Local U.S. Restrictions on the Horizon As COVID Delta Variant Surges, Experts Warn

New COVID restrictions such as vaccine mandates and group size limits could be imposed in the U.S. on a local basis, experts have told Newsweek, because of the rise of the Delta variant.

On July 30 the country reported more than 100,000 new cases in a single day—the highest 24 hour rise in cases since early February, according to the U.S. Centers for Disease Control and Prevention (CDC). The spike comes as Delta is the dominant form of the virus in the U.S.

Last week the CDC updated its mask guidance, recommending that even fully vaccinated people wear a mask indoors in areas of high or substantial COVID transmission, amounting to the vast majority of counties in the U.S. The CDC is a federal body and local authorities make most public health mandates in the U.S. The CDC offers guidance that local authorities can decide to adopt.

Since last week, areas such as the state of Louisiana and California's Bay Area have reinstated mask mandates to combat the rise in cases.

On Sunday, Dr. Anthony Fauci, chief medical advisor to President Joe Biden, said he didn't believe lockdowns would occur. But experts have told Newsweek that it is likely that some new local restrictions will be imposed if cases continue to rise.

Dr. David Bates, professor of health policy and management at the Harvard T.H. Chan School of Public Health, thinks it is "very likely" that restrictions will be introduced, particularly at the city and county level, involving masks and potentially group size limits.

Dr. Arthur L. Reingold, head of the epidemiology division at the Berkeley School of Public Health in California, told Newsweek he is "pretty sure" some areas may see restrictions on group sizes in social and business settings. Paul Ginsburg, director of public policy at the USC Schaeffer Center for Health Policy and Economics, anticipates more vaccine mandates, "for example requiring employees and perhaps employees of contractors, to be vaccinated."

Bates said: "New restrictions would be politically difficult, especially as they are most likely to be implemented in areas with large proportions of unvaccinated individuals, and many of these areas are conservative."

Pew Research Center data has suggested that Republicans are less likely than Democrats to support COVID restrictions such as face masks for travel and limits on group gatherings.

In one Pew survey conducted in February, 93 percent of Democrats said it had been necessary to ask people to avoid gathering in large groups compared with 56 percent of Republicans.

The same survey showed 96 percent of Democrats said it had been necessary to require face masks for public travel while 72 percent of Republicans thought the same.

One reason that restrictions may be unpalatable politically and socially is that they will probably affect the U.S. economy.

On July 29, Reuters reported that strong consumer spending, particularly on travel-related services, helped the U.S. economy grow in the second quarter after the initial pandemic-driven downturn of last year. But the report said a resurgence in cases posed a risk to the outlook.

"[Restrictions] are politically difficult, especially those that impact the economy," Ginsburg told Newsweek. "But the rapid increase in infections, hospitalizations and deaths are making restrictions more feasible politically."

Ginsburg said the rapid increase in cases will likely change attitudes about both vaccinations and restrictions and that restrictions that apply only to unvaccinated people "will be more politically palatable."

The vaccination drive is something that the Biden administration is continuing to push, but still less than half of the U.S. population has been fully vaccinated, according to CDC data from August 2. That day, the U.S. hit the milestone of 70 percent of the population having at least one dose of a COVID vaccine, around a month after Biden's goal for the Fourth of July.

Bates said the vaccination pace has "slowed to a crawl as most of those who want a vaccination have already been vaccinated."

But Ginsburg thinks the pace is about to accelerate substantially, driven by a combination of mandates from employers, restrictions on unvaccinated people and general concern about the health risks posed by the Delta variant.

For now, there is still a marked variation in transmission across U.S. counties despite the fact most are deemed to be areas of "high" or "substantial" transmission.

This variation means restrictions will likely vary if and when they are imposed, said Reingold.

But, he said: "I think new restrictions, at least with regard to masking indoors, will be imposed in many places.

"As for vaccination… anything we can do to increase vaccine coverage in the U.S. and its various regions, states, and territories would be a very good thing."

Times Square New York
People sit on the Times Square Red Steps in New York, some wearing face masks, in July 2021. The CDC updated its face mask guidance last week. Timothy A. Clary/AFP / Getty