“I’d rather have a dangerous freedom than a comfortable safety,” said Arkansas state Sen. Trent Garner, who successfully pressed a ban on mask mandates and, like many like-minded officials, is adamant it stay in place.

That’s left an increasingly fractured response, with some cities defying state bans and certain wary businesses stipulating that returning workers provide proof of vaccination. Meanwhile, the bans threaten longstanding public health practices that extend beyond the pandemic, from shutting down restaurants that have foodborne illnesses to vaccinating children against diseases that took decades to bring under control.

We can do the surveillance but we can’t take any action, and small outbreaks could become much bigger problems. This is the bread and butter of our public health work and we’re in danger of losing it,” said Marcus Plescia, chief medical officer of Association of State and Territorial Health Officials.

With infections expected to rise this fall as the weather and school reopenings push Americans indoors, officials in these states will have few options other than trying to cajole a resistant public into voluntary compliance.

Arkansas Gov. Asa Hutchinson is touring his state, pleading with residents to get vaccinated, and nearly every state is offering incentives and enticements to do so. Health departments in Kansas, Missouri and other hot spots that can’t require masks are recommending people wear them. Mississippi, where more than a dozen hospitals have run out of ICU beds, now advises unvaccinated people to avoid indoor gatherings.

“The era of statewide mask mandates is over for the majority of the United States and certainly for us, but there are other common sense steps you can take,” said Mississippi state health officer Thomas Dobbs.

Many Democratic-controlled states and cities have also been reluctant to reimpose mask mandates, even if they still have the power to do so. In Kentucky, Gov. Andy Beshear told reporters on Monday that there is no need to require face coverings now that people can choose to be vaccinated.

But inducements to get shots have largely failed to boost uptake and toothless recommendations to wear masks and social distance are largely going ignored, leaving local health workers and elected officials scrambling as cases mount.

Only a handful of places, such as Los Angeles County, have reimposed mask mandates as the more contagious Delta variant becomes dominant, and lawmakers from those areas argue such targeted actions are essential to combating the next phase of the pandemic.

“Some local areas will get more cases, some will get less,” said Rep. Ted Lieu (D-Calif.). “Local communities should be able to decide the best way to protect their residents. It’s really dumb to say local communities can’t try to do more to protect residents from getting sick.”

Even some Republican officials who believe mandates are ineffective and prompt backlash are torn over the question, and say local leaders, not state lawmakers, generally know what’s best for their residents.

“I’d rather have local control than state mandates because what’s happening in Northwest Kansas is different than what’s happening in Johnson County [outside Kansas City],” said Kansas Republican Sen. Roger Marshall, whose state recently took away local departments’ ability to intervene in the crisis.

Some local leaders insist they still have discretion to take action, despite what their governors have ordered. A spokesperson for Tucson Mayor Regina Romero said she would reimpose a mask mandate if infection levels are bad enough, despite Gov. Doug Ducey’s recent executive order that prohibits local jurisdictions from doing so.

Ducey’s office did not respond to a request for comment.

Other officials still hope states will walk back the bans should the pandemic’s toll reach new highs.

“If things get really bad, if our hospitals start to fill up, and we have to once again set up tents with beds in them to treat people, I think you’re going to see a reconsideration,” predicted Rep. Al Green (D-Texas). Local officials in his hard-hit Houston-area district have battled for months with the state over what pandemic precautions can be enacted.

A Missouri law that takes effect next month will limit local officials’ ability to impose measures like mask requirements or limit capacity at places like Arrowhead Stadium, where more than 76,000 Kansas City Chiefs fans are expected to gather in the fall.

Kansas City Mayor Quinton Lucas said he fears being hamstrung even as the health care system begins to buckle. But unless there is a surge in vaccinations, he isn’t sure there will be much he can do.

“These policy approaches are not in the best interest of public health or in the best interests of the people of Kansas City,” he said. “There aren’t a lot of options left.”



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