded by use of cloth face coverings can reduce the number of new infections and facilitate cautious easing of more societally disruptive community interventions such as stay-at-home orders and business closings.”

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The editorial was co-written with two other CDC officials: epidemiologist Dr. John Brooks and Dr. Jay Butler, deputy director for infectious diseases. Its publication comes on the same day as the release of a CDC study on two Missouri hair salons, which the JAMA editorial references. In that study, the CDC found that “no COVID-19 symptoms were identified among the 139 exposed clients or their secondary contacts,” likely because both the infected hairstylists and their customers wore face coverings. 

The editorial also references a just published JAMA study of coronavirus infection rates among health care workers at Mass General Brigham, a prominent Boston hospital. There, researchers found, “universal masking” — that is, the requirement that everyone wear a face covering — resulted in a “significantly lower rate” of infection.

In late February, Redfield testified before Congress that there was no need for the general public to wear masks. The assertion reflected an inchoate understanding of how aerosolized viral particles spread. In addition, there was concern a run on masks by the public would deprive hospital workers of much-needed and then-scarce protective equipment.

In the ensuing weeks, it became increasingly clear that airborne transmission is primarily responsible for new coronavirus infections. Face masks can help keep an infected person from transmitting viral particles, provided the face mask is properly worn. At the same time, the production of both disposable and reusable masks went into overdrive throughout the spring, making shortages much less likely.

Redfield and other top officials now uniformly recommend  mask wearing, but until very recently they found resistance from President Trump and his most loyal political supporters, some of whom appeared to believe that wearing a mask was a display of weakness. That opposition may now be weakening as the virus continues to exact a daily human, economic and social toll on the nation. 

In seeming recognition that the culture war over face masks was not proving productive, Trump was photographed wearing a mask in public for the first time over the weekend, in what was widely hailed as a significant development in his administration’s public health messaging. 

“With cloth face coverings, personal protection is derived from their use by all members of the community,” the editorial by Redfield, Brooks and Butler stated, in what some may see as rebuke of politicians, like Ron DeSantis of Florida, who has resisted a universal mask order even as the state he governs becomes a global coronavirus hot spot. 

There is no indication that Trump will order all Americans to wear masks. Short of that, mask-wearing will likely remain subject to the uneven federal-state-municipal response that has marked his approach to the pandemic. 

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