Derek Lacey|Asheville Citizen Times
Buncombe County's local order requiring face coverings in public has beenextended until Nov. 30, as local officials decide to hold steady with holidays and expanded vaccine eligibility on the horizon.
The order requires Buncombe residents ages 5 and over to wear face coverings in indoor public places, including businesses, offices, workplaces, bars and restaurants.
In a call with local media shortly after the announcement Oct. 27, Public Health Director Stacie Saunders said county health officials recommended extendingthe requirement for three main reasons: the county's high COVID-19 transmission rate, looming holidays that traditionally bring surges in new cases and the expected vaccine eligibility of 5- to 11-year olds.
"On the positive side, there is a lot of good news in terms of the trends that we're seeing in the community," said Board of Commissioners Chair Brownie Newman. "I think when the commissioners made the decision to reinstate the mask requirement a few months ago ... the numbers were going all in the wrong direction."
Themandate was first enacted Aug. 18 andwas set to expire Oct. 29, having already been extended once, during a Sept. 22 Board of Commissioners meeting.
It also applies in Asheville, Biltmore Forest, Black Mountain, Montreat, Weavervilleand Woodfin according to the county's statement Oct. 27.
More: Buncombe County mask mandate set to end Oct. 29; transmission still high
In August, hospital capacities were straining, Newman said, which along with school starting back up, weighed heavily on commissioners' decision.
The decision to extend the mandate this time, he said, was formally his own decision,though Newman said before making the call, hespokewith most of the other commissioners, who supported the extension.
"Although I'm signing this as chair, I wanted to make a decision that reflects the views of the overall County Commission," he said. "I wanted to do somethingconsistent with the thinking of the overall group."
Buncombe County is still an area of high transmission, per the Centers for Disease Control and Prevention definition, Saunders said, which sets that benchmark atmore than 100 new COVID-19 cases per 100,000 residents per week, according to the announcement.
As of Oct. 26, the county was recording 119 new COVID-19 cases per 100 residents per week, according to a county update.
"We have not maintained nor even achieved yet a moderate level of transmission for any period of time," Saunders said.
At5.4%, the county's test positivity rate, or the number of COVID-19 tests returning positive results remains in the moderate category,it says, and the county's death rate remains in the substantial category, at 1.9 COVID-19 related deaths per 100,000 residents per week, according to numbers shared by the county Oct. 26.
Looking back on the past two months of a reinstated mask mandate, both Saunders and Newman say they feel it has made a positiveimpact.
Two things really make an impact to transmission rates throughout the ongoing delta surgeand kept Buncombe's metrics relatively low compared to nearby counties, Saunders said: vaccine outreach andcounty leadership taking a layered approach to prevention that includes the mask mandate.
"Everyone has wanted to do what we need to do to minimize the amount of transmission and illness in the community, but also to avoid another economic shutdown in the community or a shutdown in the schools," Newman said, crediting local schools for their hard work.
When it comes time next month to make a recommendation, officials are hoping recent trends of dropping cases continue, and that another month of the mask requirement helps protect this younger group as they become eligible for vaccinations.
"We said when we reinstated the mask requirement, it was not a decision that we took lightly at all," Newman said. "It is a very strong step for the government to step in and require that in all indoor public settings, so it's not one that we take lightly."
He said he and other commissioners are optimistic, and if current trends continue through November, it's likely that commissioners wouldn't support a third extension of the mandate.
A different kind of Halloween mask
Historically, Saunders said, the county has seen new COVID-19 cases surge following holidays, and with Halloween and Thanksgiving coming in the next several weeks, county health officials recommended keeping the mask mandate in place through until the end of November.
"So maintaining that face covering requirement until the end of November makes really good sense for that first wave of 5- to 11-year-olds so that we continue to have that layered infection prevention approach so that we can potentially protect that population as they enter their eligibility," Saunders said.
Part of Saunders' recommendation to extend the face covering requirement was to help lessen COVID-19 case surges that holidays brought last yearBuncombe County.
"When we've seen our surges before, we've seen them typically come after a holiday," she said. "So we expect to see after the holidays that we might see a bump. What we want to do is minimize that bump ... while our 5- to 11-year-olds are getting their vaccination."
More: Buncombe's COVID-19 rates continue steady fall; county readies to vaccinate 5- to 11-year-olds
The higher the vaccination rate goes, the lower the transmission rate, she said, and the closer the county gets to that place of controlling and managing COVID-19 transmission.
She said she hopes the county no longer sees "steep mountains" in its case rates,but something more akin to "speed bumps."
Saunders encouraged anyone trick-or-treating for Halloween to take some extra safety precautions, especially keeping any holiday gatherings small and outdoors.
"This isn't a time for us to get 15-20 people together, we're talking about a couple of our good friends," she said. "If you are going to do indoor activities make sure that you do have a face covering on, and ... it's still important to keep distance."
Trick-or-treaters are recommended to keep distance between themselves and other groups and have sanitizer handy for in-between stops, Saunders said.
For those handing out candy, she recommended moving it outside, maybe with a table in the yard or driveway,make individual candy bags and keep sanitizer for folks to use.
Eligibility for 5-11-year-olds imminent
Saunders said COVID-19 vaccines should get full approval in early November, expecting to get the "full go-ahead" to start administering vaccines to 5- to 11-year-olds on Nov. 8.
The county has already done a lot of planning in preparation for the group's eligibility, including four straight "Saturdays at School," weekly vaccination drives at local schools.
Noting new guidance from the state on lifting mask mandates in schools, Saunders said that as the county can start to consider lifting those requirements if transmission rates drop.
The highest uptake rate is expected in those first few weeks after eligibility, she said, part of the reason for recommending an extension of the mandate.
On Oct. 20, Saunders said she expects a 60% uptake rate among the age group in that time, helping to bolster the overall rate of vaccination in the county, with the U.S. Census estimating that the county hasnearly 24,000 residents between the ages of 5-13.
According to the state Department of Health and Human Services, 63% of the county's population, or 164,842 people, have been partially vaccinated and 60%, or 157,938 people, have been fully vaccinated.
Saunders also noted that 5- to 11-year-olds make up the bulk of the county's school-age population andnew guidance updated byNCDHHSOct. 25, that recommends schools base their mask requirements on levels of community transmission per CDC definitions.
More: Buncombe hopeful 5-11-year-olds will fill COVID-19 vaccination gap, reduce quarantine time
In areas of high or substantial transmission, NCDHHS recommends maintaining mandates. Not until those rates drop to moderate or low levels for seven consecutive days does the state say school leaders can consider face coverings optional for vaccinated individuals.
The CDC lists a moderate transmission rate at fewer than 50 new cases per 100,000 residents per week and a low transmission rate at fewer than 10.
Throughout the ongoing surge of cases related to the delta variant, the community saw high numbers of unvaccinated people becoming infected, Saunders said, building natural immunity in the county.
With the large group of children set to become eligible, she called it a benchmark place that as the county enters the new year, she's hopeful that new cases and transmissions will stay low and allow the county to get to a place where it can control and manage COVID-19.
Derek Lacey covers health care, growth and development for the Asheville Citizen Times. Reach him at DLacey@gannett.com or 828-417-4842 and find him on Twitter @DerekAVL.
