The public-health officers of King County, Pierce County, and six other counties in western Washington are formally advising citizens to wear masks in any businesses and other indoor public settings—a change from recent loosening of mask guidelines since the advent of vaccinations against COVID-19.
In a joint statement issued July 26, the officials said a return to broader mask-wearing will help reduce the risk of COVID-19 to the public, including business customers and workers, help stem the increase in COVID-19 cases and hospitalizations in many parts of the state, and decrease the spread of the highly contagious Delta variant.
Vaccinations are the best defense against COVID-19 and are readily available for everyone age 12 and over, and anyone who isn’t already should get vaccinated “immediately,†the official said.
Health officers for Snohomish, Kitsap, Clallam, Jefferson, San Juan, and Grays Harbor counties also are part of the mask recommendation.
The renewed emphasis was also stated by King County’s health officer, Dr. Jeff Duchin, during a press briefing July 23.
“Wearing a mask in indoor public settings where not everyone is known to be vaccinated is easy and effective and provides an extra layer of protection for all of us as we get back to doing the things we want to do and need to do,†Duchin said.
COVID-19 has been on the rise in King County since June 29, when the county’s indoor mask directive ended. At that time, Seattle-King County Public Health reported an average of 61 new cases daily. Three weeks later, the average daily case counts were at 141.
Hospitalizations in King County also have increased, according to Duchin. In a seven-day period ending July 23, 45 people were admitted to hospitals as COVID patients, a 32 percent increase over the previous week.
According to the western Washington county health officers, recent outbreaks have occurred in indoor settings where people have prolonged contact with one another, such as gyms and social gatherings. These outbreaks, like others reported nationally, include indoor public settings where unvaccinated and fully vaccinated people aren’t masking. There are some instances of infection even among vaccinated people engaging in indoor activity in a poorly ventilated space without masks.
The health officers issued the following questions and answers to help inform the public about the need for masks:
Where and for whom does this recommendation apply?
Anyone older than 2 years old is encouraged to mask up if they are entering an indoor space that is open to the public. This includes retail and grocery stores, government buildings, or other businesses or places where people can enter freely.  If you can’t be certain those around you are fully vaccinated, mask up. Masks add another layer of protection to what vaccination has already given you. If you’re not vaccinated, it prevents transmission to others.
What does this mean for businesses?
This is not a new or separate mandate for businesses, which must still comply with statewide mask requirements and should be requiring masks for unvaccinated individuals in public indoor spaces. However, we are encouraging businesses to ask everyone to mask up when entering in order to help protect workers and customers, particularly if they are unable to verify vaccination status of everyone who enters their establishment.
Why are local health officers urging masking for all in these settings when the state Department of Health and the governor haven’t?
Local public health officials are responsible for providing their best advice and guidance for their communities on how COVID-19 is transmitted and how to prevent it. Because of the increasing case counts, hospitalizations, and transmission of the Delta variant, the health officers felt it was important to share this recommendation with their communities for reducing transmission of COVID-19.
 How will this be enforced?
This is not a mandate. It is a recommendation from the Puget Sound-area health officers to keep the community as safe as possible.
 If the vaccines are so effective, why do vaccinated people need to mask up?
The vaccines are highly effective, and this recommendation doesn’t challenge that fact. No vaccine is 100 percent effective at preventing illness. Those who are fully vaccinated are less likely to become ill with COVID, and much less likely to become hospitalized or die. Still, vaccinated people can get COVID. These are called breakthrough cases, and a small number are happening in Washington. So even though you are at least 10 times less likely to get COVID or have a severe illness if you are fully vaccinated, you still can get sick and potentially spread it to others. Well-fitting, multi-layer cloth face masks reduce spread of infectious droplets. As case rates rise, and as we continue to learn more about the highly transmissible Delta variant, masking is an extra layer of protection that the health officers are encouraging for everyone when indoors in public. Vaccination, mask wearing, good ventilation, and hand hygiene keep bad health and economic consequences of this Delta strain at bay.
Isn’t this confusing? Do people listen to the national Centers for Disease Control (CDC) or the state or local health departments?
The CDC and state and local public health officials agree that COVID vaccines and masking have been effective at reducing transmission. While the officials aren’t requiring masks in all indoor public settings for fully vaccinated individuals, even vaccinated people may still choose to mask up, and that is what we are encouraging them to do. At the same time, this ensures easy verification that all unvaccinated people are masked in those settings, as well.