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The Health 202: Trump administration resists federal mask mandate as other nations implement them

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Officials in the United States are still resisting a federal mask requirement even as more countries impose them. 

President Trump said in a Fox News interview that aired Sunday that he is a “believer in masks” but deferred to state officials on whether they should be required. 

“I want people to have a certain freedom and I don’t believe in that, no,” Trump said when asked by Chris Wallace whether he will consider a national mandate. Trump, who wore a mask in public for the first time earlier this month during a visit to Walter Reed National Military Medical Center, said he thinks “masks are good” but added this caveat: “And I don’t agree with the statement that if everybody wear a mask, everything disappears.” 

The president, who has mocked others for donning masks, called them “patriotic” in a tweet: 

Surgeon General Jerome Adams similarly sought to thread the needle: He called face coverings a key way “we can reopen and stay open” in a Fox News interview but sided with Trump in arguing against a federal mandate. Adams said mandates would be better at the state and local level, suggesting a federal requirement would be difficult to enforce. 

“If you’re going to have a federal mandate, you have to have a federal enforcement mechanism,” Adams said. “As a scientist, as an educator, I would rather help people understand why they should cooperate with wearing a mask and how they benefit from it versus just simply saying we’re going to force you to do it, particularly by sending in federal troops or using federal mechanisms.” 

The pushback highlights how the federal government relies on state and local leaders to handle the response to the pandemic. 

The result is a patchwork of rules and restrictions regarding face coverings across the country, with some states and cities requiring masks in public and others leaving it up to private businesses to decide what they’ll permit. 

Adams said such policies “work better at the local and state levels where again you have ability to work with people, educate them and not let them feel like there’s an outside entity trying to tell them what to do in a country where people very much rely on their freedom.” 

But broad mask mandates are gaining traction around the world, as nations seek to avoid the kind of viral resurgence seen in the United States.  

In France, people are now required to wear face coverings in all public enclosed spaces as of yesterday. 

In England, new rules will go into effect Friday to mandate masks inside supermarkets and other shops, as Siobhán O’Grady reports.

“A country’s caseload and mortality rate are the product of diverse epidemiological factors, but health researchers say more evidence is emerging to support what some policymakers and experts have maintained all along: Masks work,” Siobhán writes. “Although it is difficult to isolate mask use as the key factor in a country’s success so far, or draw a direct line between mask mandates and outcomes, many countries where masks were in wide, early use have fared better than those that resisted the broad adoption of face coverings.”

Some nations turned to masks to help curb the virus’s spread much earlier in the pandemic. “Slovakia and Vietnam, for example — two countries where transmission has remained low — made face masks compulsory in many public spaces several months ago. In other places, like Hong Kong, masks were understood to be an effective means to stop the spread of disease before the coronavirus emerged,” Siobhán adds.

“Many businesses mandated them early on, and many people wore them in public even in the absence of an official rule. In Japan, where the government initially faced criticism for not doing enough to prevent a massive outbreak, people quickly adopted to everyday mask use, made easier in part because face coverings were already in common use.” 

In the United States, there’s been an inconsistent message from political and health officials about masks. Federal health officials, including at the Centers for Disease Control and Prevention, initially downplayed the benefit of masks. Then last week, CDC director Robert Redfield said the country’s coronavirus outbreak could be “under control” in four to eight weeks if “we could get everybody to wear a mask right now.” 

States and businesses are now scrambling to make masks a norm across the country. 

“Even as the White House continued to resist pushing for a national mask mandate, evidence abounded that face coverings were becoming a de facto requirement — and not only in big cities where they have been in widespread use for months,” Griff Witte wrote last week.

When states first began lifting coronavirus lockdown measures in the summer, tensions around face masks had been mounting since the CDC first recommended them. (Video: The Washington Post, Photo: Sarah Hashemi/The Washington Post)

Months into the pandemic, more than half of states have now implemented some kind of order requiring face coverings. Arkansas Gov. Asa Hutchinson (R), who issued an order last week require face masks inn public, said in a recent interview on CNN that wearing masks has “become more understood.” 

“I resisted it because it is an infringement upon what somebody’s comfort or what they want to do, but it is necessary in this public health crisis,” he said. “ … We’ve got to get over any divide on this issue. It is important.”

Major retailers are following suit. Gap and Office Depot joined numerous other retailers in requiring face coverings in all U.S. stores. Target and CVS Health announced new mask requirements for all shops last week, as did Kohl’s and Kroger. They followed Walmart, the world’s biggest retailer, which will require masks at its 5,300 namesake stores and Sam’s Club locations.

The American Bankers Association announced it’s asking banks to adopt mask requirements.

But there's still mixed messaging on the state level. Georgia’s Republican governor Brian Kemp is suing Atlanta as he seeks to stop the city's enforcement of a mask mandate. “Kemp’s most recent executive order attempts to void existing mask mandates in more than a dozen cities or counties, while also extending other coronavirus social distancing restrictions statewide," Meagan Flynn and Marisa Iati reported last week. “The governor had previously tried to ban cities and counties from passing any coronavirus restrictions that went further than Georgia’s guidelines. But many cities defied him by passing mask mandates anyway, arguing that it was essential to flatten the curve. Kemp’s orders have ‘strongly encouraged’ masks," they note. “Local officials who had issued mask mandates as hospitals filled up were outraged this week as Kemp overrode their judgment.” 

