The Center for Disease Control (CDC), has gone back and forth with recommendations for wearing masks in public during the Coronavirus pandemic. Historically, masks have been successfully implemented throughout history to combat the spread of infectious diseases. The CDC now recommends the public wear non-surgical, cloth face masks due to the unknown number of people who may carry Coronavirus but be asymptomatic.
Studies have found that even cloth face masks without respirators can reduce the spread of particles discharged from mouths while in public. This is key to managing the virus because it not only reduces the chances of spreading infection from person-to-person, but also reduces viral load exposure. Viral load means the amount of the virus. Research suggests that lower viral load exposure is correlated with more mild symptoms. Conversely, higher viral load exposure or repeated exposure may cause a patient to experience worse symptoms.
Despite their apparent usefulness in combating Coronavirus, masks have not been uniformly required by each state, or on a consistent local basis. States and counties are dealing with the Coronavirus on an individualized basis, with some loosening social distancing restrictions before May 1, 2020. However, several states and counties will still require masks in public when the social distancing rules are relaxed.
This article discusses the historical use of masks to combat public health crises, as well as which states require masks today. This article also discusses some of the city and county level face mask requirements in different states.
History of Masks and Contagious Diseases
The use of masks to combat the spread of contagious diseases has been used at different times. For example, during the Black Plague outbreak in Europe in the 17th Century, Doctors tending to plague patients would wear head-to-toe coverings, and masks with menacing, long beaks. The masks were thought to protect the doctors from contaminants that spread through miasma, or noxious air coming from infected patients or corpses. The Black Plague also originated the term quarantine because sailors would be held at ports for a period of 40 days to ensure they did not show symptoms.
The Covid-19 outbreak today is often compared to the Spanish Flu of 1918, which came in waves from approximately January 1918 to December 1920. The Spanish Flu was caused by an H1N1 virus with an avian origin. The virus infected approximately one-third of the world’s population and killed at least 50 million people. The Spanish Flu was particularly deadly to young children under 5, adults between 20 and 40, and those over 65-years-old. Similar to the COVID-19, the Spanish Flu confounded the medical community because it caused lung problems, but it was unclear what made the Spanish Flu so deadly. Doctors did not successfully reproduce the 1918 virus until 2005.
Although doctors had no treatment or vaccine to combat the Spanish Flu, they utilized social distancing and masks to slow the spread of the virus. The City of San Francisco, for example, required the public to wear masks. Violators were penalized with fines and even imprisonment. Other California cities followed San Francisco’s lead and legally required masks.
Which States are Requiring Masks?
Although masks are recommended by the CDC, they are not required by every state. The list of states requiring masks changes every day as the pandemic develops. Below is a list of the states currently requiring masks and brief guidelines as of May 1, 2020.
Connecticut has required masks since April 20. The state requires masks only where close contact is unavoidable and applies to any person over age two while in public. A “safe distance” is defined as six feet. People must also use masks during any public transit or ridesharing.
As of May 1, Delaware will require people to wear cloth face coverings in public settings and on public transportation. This order is more strict than other states, because it requires face masks while in public, rather than other states that require face masks only when social distancing cannot be observed. Employees must wear masks while working, which employers must provide at their expense. Businesses must also deny entry to any customer who does not have a face covering.
Hawaii has required masks since April 20, but the order only requires mask coverings by employees of essential businesses and their customers. People are not required to wear masks while outside engaging in recreational activities but are encouraged to do so.
Beginning May 1, Illinois state police will require everyone age two and older to wear a mask in public where six-feet of social distancing cannot be observed. This requirement includes indoor public places where social distancing cannot be maintained.
As of April 18, the public must wear masks while taking public transportation. All customers over the age of nine must wear masks inside any retail or foodservice establishment that is enclosed. Parents of children between the ages of 2 and 9 should try to ensure children have face coverings, although they are not required. Retail and foodservice employees must wear masks while working in areas open to the public.
New Jersey was the first state to require masks. As of April 8, alll customers and employees must wear masks while at essential businesses. Business owners must supply masks to customers who do not have them.
As of April 17, all people over the age of two must wear a mask where social distancing is not possible in public. The order exempts those people who cannot medically tolerate wearing a mask. The order also recognizes the CDC’s guidelines that children under two should not wear masks, nor should anyone who is unable to remove a mask without assistance.
