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As virus cases spike, calls for a nationwide mask mandate accelerate

Dr. Anthony Fauci, the nation’s top infectious disease doctor, has called for mask usage.ALEX EDELMAN/Associated Press

As Massachusetts recorded its highest one-day total of new COVID-19 cases since the spring, a growing chorus of medical experts is calling for a national mask mandate to curb the virus’s spread ahead of a feared winter surge.

“Right now, it’s sort of a piecemeal system, with a lot of states doing a lot of different things,” said Dr. David Hamer, a professor of global health and medicine at the Boston University schools of Public Health and Medicine and an attending physician at Boston Medical Center. “This remains a national health threat, and having some standardized approaches to control it makes a lot of sense."


While many states have required that people wear masks in public for months, the idea of a national mandate has gained momentum in recent days as outbreaks spread across the country.

Public health officials have urged the government — including a White House that has defiantly flouted mask-wearing — to take additional steps to ensure safety.

On Sunday, the national seven-day average of new cases reached a record of nearly 69,000, according to data from Johns Hopkins University, breaking the previous high set in late July.

Massachusetts coronavirus cases continued their disturbing climb on Monday, rising by 1,216 to 148,336. The death toll from confirmed cases in Massachusetts rose by 17 to 9,657, the Department of Public Health reported.

A national mandate would convey the magnitude of the crisis and the need for collective action, specialists said.

“I would expect that overall, there would be a net benefit, and I think it sends a really important message,” Helen Jenkins, an assistant professor of biostatistcs at BU’s School of Public Health, said Monday.

While some might balk at a government requirement to wear a mask — perhaps making them even less likely to wear one than they are now — Jenkins said that if anything, masks have increased people’s freedom to live their lives.


“It doesn’t mean that everything goes back to normal, but it definitely increases our ability to get back to some of the activities that we have missed,” she said.

In May, Governor Charlie Baker mandated that all residents over the age of 2 without certain medical conditions wear face masks in public spaces when social distancing isn’t possible, calling the decision “common sense.”

“This is going to be basically a way of life,” Baker said at the time. “No ifs, no ands, no buts, no doubts. If you can’t [socially distance] inside or outside, you’re going to be expected to wear a face covering or a mask.”

Last week, Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told CNN that if “people are not wearing masks, well then maybe we should be mandating it.”

“If everyone agrees that this is something that’s important and they mandated it and everybody pulls together and say, ‘We’re going to mandate it but let’s just do it,’ I think that it would be a great idea to have everybody do it uniformly,” Fauci said.

On Sunday, Dr. Scott Gottlieb, a fellow at the American Enterprise Institute who led the FDA from 2017 to 2019, published an opinion piece in The Wall Street Journal headlined, “Winter Is Coming: Time for a Mask Mandate.”

“We’re dangerously behind the curve in confronting rising Covid spread across the US," Gottlieb wrote in a Twitter post linking to the op-ed. "We need to maximize steps that are less intrusive now; so we can minimize those that are more disruptive later.”


Gottlieb’s message drew strong support from the public health community, including surgeon and author Dr. Atul Gawande, who called universal mask-wearing “our one way to avoid overwhelming our hospitals with cases.”

Enforcing such a mandate would be difficult, particularly as masks have become increasingly politicized. Even in Massachusetts, where residents have largely embraced masks as a necessary inconvenience, many have ignored the rules despite the threat of fines in some communities.

Yet Claude Jacob, chief public health officer for the city of Cambridge, said a nationwide mandate “would be an amplifier, and it would demonstrate an alignment of our efforts.”

“Until there’s an actual effective vaccine, this is the best intervention that we have available," Jacob said.

Dr. Daniel R. Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital, said a national mask mandate is the proper path, even if it is difficult to enforce.

“It’s the right thing to do from a public health perspective,” he said. “If the federal government sets that as the expected standard for behavior, then hopefully that will have influence and lead people to take appropriate measures.”

Wearing a mask is not only the most visible reminder of the pandemic, it could be the key to keeping the economy open, Kuritzkes said.

“The way to avoid doing [a shutdown] is to take those measures we know are effective and allow most, not all but most, businesses and economic activity to return normally,” he said.


“In hindsight, we should have done this at the [pandemic’s] outset," he added. “You learn from your mistakes.”

Dr. Abraar Karan, an internal medicine and global health physician at Brigham and Women’s Hospital and Harvard Medical School, said masks can help slow the current surge in cases, although it is too late to stop it completely.

“Mandatory masking, while important, would have had more of an effect a few weeks ago,” he said by e-mail. “We are now already set in motion for our third surge — masks can help slow it down but won’t be able to stop it altogether."

Globe Correspondent Nick Stoico contributed to this report.

Dugan Arnett can be reached at dugan.arnett@globe.com. Travis Andersen can be reached at travis.andersen@globe.com.