GOSHEN — The Elkhart County Health Department, in a directive issued Friday night, strongly encourages wearing face masks, though the guidelines fall short of the sort of mask mandates established elsewhere.
Also, on Saturday, the Indiana State Department of Health confirmed more than 100 new infections in Elkhart County, the most reported yet in a single day.
The county health department published a three-page document on its Facebook page explaining when face coverings should be used and who does or doesn't need to wear them. It encourages people to wear a covering over their nose and mouth when they are at an indoor area that's open to the public, including public transportation, or at an outdoor public area or indoor private area where a 6-foot distance from other people can't be maintained.
People who don't need to wear masks include children under age 2, due to the risk of suffocation, and people whose breathing could be impaired.
The intent of the guidelines is to ensure the public recognizes the importance of wearing masks to prevent the spread of COVID-19, officials said.
Wearing masks is strongly recommended by the health department, according to the directive, because the virus is carried by respiratory droplets and may be spread by infected individuals with or without symptoms, and possibly even by those who will never display symptoms despite being positive.
"This guidance is issued based on evidence of increasing occurrences of COVID-19 within Elkhart County and our awareness that individuals in Elkhart County currently do not often wear face coverings in public," states the directive, which is signed by county Health Officer Dr. Lydia Mertz. "This guidance is issued based on scientific evidence and best practices regarding the most effective approaches to slow the transmission of communicable diseases generally and COVID-19 specifically."
The guidelines note that the use of face coverings doesn't replace other protective measures, such as hand washing, isolating at home when necessary and sanitizing frequently touched surfaces. They also note that not wearing a mask isn't grounds for harassment or law enforcement action against someone.
The guidelines will be published on the county government's website along with a lengthy FAQ. The Elkhart County Board of Commissioners plans to vote Monday on a resolution that would signal their support for wearing face masks.
Commissioner Mike Yoder on Saturday said the health department's action doesn't represent a change in the county's position but an effort to clarify when masks should be used.
"Our effort now is to increase communication of the importance of wearing masks, but also, from what we hear in the community, there was significant confusion about when you should and when you don't have to," he said. "This order, in my mind, does a couple things. It reiterates the importance of mask wearing and helps clarify when it's appropriate and when it's not necessary."
He said one key metric county officials will be keeping an eye on is whether hospitalizations go up alongside positive cases.
"The percent of positive tests that we're seeing right now, health professionals are telling us that in 10 to 14 days, that could lead to higher hospitalization rates. If that does happen, then that tells us the community is not handling the virus as well as it has been for the last month," he said. "At the moment, it looks like everything is fine. There's more people testing positive for the virus, but hospitalization rates have been steady. ... For now, we have to figure out a way to allow this virus to move through the community in a way that doesn't overwhelm our hospitals and keeps the most vulnerable component of our community safe."
Yoder said county officials may also consider a recommendation against gatherings of more than 50 people, which would be a departure from the state's new limit of 250 people after the move into Phase 4 of the reopening plan. He observed that contact tracing has shown social gatherings have contributed more to the spread of COVID-19 in Elkhart County than contact in the workplace.
"The increased percentage of positives are coming not from the workplace, but are coming from out in the community," he said. "Community activities: family gatherings, social gatherings. That's where the spread is happening at this point."
The St. Joseph County Health Department issued an order on May 3 requiring residents there to wear face masks until July 4. It also requires businesses that are open to the public to make hand sanitizer available.
Local leaders meeting to discuss the virus talked at length about the possibility of mandating masks, according to Yoder. He said the problem is that the county couldn't back up such an order with enforcement, so they opted to step up their education efforts instead.
"The reason we haven't done anything mandatory is because there's no way to enforce it," he said. "In our community, it seems to us from a policy standpoint, if we pass an ordinance that we upfront say we can't enforce, it's pretty meaningless. So we're maintaining the expectation that if the community knows the facts and the reasoning why, that they will take the appropriate action."
He expressed a belief that Elkhart County residents will respond better to education efforts than policy changes.
"I have more confidence that if we passed a mandate, that it would be ignored. People that are already inclined to wear a mask are wearing masks. Those who are not inclined to wear a mask, if we pass a mandate and the question is can you enforce it, the answer is no, they will not wear a mask," Yoder said. "My experience in this community is, if you share the information, you share facts, you share reasoning as to why you need to make some changes, that tends to move the needle more than if you pass a law."
Elkhart Mayor Rod Roberson is one local leader who has said he wished masks could be mandated.
Nappanee Mayor Phil Jenkins expressed concern with the high number of positive cases in Elkhart County, which he noted made up 10 percent of the positive cases in the state in the past week. But he also remarked that he would not be in favor of a mask requirement in the county.
"I think face masks are a step in the right direction to prevent the spread but do not favor a mandate," he said. "If you cannot maintain 6-foot separation while away from home, wear a mask."
Richard Aguirre, part of the Latino pandemic response team put together by the county health department and Goshen College, pointed to the apparent success of the mask mandate in St. Joseph County and asked why it couldn't work in Elkhart. He also questions the logic behind not requiring masks.
"I don't know if it could be effectively enforced, but I do know there are a lot of people in Elkhart County, if they were told they have to wear a mask in every public building that they went to, I bet a lot of them would," he said. "I understand the dilemma the county's in ... but a lot of people aren't going to want to obey it. But I would say the same thing about other laws we all obey — I stop at a stop sign even when no one's around, because that's the law, right?"
He also expressed a fear that people who choose to wear masks could be stigmatized.
"Just like everybody else, I'm tired of not seeing my friends, I'm tired of not going to restaurants. But I have to believe the statistics, and I think it's important for people to believe the statistics and know that we're all in this together," Aguirre said. "What I hope doesn't happen out of this is that people will say, well it's the Amish fault or the Latino community's fault. It's nobody's fault that they have COVID-19. We all have to take precautions to try to protect ourselves and those that we come in contact with."
By the numbers
The latest report from the Indiana Department of Health on Saturday showed 104 new cases of COVID-19 in Elkhart County, all but one from Friday. The total of 103 new cases is the highest number yet for a single day since 88 cases were reported on June 4.
That brings the total number of cases in the county to 2,030, the fourth highest total among all counties in Indiana and just behind Allen County, which had 2,168.
No additional deaths were reported in the county, leaving that total at 32.
Across the state, 17 more people have died, health officials said Saturday, bringing to 2,231 the number of people who died with confirmed COVID-19 infections. The heath department also has recorded 182 fatalities considered coronavirus-related by doctors but without confirmation of the illness from test results.