Face coverings remain optional in newest COVID-19 spike, but doctors encourage people to put on masks again

After a welcome lull in new COVID-19 cases in March following the winter omicron surge, cases are once again spiking, another uptick in the seemingly endless cycle of the pandemic’s virus spread.

“It’s time to start putting on masks, if we ever took them off, … to blunt the increase,” said Dr. Allison Bartlett, associate professor of pediatric infectious diseases at the University of Chicago.

This time, though, masks are optional.

Public officials and businesses appear reluctant to return to a mandate and individuals are taking a wide-ranging approach, with some continuing to mask in some settings while others have little appetite for it.

Chicago’s public health Commissioner Dr. Allison Arwady has said she does not foresee a reinstatement of the mask mandate unless hospitals begin to be overwhelmed.

In a regular Q&A session on Tuesday, Arwady said the city is seeing “quite the uptick” but she also said case numbers may be plateauing. Omicron and its subvariants remain the dominant strains in the area, and many people who became infected during the winter’s omicron surge still have some protection.

Still, she said Cook County is likely by Friday to reach a designation of having a high level of community transmission, a metric used by the CDC that draws on case numbers and hospitalization data. And even though masks are no longer required, public health experts are advising people to once again wear masks indoors, as well as get booster shots and track the data to make their own masking decisions going forward.

“If we move to high later this week, masks will remain even more strongly recommended indoors,” Arwady said. “The city would not be putting a mask requirement in, again, because our hospitals at this point are doing just fine.”

In Illinois, new COVID-19 cases are hitting a seven-day average of nearly 5,400, according to data from the Illinois Department of Public Health, up from March’s low point of a weekly average of about 1,000 cases.

The figures, though, are still well below the omicron peak, which saw weekly averages of up to more than 32,000 new cases.

Chicago is experiencing a weekly average rate of about 42 new cases per 100,000 residents, up from about five in March, according to data from the Chicago Department of Public Health.

Chicago Public Schools has experienced a steady rise in cases among students and employees from the end of spring break in mid-April until last week, according to district data. About 1,400 new student cases and nearly 600 new adult cases were reported by CPS last week, down from the prior week, when 1,900 student and 700 adult cases were reported.

Hundreds of these cases were detected through CPS’ in-school testing program, where the positivity rate last week was 1.2% of 64,000 tests conducted. The positivity rate for the prior week was 1.3%, the most since January, near the end of the omicron surge, according to CPS data.

Around 2,600 students and 400 adults were in quarantine Sunday because they tested positive for COVID-19 or in isolation because they are not fully vaccinated and came in close contact with an infected person. CPS dropped its mask requirement in March, though students in some classrooms have been instructed to wear masks since then because of the case numbers at their individual schools. The last day of classes for students is June 14.

Health experts caution that the real COVID-19 tally is likely larger due to unrecorded home tests. And though deaths and hospitalizations remain low due to vaccinations and new treatments, COVID spikes that take students out of school and put essential workers out of commission during isolation periods nonetheless have a disruptive effect.

In the midst of the winter’s omicron surge, COVID-19 cases spiked to their highest levels of the pandemic, causing an accompanying increase in hospitalizations while resulting in upheaval as workers relied on for transportation, food production and other essential functions were out sick in droves.

“We’re starting to see a little of it in the health care system right now, with health care workers getting COVID infections in the community just like everyone else,” Bartlett said. “We’re not going to have enough people working in hospitals again.”

The Centers for Disease Control and Prevention has designated Cook County and the surrounding area as having medium levels of transmission. The CDC categorizes areas as having low, medium or high community transmission levels based on case numbers, hospital admissions and inpatient bed use.

Eight Illinois counties currently record high transmission levels, including Champaign County and neighboring Ford, as well as Rockford-area counties Winnebago, Stephenson and Boone.

Health experts are encouraging people to again wear masks in public settings.

“It’s a really tricky place for the city to be. Most experts would agree masking is absolutely the right thing to be doing,” Bartlett said. “A lot of people out there are very resistant. It would be a major uphill battle for cities to reimplement mask mandates.”

Dr. Khalilah Gates, a pulmonary critical care physician at Northwestern Memorial Hospital, recommended that people track case numbers on their own, regardless of whether a mandate is in place, in order to make informed decisions about whether to don a mask.

“Individually, you have to really pay attention to the data and make decisions off of that,” she said.

Doctors also encourage people to get booster shots, which offer greater protection against omicron but have been underutilized across the country. Only about 47% of eligible people in the United States have received a first booster, according to data from the CDC.

The Food and Drug Administration last week approved the Pfizer booster for children 5 to 11, though children in that age group are lagging overall when it comes to COVID-19 vaccinations.

“Please, as we are potentially moving into high, get those boosters,” Arwady said.

As cases rise, the FDA is posed to review data from Moderna and Pfizer trials on children 6 months to 5 years on June 15, a highly anticipated step toward authorizing a vaccine for the youngest and final age group.

Overall, doctors warn people to continue to take precautions, including masking, getting vaccinated and receiving the booster, even without a mandate, noting that reducing the spread offers fewer opportunities for new variants.

“The best case is we continue to have these little spikes but maybe learn from them be more aggressive of masking shortly after an increase to blunt the spike,” Bartlett said. “The worst case scenario is that the next variant makes people sicker and there is a much larger and more clinically severe outbreak.”

mabuckley@chicagotribune.com