163: Mask Mandate Ruling

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Friday, April 22nd, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

The justice department appealed a federal court ruling this week striking down the mask requirement for people on planes, trains, buses, and other forms of public transportation. Andy Baker-White is ASTHO's senior director for state health policy. We get his take on the legal concerns and the impact of the ruling in today's morning conversation.

What's ASTHO's reaction to the court decision?

ANDY BAKER-WHITE:

Well, seeing as how the decision earlier this week basically denies CDC the authority to require the use of mask-compelled transportation, such as airplanes, trains, buses, and such, it is something that ASTHO is watching and monitoring—not just this decision, but similar decisions, as well as other legislation that limits or denies the exercise of public health authority.

What we're seeing and what we're hoping doesn't happen is that what these decisions, and this type of legislation does, could perhaps end up causing us to pull our punches, so to speak, as we try to prevent the spread of COVID-19 and manage the continued response to the pandemic.

JOHNSON:

Does this ruling mean masks are no longer a tool for public health?

BAKER-WHITE:

No, masks are still a tool for preventing the spread of COVID-19. The CDC, as well as several states, still recommend or advise use of masks in certain settings. Some states continue to require masks in certain places, especially congregant places or healthcare settings like long-term care facilities, prisons, emergency shelters, and even on transit systems that might be under the state's jurisdiction's control.

Sometimes these requirements are tied to the level of community spread within an area. Guam actually still has an indoor mask requirement that's in effect until early May when it's set to expire, and some local jurisdictions also have re-instituted mask requirements—I think most notably here recently, Philadelphia.

JOHNSON:

Given the ruling, where does public health go from here?

BAKER-WHITE:

Well, we're all pretty tired of COVID, but we have to understand that the pandemic's not quite over. There are still hundreds of people who are dying each day of the virus, and we're starting to learn more about the long-term effects of infection.

This decision, though, it creates a gap within the coordination and sustaining the management of the COVID response, especially since the federal government is the entity that has the authority over interstate travel while states don't necessarily have the power to regulate those venues.

That, as we move forward, the public health system continues to prepare for future surges by increasing immunization rates and supporting healthcare readiness. It can strengthen public health infrastructure by ensuring the readiness of the public health workforce in sustaining appropriate disease investigation and testing capacity. And it can prioritize high-risk groups by improving infection control and practices in long-term care facilities and working to improve ventilation and air quality in schools.

JOHNSON:

The CDC continues to recommend that people wear masks when using public transportation, especially older adults, and those with underlying health conditions.

The Public Health Communications Collaborative has updated messaging on this topic. You can read it using the link in the show notes.

Another case of how COVID-19 has impacted public health—this time, the focus on diagnosis and treatment of tuberculosis. The CDC says incidence of the disease dropped to historic lows in 2020, but Phillip Talboy, senior advisor in the CDC's Division of TB Elimination, suspects there's more to the story.

PHILLIP TALBOY:

The declines may represent a true reduction in TB disease, but my gut feeling is it's not. It's probably missed or delayed TB diagnosis due to the multiple factors associated with COVID, such as staff being redirected.

JOHNSON:

Last year, rates were trending up again—9.4% over those recorded the year before. Talboy says awareness is a key component to the response

TALBOY:

Clinicians in this country don't see TB on a regular basis. They might see one case in their entire career. So we need to raise awareness to say TB—if a person comes in with a fever and cough and all those things, rule out TB as well. If we get more physicians to do that, then the diagnosis is not delayed and the spread is decreased.

JOHNSON:

You can see the numbers and other information about tuberculosis using the links in the show notes.

The pandemic may have caused a delay in their plans, but it did not stop the Louisiana Department of Health from launching a mentorship program.

A few years ago, department employees said they wanted mentors, but COVID-19 happened. The work was put on hold while the team responded to the crisis until last year when the initiative was revived.

Find out how it's going in a new ASTHO blog article, available now via the link in the show notes.

Finally, today is Earth Day. You can read ASTHO's statement on environmental health policy—like everything else, it's in the show notes.

Before we go, we want to remind you to follow the show on your podcast app. And if you're on Twitter, Instagram, Facebook, or LinkedIn, we'd really love a shout out.

That'll do it for today's newscast. We are back Monday morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.