LOS ANGELES — As has happened each December, Covid-19 cases are ratcheting up in Los Angeles County, with hospitalizations nearly tripling in the past month — a signal that another mask mandate could be on the horizon.
The region is no stranger to pandemic orders, having experienced stringent lockdowns and a state-imposed curfew in late 2020.
But this time around, even as the numbers in Los Angeles become the highest in California, many have grown weary of warnings and talk of precautions. Covid updates do not elicit the unease they once did — in part because cases and hospitalizations during the current outbreak are nowhere near where they were during the worst stretches. But also because the subject has grown tiresome, residents said.
“I think it’s just kind of run its course with me,” said Kirk Carter, 60, a retired television writer who lives in Los Angeles. “It’s become normalized.”
The perception of the coronavirus, in the age of vaccines and survival stories, has seemingly evolved from a deadly threat to an annoyance for the healthy. And health officials noted that, at some point over the last year, indifference supplanted fear, and face coverings became a casual accessory, often tucked under a chin if worn at all.
When Mr. Carter, who is vaccinated and boosted, recently took a trip to New York to visit his daughter, he felt no need to don a mask while on the plane, which he had always found uncomfortable.
“I’m less worried about getting sick by Covid than I am about being inconvenienced by Covid,” he said.
That feeling is reflected across the nation even as it is once again experiencing an uptick in cases in the weeks after Thanksgiving. New case reports and hospitalizations are up by more than 25 percent, and test positivity rates are rising quickly, particularly in major urban areas.
The virus is likely spreading faster than case numbers suggest because people are increasingly relying on at-home tests and are not reporting the results. And epidemiologists warn that it is too early to declare that this winter will be less severe than during the past two years, especially as Americans gather again for the holidays later this month.
While healthy individuals seem less concerned about Covid this December, the virus spread poses serious risks for older people and those who are immunocompromised.
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New York currently has the highest per-capita daily case rate of all the states, with New York City showing the highest rates of new cases and hospitalizations. In both the city and the state, more people are hospitalized with Covid-19 than at any point this summer, when the BA.5 subvariant drove a notable increase.
In California, hospitalizations have risen by more than 60 percent in recent weeks, a sharper increase than in almost any other state, which could be a sign of an impending larger surge.
But the rising rates are also a fraction of last winter’s numbers. Deaths from Covid are nearly as low as they have been since the start of the pandemic, with about 290 reported across the country each day. Fatalities, however, typically rise weeks after an increase in cases.
And reports of a surge have not had the same effect they did a year ago when the Omicron variant caused many people to cancel travel plans and pare back holiday gatherings. That shift in attitude could be a tension point should officials attempt to reinstate mask mandates.
Barbara Ferrer, the director of the Los Angeles County Department of Public Health, said a mandate would happen if thresholds for case rates as well as two hospital indicators — the rate of admissions and the proportion of beds used by Covid patients — were surpassed. As of this week, only the metric for hospital admissions has been met, she said.
“We’ll wait, but, you know, from my perspective, I wish it was less focused on whether it’s mandatory or whether it’s a strong recommendation,” Ms. Ferrer said. “What it is, is this is the time for everyone to put their mask back on right now. Not two weeks from now, not four weeks from now. If we want to make a difference and start reducing community transmission, we need to get the mask back on.”
The idea of a mandate had been floated earlier this year by the county when Covid cases rose in the summer. The notion was immediately met with criticism.
Los Angeles County leaders have a history of going further than officials elsewhere, requiring masks at airports and on public transit in the spring when state and federal requirements had relaxed.
In much of New York City, Covid transmission levels have already reached the threshold at which the Centers for Disease Control and Prevention recommends indoor masking, but leaders there have announced no new public health mandates.
“The early days of ‘What I do affects you, and what you do affects me’ — there are very few people who still think that way,” said Robert Wachter, the chair of the department of medicine at the University of California, San Francisco. “It’s a natural phenomenon to move from a communal point of view to this individual risk benefit point of view.”
Dr. Wachter said mask mandates had been about signaling a level of seriousness and creating a social standard. “I don’t think it was ever enforceable, I think it was just a consensus that it was the right thing to do, and there was a lot of social pressure to do it,” he said.
Nowadays, that pressure seems to have reversed. “I’ve seen people go into a space, see that no one is masking and take off their mask,” Sara Cody, the Santa Clara County public health director, told reporters on Tuesday.
Dr. Cody also announced that wastewater numbers in her area, which includes the Silicon Valley, were “absolutely skyrocketing,” indicating a high spread of Covid. She encouraged people to mask although she did not anticipate making anything official. “Three years in, it is extraordinarily difficult to mandate,” she said.
A mandate would only truly be effective if everyone wore N-95 masks, not the surgical or fabric masks that still abound, said Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. He pointed out that boosted people can have a false sense of security because protection drops greatly after several months. “The virus is still in the driver’s seat,” he warned.
Dr. Osterholm said that over the last two weeks he has seen at least seven acquaintances — all of whom were once diligent about taking precautions — become sick with Covid-19. “And why? Because they think it’s over,” he said. “What they’re trying to do is move into a post-Covid world. And unfortunately, that world isn’t ready for us yet.”
It is not clear what a decree would look like in Los Angeles at a time when masks have been absent from a crowded hot yoga class in Koreatown for months.
And at a mall not far away, if shoppers wore masks, they were the plain surgical type. The colorful fabric masks on sale at one stall are still purchased often, said Amaris Cho, 22, an employee at Luv Bling.
Ms. Cho moved to the area last year and said that, back then, masks were mandatory at her workplace and at her community college. But the rules disappeared and now those in masks stick out, even on her city bus.
She is fine with the change, having been vaccinated and boosted, and would not wear a mask again unless it became mandatory. Besides, it’s different here, she said. Back at home in Korea, people would often put their masks on when they left the house and kept them on. In Los Angeles, she said, “They put it on as you start a conversation.”
In Boyle Heights, a neighborhood east of downtown, the Food 4 Less showcased just how optional face masks had become. It was a scene far different from the era when grocery stores represented the only reason to leave the house and patrons wore plastic gloves and traveled in one direction down aisles.
There, a mother pushed a shopping cart, children in tow, searching for school lunch ingredients. None of the family members were masked. A woman in her 30s had a mask on, while her husband did not. About half of the employees wore no face coverings.
Across the street, Mariscos Linda, a seafood restaurant, hinted at another truth of the moment: many businesses have been unable to fully rebound. The red leather booths wrapped in tinsel and the bar with neon lights did not draw the crowd that had been anticipated for the World Cup screenings. Patronage had dwindled over the past few weeks.
“When cases go up, customers go down, and even workers get sick,” said Jhonatan Chavez, an assistant manager and cook. Mr. Chavez, who has worked at the restaurant for five years, said he has noticed that customers seem to maintain a wariness of their surroundings. No matter how much people have tried to return to their prepandemic attitudes and habits, things still don’t feel the way they did before.
Jill Cowan and Soumya Karlamangla contributed reporting from Los Angeles. Mitch Smith contributed reporting from Chicago. Sharon Otterman, Grace Ashford and Joseph Goldstein contributed reporting from New York.