As pressure mounts for a new statewide mask tenure, experts are divided over whether such demands work

“As the number of COVID-19 cases and hospitalizations continues an alarming upward trend that is straining our health care system, doctors at the Massachusetts Medical Society recommend that masks be mandatory in all public places interiors of the Commonwealth, regardless of immunization status, ”said Dr. Carole Allen, president of the company, in a statement.

But Gov. Charlie Baker resisted those calls, reiterating on Monday that he had no plan for a statewide mask mandate, noting that 5 million people in Massachusetts are fully immunized and that 1.5 million of them have received booster shots.

New data from the Metropolitan Area Planning Council shows that of the 101 communities it tracks in Greater Boston, nearly half now have some form of indoor hiding rules. At least 22, including Boston, require masks in all indoor public spaces, and 24 more have warrants for at least their municipal buildings.

Some infectious disease experts say warrants alone may not be enough to convince a pandemic-weary audience to don face coverings again. John Brownstein, epidemiologist at Harvard Medical School and director of innovation at Boston Children’s Hospital, concluded in a study published earlier this year that communities with reported high rates of mask wear and physical distancing were able to better curb transmission of the virus – but government mandates did not appear to increase the number of people wearing masks.

“The mandate itself is not necessarily the most effective,” Brownstein said. “What we found, in general, is that [mask wearing] increases when there is a threat other than a government mandate.

He said a growing number of cases and an increase in hospitalizations after Thanksgiving, associated with so many unknowns about the rapidly spreading Omicron variant, are just as likely to convince people to put their masks back on.

And the latest COVID-19 trend data from Carnegie Mellon University and the impact study seems to agree with this assessment. It shows that the percentage of Massachusetts residents who say they wear a mask jumped to 67% earlier this week, from 61% just before Thanksgiving.

Ali H. Mokdad, professor of health metrics science at the Institute for Health Metrics and Evaluation at the University of Washington, said there is no doubt that masks “can control the spread of this virus. “.

The institute predicts that if 95% of Massachusetts residents wore a mask, by March 2022 mortality from COVID-19 would drop to just three new deaths per day, instead of the expected 29 per day if nothing changes. This would prevent around 1,500 deaths.

On Monday, the State Department of Public Health reported an average of 17.4 deaths over seven days.

But Mokdad warned that the IHME model is three weeks old and does not yet consider Omicron. Once the new, fast-spreading variant was added into the calculations, the effects of masking would be much greater, he said.

Mokdad supports vaccines and immunization mandates as the first line of defense, but he warns that those vaccinated could play an important role in the spread of the virus if they come out without a mask. People who have been vaccinated may have little risk of becoming seriously ill, but they can still become infected and transmit the virus to vulnerable or unvaccinated people without knowing it.

“Mask warrants are working,” Mokdad said.

But Joseph Allen, director of the Healthy Buildings program at Harvard TH Chan School of Public Health, said a mask warrant wouldn’t be the most useful tool at this point.

For fully immunized and stimulated people, the masks offer “little additional benefit,” Allen said during an online news briefing Tuesday. And those who would benefit the most from wearing masks – the unvaccinated people – are the least likely to wear them.

Allen said public health officials should have relaxed the messages on the masks last spring and summer when the public knew transmission of the disease was low. Now “fatigue has set in”.

“We have taken the power of this tool out of our arsenal by not reactivating it at the right time, so that we can put it back in place at the right time,” he said. “The public is largely frustrated with this message – knowing the risk was low at times, but the public health message has remained on code red.”

Instead, public policy should focus on vaccinations, boosters and testing, he said.

Allen supports New York City’s approach of requiring either a vaccination or a negative test to enter a public place. “In a fully vaccinated environment, I don’t think people need to wear a mask,” he said.

In some small towns and villages in Massachusetts, mask warrants may have become impractical for already stretched health services.

Public health officials from Leominster and Gardner, for example, opted not to impose a mask, saying on Tuesday that due to their efforts to manage vaccines and testing clinics, they were no longer members of the staff to devote to the application of mask practices.

“A mask warrant requires tracking and enforcement and generates complaints when people don’t comply, and that will clear up.” [our] staff to a point where they may not be effective in just one area, ”said Jeffrey Stephens, director of health for Leominster. “So our department decided to focus on mitigation through testing and vaccines.”

Stephens, who manages a staff of six in a town of 40,000, said a majority of residents have started wearing masks with the recent spike in cases. Instead of a warrant, he said, they hope to increase respect for masks with educational messages.

Meanwhile, in Boston, which reimposed its indoor tenure in September, a walk through the neighborhoods on Tuesday revealed fairly good compliance with the rules.

Inside the Price Rite grocery store in Dorchester, all shoppers and store employees wore masks. Beside, at Target, all faces also remained covered.

Outside, in the parking lot, some people even kept their masks on while unloading their shopping carts into their cars.

But a few miles away in Milton, which only requires masks in town buildings, few face coverings could be seen in local stores.

An older couple held hands as they walked into a wine store, without a mask. At Mackie’s Barber, several hairstylists and clients were lounging in the salon, their smiles and laughter evident without masks.

At the Coffee Break cafe, the only mask in sight was the one placed on a customer’s chin as she drank her drink. Two baristas behind the counter were both maskless as they prepared drinks for guests.

One of the baristas, Jeremy Lewison, 19, of Milton, pulled a mask out of his pocket and said he usually puts it on when the store is crowded. But with only a few customers inside the cafe, he didn’t feel like he needed them.

“At this point, I trust everyone to make their own decisions, but if there is a mandate and people continue to not wear masks, that’s a whole different story,” Lewison said.

But Daniel Vasquez, 38, was walking nearby with a mask firmly in place. Vasquez, from Roslindale, was in Milton to visit his mother. He said he wears masks whether or not there is a warrant.

“For me it really is an easy decision,” he said, adding that his wife had asthma.

Vasquez said it was frustrating to see people without masks in the grocery store and in the city.

“It’s the contempt for others that bothers me. It’s not just for yourself, you are protecting others and getting involved in something to keep people safe, ”he said. “I would prefer a warrant.

Travis Andersen and Andrew Brinker contributed to this story.

Kay Lazar can be reached at [email protected] Follow her on twitter @GlobeKayLazar. Felice J. Freyer can be contacted at [email protected]. Follow her on twitter @happyjfreyer. Julia Carlin can be reached at [email protected].