Facing a resurgence in coronavirus cases and hospitalizations, St. Louis on Friday became the latest major U.S. city to revive its mask mandate, joining Los Angeles in requiring face coverings indoors.

The mandate takes effect Monday and will apply to everyone, even vaccinated people, in indoor public places and on public transportation. It comes a little more than two months after the city lifted the rules, which had been in place since last summer.

In King County, Washington, the top health official recommended mask-wearing indoors.

Officials said the move was designed to combat the spread of the hyper-transmissible delta variant of the virus, which has caused infections to spike around the country in recent weeks and threatens to upend progress against the pandemic. The situation is particularly dire in Missouri, where vaccinations have lagged and the case rate among the unvaccinated is now as high as it was near the state’s peak of infections in January.

“If our region doesn’t work together to protect one another, we could see spikes that overwhelm our hospital and public health systems,” Fredrick Echols, acting director of health for St. Louis, said in a statement. “The City and County health departments are taking this joint step to save lives.”

Similar moves are being discussed around the country, from the Bay Area to Manhattan, and there’s been a steady drumbeat of comments from health officials lately advising the public that a return to masking may be around the corner. The Centers for Disease Control and Prevention’s most recent guidelines still say vaccinated people don’t need masks indoors, but local leaders are mulling whether tighter restrictions are necessary as new disease hot spots emerge.


“We certainly are seeing a surge in cases with the delta variant, which is now dominating in this country,” White House medical adviser Anthony S. Fauci told Fox News on Friday. “So it’s quite understandable why local authorities are now saying, ‘Good that you’re vaccinated, but in a situation where you have people indoors, particularly crowded, you should wear a mask.'”

A growing number of experts say it’s time to cover up again. The influx of new patients is straining many local health-care systems, and the pace of vaccinations has slowed to the point that the Biden administration has warned of a “pandemic of the unvaccinated.”

Eric Topol, a cardiologist and director of the Scripps Research Translational Institute, called the reinstatement of St. Louis’s mask mandate “wise.”

“We should be doing it across the country until the Delta wave passes,” Topol told The Washington Post in an email. “Besides vaccinations, masks and distancing is all we got to fight this superspreader strain.”

But the renewed push for masking is prompting a wave of backlash and reigniting debate that raged last year over how to combat the pandemic.

In Los Angeles County, some local leaders are seething over the requirement to wear masks indoors, saying the top-down approach only creates confusion in the sprawling urban area, where circumstances differ from one community to the next. Some officials have gone so far as to demand resignations and threaten to cut ties and form their own public health departments over the mandate, which took effect last weekend.


Mandates have become non-starters for a number of Republican governors, too. In Florida, Gov. Ron DeSantis recently doubled down on his opposition to mandates in schools, threatening to outlaw the requirements if school districts buck him or if the federal government sets standards. His remarks came just a few days after the country’s leading pediatric group recommended masking in classrooms for anyone over age 2 this fall, regardless of vaccination status.

Even in Arkansas, where cases are spiking and vaccination rates are among the lowest in the country, Gov. Asa Hutchinson, a Republican, says a statewide ban on mandates passed by the legislature this spring will remain in place.

“Arkansas [is] a state where we have a prohibition on mask mandates. We don’t have vaccination mandates either, which is typical of a Southern independent, rural state,” he said at a summit in Washington this week. “Culturally that’s not where we are.”

Sarah Sanders, the Republican former White House press secretary who is running in the election to succeed Hutchinson, has also vowed to preserve the bans. “We believe in personal freedom and responsibility. It’s one of the key cornerstones, frankly, of our country,” she told Fox News this week.

In St. Louis, the announcement of the mandate Friday immediately drew a rebuke from Missouri Attorney General Eric Schmitt, a Republican, who said he planned to go to court to block it.

“The citizens of St. Louis and St. Louis County are not subjects — they are free people,” Schmitt, who is running for U.S. Senate, tweeted from his campaign account Friday. He added: “If the last six months have taught us anything it’s that when it comes to expansive, authoritative executive action we have to fight back with everything we’ve got — all the time.”


Health officials are particularly alarmed by the sharp rise in cases in St. Louis this month. The average number of new daily cases in the city jumped by nearly 40% over the previous week, officials said. They noted also that the regional positivity rate had risen to 10% — far above the threshold for controlling community spread — and that African Americans made up 80% of new reported cases since May.

“We need everyone, vaccinated or not, to wear masks in crowded indoor settings. We must protect our most vulnerable residents as well as children under 12, who are not yet eligible for vaccinations,” Faisal Khan, acting director of the St. Louis County Department of Public Health, said in a statement.

For now, many other cities have stopped short of requiring masks, instead opting for guidelines and recommendations intended to nudge their populations in the right direction. Even those that want to order masking may be barred from doing so by legislation banning the mandates.

Across the state from St. Louis, in Kansas City, officials aren’t reinstituting their mask mandate yet. The Democratic mayor, Quinton Lucas, told local media he was in regular contact with St. Louis officials and urged residents to take action on their own accord.

“While masks are not currently mandatory in Kansas City, we continue to encourage Kansas Citians to wear masks in large indoor settings, or if you are in close proximity to an unvaccinated person,” he said. “Kansas City, please — please — take the vaccine if you have not yet.”