Ohio is one of the states that will be reopening in phases starting May 1. As of May 4, construction operations and general office businesses can reopen. Businesses engaged in service and restaurants will open May 12. As of May, all employees and customers must wear masks at all times or will be denied work and service. Ohio has adopted the phase, “No mask, no work, no service, no exception” in its protocols for businesses.
Since April 19, Pennsylvania has required essential businesses to provide their employees masks, which must be worn at all times while working. Customers at essential businesses must also wear masks, and customers without masks must be denied entry.
As of April 18, essential businesses must provide employees with masks. The order does not require customers to wear masks, but encourages businesses serving customers face-to-face to encourage their customers to wear masks.
Mask Requirements at the Local Level
Counties have the ability to enforce their own mask requirements above and any order issued by the state’s Governor. Below are some examples of counties nationwide that issued their own mask requirements.
Los Angeles County, California
Los Angeles now requires face coverings while the public visits any essential business, like grocery stores, as well as observing social distancing. Governor Gavin Newsom has not instituted a similar mask mandate for the rest of California, but encourages the use of masks.
Other Southern California cities, like Burbank and Beverly Hills, require face masks even when people go outside for recreation purposes.
Osceola County, Florida
As of April 13, Osceola County required the public to wear a facemask when in public. Police officers have been given authority to fine anyone not wearing a face mask in public with a fine up to $500 or up to 60 days in jail. The order does not require people exercising to wear masks, so long as they are observing social distancing.
Colorado Governor Jared Polis issued an order in April requiring essential workers to wear masks. Those who come into contact with the public should also wear gloves.
Harris County, Texas
Harris County requires all residents over the age of 10 to wear masks in public. Failure to do so carries a punishment of a $1,000 fine or 180 days in jail. The mask order was signed by Harris County Judge Lina Hidalgo, due to the fact that Harris County is the epicenter of the virus in Texas. Judge Hidalgo’s order was more restrictive than Governor Greg Abbott’s Orders, which drew criticism from the public. Judge Hidalgo later indicated she would amend the order to conform to the Governor’s, but emphasized the importance of a face mask order in light of the high number of Coronavirus cases in Harris County.
Wheat Ridge, Colorado
As of this week, Wheat Ridge, a town five miles from Denver, will require face masks to be worn by all people while visiting essential businesses. Failure to comply is punishable by a misdemeanor. The order will run until May 30. Although Governor Jared Polis has not implemented a similar state-wide mandate except for essential workers, he stated he agrees with the mandate.
State versus Local Orders
Local governments can theoretically implement a face mask requirement greater than that adopted at the state level. In some cases, like Harris County, Texas, a mandatory mask requirement may be necessary to combat in a certain locality as opposed to the state level to combat a severe outbreak.
However, a city or county order requiring masks and imposing fines for violators will likely not hold up if challenged in court or by the Governor. A local order likely cannot impose a punishment greater than that ordered at the state level. This is because a Governor’s order supersedes an order by a locality.
State orders requiring masks may run afoul of laws prohibiting face coverings in public. Georgia, New York, and Washington D.C. are just a few states with laws that criminalize the use of unusual face masks or coverings in public, except at entertainment events.
Anti-mask laws date back to the 19th Century. The purpose of anti-mask laws is to deter crime based on the fact that the desire to be anonymous in public is associated with criminal behavior. Some states adopted laws criminalizing face coverings to prevent groups like the Ku Klux Klan’s use of hoods to hide their faces while violently targeting African Americans. However, these laws have also been used to punish protestors, like Occupy Wall Street protestors who wore masks at their sit-ins.
These laws are now suspended in light of the laws requiring face masks. Because the criminal laws prohibiting masks require some element of intent on the behalf of the person wearing the mask, people wearing masks for Coronavirus purposes cannot be punished.
Exceptions to Mask Laws
Generally, children under 2 are not required to wear masks, and the CDC recommends they should not wear masks. Those who are medically unable to wear masks are not required to. They are not required to provide medical documentation in order to be allowed in public or enter a business without a mask. Masks need not be surgical grade. Rather, simple cloth masks will comply with most state orders.