Masks could be required, and experts strongly recommend them

MADISON – If Alabama follows the lead of several other states, a modified stay-at-home order could require residents to wear masks in public.

“Discussions continue around the use of cloth face-coverings in public settings,” Assistant State Health Officer Karen Landers said Friday when asked if such a requirement might be included in a future health order.

Seven states and numerous local governments have issued emergency health orders requiring masks to be worn in certain public settings, usually when in an enclosed space with others or when 6-foot distancing cannot be consistently maintained.

David Spillers, CEO of Huntsville Hospital System, last week recommended such an order.

“There has been a lot of conversation about opening up the economy and I think when we see that, I certainly hope that one of the recommendations that comes from the state when we open back up is a requirement to mask,” said Spillers, who oversees hospitals in Morgan and Limestone counties. “I think everybody in a store buying a product should be masked.”

The strict stay-at-home order issued by State Health Officer Scott Harris on April 3 expires at 5 p.m. Thursday, and he and Gov. Kay Ivey have said an announcement will be made beforehand about whether it will be extended, modified or allowed to lapse. Ivey last week reiterated previous statements suggesting that, whenever the order expires, it will likely be replaced with new mandates designed to ease the economic damage of the current order while maintaining health protections.

Some states and local governments have sought to find that balance by requiring masks.

Judy Smith, administrator of the Alabama Department of Public Health Northern District, said she is disappointed more people are not wearing masks in public.

In addition to social distancing and frequent hand-washing, she said, masks are a crucial tool in limiting the spread of the virus.

“This virus we’re dealing with, which clearly is highly transmittable, is a respiratory virus. One of the best ways for people to protect themselves and especially others is with the use of masks,” Smith said Friday. “In a time when we do not have a vaccine, we don’t have an antiviral that works on this, wearing a mask is one of the most crucial things anyone can do.”

While homemade cotton masks are far less effective at preventing the wearer from contracting COVID-19 than medical-grade masks like the N95, research at the Missouri University of Science and Technology and other institutions indicates some may provide limited protection.

Their most important benefit, however, is in protecting others. One of the unique features of the coronavirus is that people who never develop symptoms can infect others, and even those who eventually develop symptoms are contagious before the symptoms appear.

“The mask may decrease a person who is asymptomatic or pre-symptomatic from spreading the virus by coughing or sneezing,” Landers said.

The Centers for Disease Control and Prevention this month recommended “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain,” such as grocery stores and pharmacies. “It is critical to emphasize that maintaining 6-feet social distancing remains important to slowing the spread of the virus,” according to the CDC. “CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.”

Another benefit to wearing masks, Smith said, is it reminds people that the wearer takes the disease seriously.

“One of the biggest things we’re dealing with is complacency,” Smith said. “The big fear is once things open up — and they’ve got to open up for people’s livelihood — people will think it’s over. There are people who have been horribly affected by this virus, but there are other people who just don’t see this as a real problem.

“A mask is crucial in communicating, ‘I’m in this to protect everybody.’ ”

Somewhat complicating the issuance of an emergency order requiring masks in Alabama is a 71-year-old loitering law that prohibits the wearing of a mask in a public place. Exceptions to the law have been carved out for masquerade parties, parades, sporting events and various educational, religious or historical presentations, but not for health issues.

State Attorney General Steve Marshall this month said the law would not be enforced against people wearing masks for health reasons. Georgia’s governor this month issued an executive order declaring a similar law, also aimed at unmasking Ku Klux Klan members, does not apply to anyone who “is wearing such device for the purpose of complying with the guidance of any health care agency or to prevent the spread of COVID-19.”

Ivey’s office referred questions on the anti-mask law and the possible inclusion of a mask requirement in future health orders to the ADPH.