And the polarization on the issue has left retail and service workers across the country on the front lines. Some have reporting that they’ve been assaulted and berated for trying to enforce mask rules. 

“State and local governments have taken different approaches, but they all have one thing in common: They leave business owners and employees to change peoples’ behavior at a time when tempers are already running high,” Lindsay Wiley, director of the Health Law and Policy Program at American University’s Washington College of Law, told Abha Bhattarai this month. “Retail workers — who are already at great risk because they’re being exposed to people all day — have now also been put in the position of asking people to mask up.”

The message from the federal government has evolved to focus on personal responsibility. 

Even as he argued against a national mandate, Adams urged individuals to “do the right thing” and wear masks. 

“I’m pleading with your viewers, I’m begging you, please understand that we are not trying to take away your freedoms when we say wear a face covering,” Adams said. “We are not trying to take away your ability to go out when we say keep restaurant capacity under 50 percent. We are saying if we do these things, we can actually open and stay open. We can get back to school, to worship, to jobs. We can do this.”

Ahh, oof and ouch

AHH: A vaccine candidate from the University of Oxford proved in early human trials to be safe and to yield a strong immune response. 

That’s according to a study published in the British medical journal the Lancet. The U.S. and European governments have placed substantial bets on the candidate from Oxford and British-Swedish pharmaceutical company AstraZeneca, William Booth and Carolyn Y. Johnson report. 

There are 23 vaccine candidates being tested in human trials, and no candidate has yet proved to protect people from infection or illness.

“And scientists caution that no one yet knows what level of immune response will be a shield against the virus in the real world through a cross section of humanity — young to old, healthy to those with preexisting conditions,” Carolyn and William write. “But with hopes soaring that a number of vaccines will soon emerge to quiet the global pandemic, governments are making massive investments and pharmaceutical companies are readying production.”

They add: “The U.S. government has pledged up to $1.2 billion toward the Oxford effort and secured a promise of 300 million doses by October. A European alliance has claimed 400 million doses, while the British government has dibs on 100 million doses, alongside another possible candidate being developed by Imperial College London.” 

Separately, a second report in the Lancet on a Chinese vaccine candidate showed modest positive results, according to researchers not involved in the study. 

“To me, the message is it looks like it warrants further study. There’s no showstopper here,” Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine told The Post. “The bottom line is there’s maybe some promise, but definitely you cannot declare victory by any means on these two vaccines. There’s nothing here that would cause me to say we can now release this to the public.”

OOF: Florida’s largest teachers union is suing top state officials over an order requiring school to reopen. 

It’s the latest escalation in an ongoing debate over whether to resume schooling in person in the fall.  

“The suit from the Florida Education Association asked a judge to stop Gov. Ron DeSantis (R) and Education Commissioner Richard Corcoran from requiring the return of in-person schooling without first reducing class sizes and ensuring that educators have adequate protective supplies,” Matt Zapotosky reports. “The move came as confirmed cases of the novel coronavirus are increasing in many states, including Florida, raising fears in some quarters that a return to brick-and-mortar schools in the fall could put students and teachers at risk and exacerbate the spread of the virus. Others argue that reopening schools is a critical step in a return to normalcy.” 

The issue of whether to reopen schools has been tricky, in part because there is no clear science yet that points to how the coronavirus spreads among children and how it spreads from children to adults. 

The teachers union said in the lawsuit that the order to reopen schools “would create an unsafe and unsecure environment for students, employees, and the community at large.” Matt adds: “Corcoran, the Florida education commissioner, shot back that the union did not seem to have read or understand his emergency order, and that even before it, state law required schools to operate for 180 days a year, which amounts to five days a week.” 

OUCH: Some federal relief programs are about to expire, which could endanger states like Arizona that appear worse off now than they were in the pandemic’s early stages. 

Arizona is one of the worst coronavirus hot spots in the country. There were more than 143,000 cases and more than 2,700 deaths as of this past weekend, Tony Romm reports. 

Arizona reported a record number of hospitalizations on July 2 due to a spike of covid-19 cases. Health workers urged the public to wear masks and stay home. (Video: The Washington Post)

“Hundreds of thousands of people are still out of a job, some for the second time this year. Restaurants, gyms and other companies are closing up shop once again — perhaps for good. Even government officials say they are bracing for a crippling blow, with the latest shutdown expected to cleave further into their still-souring finances,” Tony writes. 

The surge in cases could fuel another round of closures, which could mean that “families and businesses that fall into dire straits are at risk of even greater financial trauma: Nearly 1 million Arizonans, for example, are set to lose extra money in unemployment assistance after this week, leaving them with benefits that are much lower than most other states.” 

Experts and local leaders say one lesson for the rest of the nation is that states that have sought to prioritize economic recovery over public health risk undermining both. 

The Trump administration’s efforts

Critical hospital data related to the pandemic will now be published on a Health and Human Services system that went live yesterday. 

