Health officer urges people to wear masks, says no regrets over decision to pass on mandate in April

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Wear a mask.

In late April, Ventura County Public Health Officer Dr. Robert Levin made headlines by announcing he would not issue a cloth mask mandate for Ventura County. He said he supported people who chose to wear masks but cited the lack of incontrovertible evidence about the benefits of cloth coverings.

He also pointed at the need to preserve medical-grade masks for healthcare professionals.

Now as the state of California wages a "Wear A Mask" campaign in support of Gov. Gavin Newsom's statewide mask mandate in June, federal and state officials have cited scientific evidence supporting the value of cloth face coverings. The shortage of some personal protective equipment has subsided.

And Levin wants to make himself clear.

Covering your face can protect other people.

"I think a preponderance of experts advocate for the use of cloth masks, and I support the use of masks without any ambivalence," Levin said in a phone interview Thursday.

He said he has also initiated ongoing discussions about the possibility of issuing citations to people who violate California's requirement for masks.

"We're looking at it in the county," he said. "I hope that answers any questions about my adherence."

As part of the state campaign aimed at promoting the use of masks, California officials have encouraged people to wear cloth masks, using pleated disposable surgical or procedure masks only if they are in health care or jobs where such protection is needed.

Don't buy medical masks for personal use, they say.

It's different in Ventura County, Levin said. Emergency operations leaders say supplies of surgical masks have grown to the point where there is no longer a shortage.

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"We're doing really well," said Patrick Maynard, director of Ventura County Sheriff's Office of Emergency Services, noting he's also seen an increased number of pleated procedure masks for sale in area stores.

In a June statement supporting Gov. Gavin Newsom's statewide mask mandate, Levin said medical masks are more effective at preventing transmission than cloth masks and can be found online or in some drug and grocery stores.

On Thursday, he reiterated that ample health-care and front-line worker supplies mean people can buy medical masks for personal use.

"I don't want it to seem like I don't place any stock in cloth masks because I do," he said, noting they are easier to find and can be cleaned while procedure masks are designed for one use only.

He advised against using N95 respirator masks. The Centers for Disease Control and Prevention and the California Department of Public Health both say the masks — designed to prevent the wearer from infection — should be reserved for healthcare workers.

Masks that have valves built into them also pose problems because they don't prevent the person wearing the mask from making others sick, Levin said.

He prefers surgical and cloth masks because they're designed to keep the wearer from infecting others.

Maynard said the problem with procedure masks is they're designed to be used only once. The issue with cloth masks is they need to be sanitized via laundering often — as much as after every use.

Too often people wash their masks only after several days, Maynard said.

"You wouldn't wear the same underwear a week," he said. "If laundered regularly then I think cloth masks offer equal protection as a procedure mask."

Need at least 80% compliance

Dr. George Rutherford, an epidemiologist at UC San Francisco, said fabric masks work as effectively as procedure masks in blocking virus transmission that comes in face-to-face conversations between people. Cloth masks may be less effective in blocking transmission linked to singing, coughing are sneezing.

His concern about procedure masks involves availability.

"Are there enough surgical masks around?" he said. "Right now there are. Given the surges, who knows what's going to happen."

Levin said he has been told by emergency operations leaders there are enough medical masks in Ventura County even if the surge continues. Maynard said the availability has improved tremendously.

Rutherford cited research suggesting that if at least 80% of the population wears masks, positive COVID-19 cases would plummet dramatically. The masks, he said, reduce available targets.

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"The virus can’t find enough people," Rutherford said, suggesting that while social distancing is also vitally important, face coverings have more impact.

"It’s the thing that’s going to save us from being locked down again," he said. "People have their choice. They can wear masks or they can get locked down."

Levin contends masks can't be depended on alone to protect people.

"Masks are part of a strategy that is effective that also involves social distancing and hand washing," he said, asserting all the protections are needed together.

Mask backlash

Masks have become part of the dividing line in Ventura County and across the nation. As public health officials and infectious disease specialists urge people to wear coverings, some people refuse. They complain in government meetings that mask mandates infringe on their rights.

Kevin Daly, of Ventura, said he doesn't wear a mask because it would exacerbate an existing medical question. He also questions the effectiveness of masks and asserts that while the virus is real, its communitywide threats have been exaggerated.

Masks have become a political weapon being used in an election year to create fear and control people, he said.

"Our civil rights are being violated," he said." Our constitutional rights are being trampled… To force people to do anything is a constitutional violation."

No regrets

Levin's decision in April not to enact a county-wide mandate was accompanied by a summary of research findings. It concluded there was not yet enough scientific evidence to prompt a cloth mask order, also citing the need then to protect supplies of medical masks.

He said Thursday he has no regrets over the decision, noting he was relying on the information available at the time. He also responded to those who contend an early mandate would have slowed county COVID numbers that have surged recently.

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"I suggest they look at Santa Barbara County and its history," he said, noting the county enacted a mask mandate in May. Like Ventura County, Santa Barbara County was placed on a state watch list for regions struggling with COVID issues.

Levin also noted recent research shows the value of masks, asserting he fully supports the statewide mandate.

"I think I made that pretty clear," he said, referring to his written statement issued in the wake of Newsom's mandate.

"We know that an effective mask will prevent someone who is infected from passing this virus to another," he wrote in the statement. "And we now know that cloth masks afford significant protection to those who are wearing them."

Cover your mouth and nose

At a Wednesday press conference that focused on surging COVID-19 hospitalization numbers, Ventura County Board Supervisor Linda Parks stepped to a microphone wearing a light yellow procedure mask.

She urged area residents to socially distance, avoid gatherings and wear face coverings.

"We have the ability to flatten the curve," she said, noting some people wear the masks over their mouths and leave the rest of their face exposed. "That's not how you do it. You cover your nose."

In a phone interview on Thursday, Parks contended the county should have enacted a face-mask mandate earlier, suggesting it would have brought a higher rate of compliance.

She said she didn't know if such a mandate would have impacted COVID numbers.

The county's cases are currently being driven by community transmission, Parks said, also noting more than 20% of the county's cases are believed to have involved people who showed no symptoms.

Masks, she said, help prevent the wearer from infecting others.

"Now, more than ever they are needed," Parks said, later referring to the people who contend that covering your face represents submission.

"Wearing a mask is not a sign of weakness," she said. "It’s a sign of respect."

When should you wear a mask?

• In any indoor public space
• When waiting in line
• When getting health care
• On public transportation or when ride-sharing
• At work, when near others or moving through common areas 
• Outdoors, if you can’t stay 6 feet away from others

When can I take my mask off?

• When eating or drinking
• If a hearing-impaired person needs to read your lips
• If wearing a face covering imposes a risk to you at work – for example, if it could get caught in machinery
• When you’re not sharing a common area, room or enclosed space with others
• When you are getting a service to the nose or face
• When outdoors in public and can stay six feet from others

Source: Covid19.ca.gov

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

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