Orange County’s chief health officer has issued a recommendation “strongly encouraging” face coverings for workers at essential businesses which remain open during the COVID-19 pandemic.

Dr. Nichole Quick, who has the authority to mandate the action, stopped short of doing so. Her order was issued two days after the Orange County Board of Supervisors rejected Supervisor Andrew Do’s motion to make face coverings mandatory for at least food industry workers. Do declined to comment on Dr. Quick’s recommendation on Thursday.

Quick said she decided on a recommendation versus a mandate “based on what we’re seeing numbers-wise. I’m hopeful we’re seeing a flattening of the curve.”

The evidence that there has been a slowing of coronavirus cases in Orange County due to social distancing may be shown in the fact that the county is not seeing an exponential increase in cases on a daily basis, Quick said. The number of hospitalizations have also remained stable, she noted.

If COVID-19 cases take off again down the line, Quick said she would revisit a mandate.

Quick said the recommendation follows guidance from the California Department of Public Health issued April 1.

“Residents can make their own face coverings at home from a variety of materials and should refrain from purchasing personal protective equipment that is critical and in short supply for our healthcare workers, such as N95 and surgical masks,” Quick said.

A face covering should be worn over the nose and mouth, she said. Any sort of ties or straps should be used to secure it to the head. They can be factory-made, folded, sewn or improvised from common household items such as scarves, T-shirts, sweatshirts or towels, she said.

“Face coverings are an additional tool that may help protect staff and patrons from COVID-19, but they are not a substitute for proven protective measures like frequent hand washing, keeping your hands away from your face, practicing social distancing and staying home,” she said.

Beginning Friday, Los Angeles and several other cities in Los Angeles County will make face coverings for workers mandatory. The city of Irvine issued an order Wednesday making them mandatory, with the City Council expected to ratify it Friday. San Diego County adopted a similar policy last week.

Orange County health officials reported 67 new COVID-19 cases on Thursday, with the number of deaths unchanged at 17.

The number of hospitalized patients increased from 99 on Wednesday to 127, with the number of patients in intensive care increasing from 59 to 63, according to the Orange County Health Care Agency.

Of the county’s 1,079 cases, 15 — about 1% — involve people under 18 years old; 9%, 93, are between 18-24; 16%, 174, are between 25-34; 15%, 159, are between 35-44; 40%, 433, are between 45-64, and 19%, 205, are 65 or older. Men make up 52% of the county’s cases.

Officials say 12,239 people have been tested for COVID-19 in the county, with 1,578 more tests available. Since Wednesday, 448 people were tested.

Anaheim has the most cases with 114, followed by Irvine with 90 and Newport Beach with 81. Huntington Beach has seen a sharp rise to 76 cases, just two behind Santa Ana.

Laguna Woods now has seven coronavirus cases. Wednesday was the first time the Health Care Agency had reported statistics from the South County community, which has a population under 25,000, most of whom are of retirement age. Cases from such cities are not reported until they exceed five. Villa Park, which has a population of 5,933, on Thursday entered the list since it reached five cases.

For the first time, the county, on Thursday, provided some demographic statistics related to COVID-19 in the area, but Quick cautioned that officials were only getting about half of the racial breakdowns of patients and victims.

Of the 17 patients who died, six were Asian, three were Latino, two were white, five were of unknown ethnicity, and one was “other,” she said.

Of the total cases, 52% are of an unknown race or ethnicity, 21% are white, 12% are Latino, 7% are Asian, 6% are in the “other” category. Nine people, or about 1%, are black.

Jerika Lam, a Chapman University associate professor of pharmacy and expert on viral infections, said face coverings ought to be mandatory. Lam said that with state officials now able to acquire masks for healthcare workers on a mass scale, the fear of residents gobbling up a scarce supply has waned.

Lam said a newly published study showed how the virus can be spread in the air by talking.

“When we are talking, we can spew saliva, some of it can be in a fine mist, depending on the temperature,” Lam said. “When we’re in dry places like the desert, our saliva — the spit that comes out — may be in the form of aerosol, because there’s not much humidity to press it down.”

Lam added, “We will all get more used to wearing masks … Making this mandatory would not be unreasonable, especially when we’re trying to blunt or flatten the curve.”

The incubation time for the infection is four five days, and the average time to develop symptoms is 11 to 12 days, she said.

“I may be infected and not know I have it, walking around, and if I don’t use a mask to protect someone from getting it from me, I am putting that other persona at risk from getting infected, too,” Lam said.

Dr. Shruti Gohil, a UCI professor of infectious diseases, said “the jury is out what masks really do for you.”

Masks will not be effective if people don’t practice more important habits such as hand washing and refraining from touching the face, Gohil said. A small study of a handful of coronavirus patients who used masks showed the “outside of the masks were full of coronavirus,” she said.

“People cannot help it — they just touch their face,” Gohil said of studies.

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