The new system called HHS Protect “replaces a CDC system and relies on outside vendors who have received at least $35 million combined,” Politico’s Rachel Roubein, Dan Diamond and Darius Tahir report. “Democrats and public health experts have expressed alarm about the move, concerned it would sideline the federal public health agency and cause confusion among hospitals and states amid a pandemic.” 

The switch-over follows the administration’s move to order hospitals to bypass the CDC and instead report details about the number of hospitalizations, as well as the number of available beds and ventilators, to HHS directly. 

“The move reflected senior officials’ frustration with the CDC’s system, which White House coronavirus coordinator Deborah Birx and others faulted for being ill-suited to the pandemic. It was the latest manifestation of broader turf battles within the administration between HHS and CDC,” Rachel, Dan and Darius add. “HHS Secretary Alex Azar touted the administration’s new approach on a 2 p.m. call today with governors, arguing that it would be more transparent and capture a wider range of health information than was possible through the CDC's systems, according to a person with knowledge of the discussion. Azar also sought to quell fears that the new data reporting procedures would cut the CDC out of the process, telling the governors that the public health agency would be given access to all of the information the administration collects through HHS Protect.” 

In the states

The National Governors Association wants the administration to provide more resources, including additional relief aid and funding for schools. 

Maryland’s Republican Gov. Larry Hogan, the organization’s chairman, called on the White House yesterday to address states’ “five urgent priorities,” Reis Thebault writes for The Post’s live blog. 

“The plea is another sign of the frayed relationship between many of the country’s governors and Trump, who has largely foisted the burden of navigating the pandemic onto the states,” Reis writes. “The request comes just days after Hogan blasted Trump’s handling of the crisis in a Washington Post op-ed, writing that the White House ‘bungled’ the rollout of testing infrastructure and that the president ‘downplayed the outbreak’s severity.’ ”

“The president, vice president, and Secretary Mnuchin have all previously committed to support this funding, but there are growing indications that it is no longer a priority,” Hogan said in a statement. “It is crunch time now, and we are ready to work with leaders in both parties to get this done.”

Meanwhile, seven states and Puerto Rico reported a record number of virus hospitalizations. 

“Florida, where virus hospitalizations have climbed steadily for at least 10 days, reported more than 9,400 covid-19 patients in the state’s facilities — second only to Texas, which alone accounts for nearly a fifth of the infected people hospitalized in every state that reports such data, according to a Washington Post analysis,” Reis and Jacqueline Dupree report. “Georgia, Nevada, Kentucky, North Dakota, Arkansas and Montana had each also reported new highs in hospitalizations by early Monday evening.” 

Congress on coronavirus

The Republican coronavirus relief bill will likely include a payroll tax cut and measures making reopening plans a condition of school funding. 

Some of those provisions, which embrace the president’s priorities, are already drawing pushback from senators in his own party, Erica Werner, Jeff Stein, Robert Costa and Seung Min Kim report. The bill is also likely to include very little money for state and local governments and is poised to fuel tension with Democrats. 

“That clash could come Tuesday, when Treasury Secretary Steven Mnuchin and White House Chief of Staff Mark Meadows are set to meet with House Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Charles E. Schumer (D-N.Y.) for the first bipartisan talks on what will almost certainly be the last major coronavirus relief bill before the November elections,” they write. “Mnuchin and Meadows will also meet with Senate Republicans on Tuesday as they seek to quell any discontent.”

They add: “Senate Majority Leader Mitch McConnell (R-Ky.) is giving Congress just three weeks to write the bill before adjourning for summer recess. With multiple issues dividing the two parties and creating rifts between the White House and Senate Republicans, it’s shaping up as a daunting task.” 

Coronavirus latest

More on the administration’s efforts: 
  • Trump told reporters the White House will resume coronavirus briefings. “It’s not immediately clear who will participate and how often they’ll happen, but if they’re at the White House, it’s a safe bet that Trump will take center stage, as he did in the past,” Amber Phillips reports.
  • The effort to bring back the briefings “comes as Trump has struggled to turn the country’s attention away from the surging coronavirus and accompanying economic devastation months before voters head to the polls,” Toluse Olorunnipa and Josh Dawsey report.
  • Health experts are worried the coronavirus case surges across the United States could hinder efforts to expedite testing by pooling testing samples. “But the U.S. outbreak is now so out of control that health experts and testing labs say it won’t work here. In areas where the virus is widespread, many pools would test positive — requiring additional tests of each person in those pools,” Politico’s David Lim reports.
There’s a flood of information: 
  • In the absence of authoritative guidance from federal health officials, some people are crowdsourcing advice on what to do during the pandemic. That means seeking recommendations from a combination of other parents, scientists, media commentators, local public health officials, celebrities, social media influencers, self-appointed experts and political activists, Marc Fisher and Rachel Weiner report.
Good to know: 
  • The Washington Nationals announced Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, will throw out the first pitch on Opening Day on Thursday.

Sugar rush

SNL’s Colin Jost on coronavirus impact and reports of the show returning to the studio this fall (Video: The Washington Post)
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