New Orleans City Hall (Michael Isaac Stein/The Lens)

Following surging COVID-19 case numbers locally and around the state, Mayor LaToya Cantrell announced a mask “advisory” at a Wednesday afternoon press conference. The advisory calls on both unvaccinated and vaccinated people to wear masks while at public places — such as businesses — while indoors. 

“We have to move towards an indoor mask advisory, putting more responsibility on residents in our community that have yet to be vaccinated,” she said.

The so-called advisory is just that: a recommendation, not a legal requirement. And in practice, the advisory isn’t much of a departure from existing city policy. For much of the crisis, the city had a legally enforceable mask mandate for indoor businesses and other public buildings. But that was lifted in May and replaced with a mandate for unvaccinated people to wear masks indoors, a requirement that was impractical to enforce. 

“What we’ve also found is, that isn’t happening,” Cantrell acknowledged of the requirement.

Cantrell said that the major difference between the advisory and a mandate was that the city would not be involved in enforcing mask-wearing.

But, she added, the city would be revisiting its restrictions as the outbreak progresses. 

“We look at data all the time,” she said. “And we’ve also stated that we have a great fall that we’re all looking forward to, and that could be, and will be, jeopardized if we do not do the right thing.”

Wednesday’s COVID-19 data from the Louisiana Department of Health suggested that a major case surge on par with last spring or summer is already under way statewide, driven by the extra-infectious delta COVID variant.

On July 5, the city was averaging 11 COVID cases a day over a week-long period. As of yesterday, it was averaging 104. 

“That’s a ninefold increase in just two weeks,” Cantrell said.

According to LDH data, the city’s positive test rate is now 6.5 percent, up from 3.7 percent last week. That’s higher than at any time since January. City data, which is updated more regularly but is less accurate than LDH data, shows that test positivity may have spiked above 10 percent in the past few days.

New Orleans, which was hard hit by the first wave of COVID, has been faster to implement and slower to lift restrictions than the rest of the state. The city kept its mask mandate in place until mid-May, when the CDC issued new guidelines for fully vaccinated people. The state had lifted its mask mandate weeks earlier, though restrictions have remained in place for some state buildings and schools.

But the breakneck spread of the delta variant has left public health officials across the country scrambling. Los Angeles recently reinstated a mask mandate, and other California cities quickly followed suit.

The variant was first spotted in Louisiana in May, and now makes up about 85 percent of cases nationwide. It’s infectious enough that reports have begun appearing of transmission in fleeting outdoor interactions.

However, all US-approved vaccines appear effective against the virus.

Over the last two weeks, new cases have nearly tripled in Louisiana. LDH is reporting an average of about 750 cases a day over the last week, and reported more than 5,000 cases today, among the highest single-day increases of the entire pandemic.

“Transmission is increasing at a rate we have not seen since last spring,” said Dr. Jennifer Avegno, the city health director.

Since late June, New Orleans’ infection rate — the number of new people that each existing case will infect — has remained above one, indicating a growing outbreak.

More infections are occurring in 18-29 year olds than any other age group. In New Orleans, about 55 percent of the age group has not received a single dose of a vaccine, the lowest of any adult group.

Notably, few cases are occurring in the high-risk over-70 age group. According to LDH’s vaccination data, there are only about 500 people in New Orleans who are both above 70 and have not received at least one dose of a vaccine.

“We don’t even know what’s happening with deaths yet, because it’s too early,” said Avegno. Deaths have so far trailed case numbers by several weeks, although Louisiana is currently seeing a spike in COVID hospitalizations.

“I hadn’t seen a COVID patient in weeks come to the emergency department,” said Avegno, who practices emergency medicine. “I saw six in one day. Just me. There’s plenty of other doctors seeing patients.”

However, national trends suggest that this wave of COVID may be less deadly in Orleans Parish, because vaccinated people are extremely well protected from severe illness.

Overall, 69 percent of New Orleanians over 18 have begun their vaccine series, slightly above the US average. And Orleans Parish has the highest rate of completed vaccinations in the state, according to the latest LDH data. 

But delta may hit surrounding parishes with lower vaccination rates much harder. That will speed up transmission in New Orleans, and put children, the elderly, and the unvaccinated at risk. But it also threatens to again overwhelm the city’s hospital system, which admits serious patients from across the region. “We do not have the healthcare capacity to absorb the rapid increase in cases we’re seeing statewide,” said Avegno.