The mask mandate will be lifted when the new Shelby County health directive goes into effect Saturday, May 15. The word “recommend” will replace “must” and “required,” essentially leaving masking up to personal choice.

Behind the scenes, some health leaders worry it will kick off surge-size infections in ZIP codes where vaccination rates are less than half what they are in other parts of the county.

County poised to remove mask mandate

The most vulnerable are Hickory Hill and a wide swath of Frayser, Oaklawn, Northaven and Benjestown in ZIP code 38127.

“If you go into neighborhoods where the predominant number of folks are getting COVID and you lift the mask mandate, holy shmoly, you’ve just created a disaster,” said Dr. Scott Strome, executive dean of the College of Medicine at University of Tennessee Health Science Center.

“Not could it tick up, it will tick up. There will be absolutely no question,” he said.

The Health Department is scheduled to release the new health directive on Wednesday, May 12. It is not clear if all business restrictions will also be lifted, including six feet of distancing between tables in bars and restaurants.

The new directive will recommend people wear masks and continue to social distance in accordance with Centers for Disease Control guidelines. Business owners are expected to decide for themselves if they will require masking. Businesses governed by OSHA restrictions will be expected to continue masking, including factories and warehouses.

At the Urban Gardener in East Memphis, the mask sign will stay on the door, says co-owner Allison Clark.

“Until it is really safe, we will continue to do that,” she said. 

Customers who come in without a mask will be asked to comply, said Clark, who is also happy grocery stores will still require masks. 

“I think they should until the CDC says otherwise.”

Kroger has continued its masking requirement in states where mandates have been lifted. Target has a similar policy, including for people who have been vaccinated.

On April 27, Gov. Bill Lee lifted the indoor mask mandates and business restrictions in the 89 counties in the state that still had them. Shelby County and five other metro counties have autonomous health departments, which do not have to follow state rules.

Lee asked those counties to follow suit. With the exception of Shelby and Davidson counties, they all did. Davidson will lift its business restrictions May 14. It has not said when it will lift its indoor mask mandate.

“We our scratching our heads as many states are reopening and taking out restrictions and lifting mask mandates,” said Dr. Diego Hijano, pediatric infectious disease specialist at St. Jude Children’s Research Hospital.

“From my perspective, I keep encouraging people to use their masks at all times for many reasons, first because there are many people in the community who are not vaccinated,” he said.

Second, he finds widespread belief that having had the infection is enough for long-term immunity.

“That is not entirely true. We know people who have COVID-19 may or may not have good response, but if you get vaccinated, you will definitely have a good response and be protected,” Hijano said.

Dr. Jeff Warren, a member of the Memphis City Council and the Memphis-Shelby County COVID-19 Task Force, said low vaccination rates are a concern. 

“If we get another 80,000 people vaccinated in the next two to three weeks, we should be OK.

“We have enough people vaccinated now that I am hoping we are not going to see a huge spike and a fourth wave,” Warren said. “The problem is we’ve got the Brazilian variant now and the variant from India. And variants from New York and California.” 

Because Memphis is a global distribution center, Warren says it is wise to continue the mask mandate.

“We have people coming in and out of Memphis from all over the world all the time. We’re going to constantly be having stuff come through here.”

Health authorities have been discussing what the new directive should say with health experts and community leaders, including municipal mayors, for weeks. 

The municipal mayors met with health authorities Thursday, May 6.

“We have asked for consistency with the rest of the state for months as suburban mayors,” said Mike Wissman, mayor of Arlington.

“From where I live in Arlington, I can drive to Oakland and not have any restrictions versus what I’ve had in Arlington this whole time,” he said.

Doctors who have been in on the health calls with the mayors disagree with lifting the mandate, he said.

“Medical doctors say they would like to see the masks remain longer, but I don’t think they are going to win that argument,” Wissman said.

Getting 80,000 people vaccinated in the next several weeks would mean getting all 50,000 of the youth ages 12 to 15 in the county, plus 30,000 adults. The city is preparing to begin vaccinating 12- to 15-year-olds on Thursday, May 13.

In the past seven days though May 10, the city only vaccinated about 11,000 people.

Countywide, about 66% of people have antibodies to the disease, either from having had it themselves or from getting the vaccine.

Because of that, Dr. Jon McCullers says he does not have an issue with “the county deciding to remove the mandate and to strongly recommend masking, particularly for those who are not vaccinated.”

“I do think, and I have said repeatedly, we have to couple that with increased efforts to reach those who may have had access issues contributing to the fact that they are not vaccinated,” said McCullers, chief pediatrician at Le Bonheur Children’s Hospital and infectious disease researcher.

“But, the fact is, more vaccinations have been available and people are choosing not to get it right now. We have to make it easier, and we have to reach out so the ones who will get it, get it, but I don’t object to the county moving forward.”

Suburban leaders optimistic about new health directive

“Those people who want to be safe, they know it is important to continue masking,” said Dr. Manoj Jain, infectious disease physician and a member of the Memphis-Shelby County COVID-19 Task Force.

“It’s hard to say at this time if lifting the mandate means people won’t mask at all,” he said.

In ZIP code 38127, near Shelby Forest, the vaccination rate per 100,000 people is 18,552. Hickory Hill is slightly better at 19,790. But compared to Germantown and Collierville, where the rate per 100,000 people is 58,764, these communities of mostly Black and brown people are vulnerable.

“The problem you have is, politically, how do you say, ‘Well, we’re going to lift the mask mandate in Memphis, but in Hickory Hill, which is predominantly a community of color, we’re going to keep it,’” Strome said. “Politically, it’s not going to work. When you talk about risk, that is the risk.”

Kenyatta Wright and her family live in an apartment in Hickory Hill with relatives who stay with them to be closer to work.

“I do worry about that. My daughter goes to school here, and we shop here,” she said.

“It can still spread just as easily as when it started. What are they going to do, just lift it?”

Several other ZIP codes also have low rates of vaccination, including 38106 in southwest Memphis and 38108 in North Memphis.

Lifting the mandate is probably safe in the neighborhoods with high vaccination or immunity rates, Strome says.

“If you lift the mask mandate in one neighborhood, it’s going to have a very different effect in another neighborhood,” he said. “From where I sit, when we make policy, I always think, who is going to be the unintended victim of that policy, and unfortunately, the answer is always the same.

“It’s always the underserved. That’s my worry about lifting the mask mandate. It’s not so much for East Memphis, it’s for communities, particularly those where the vaccine rates are lower.”

Beginning Thursday, teams of volunteers will begin knocking on doors in 38106 in southwest Memphis, hoping to engage residents with facts about the vaccine. The goal is to knock on 2,000 doors.

“Unfortunately, the reason people have a hard time talking about this and taking a stand is that it is extremely complicated, with a lot of issues,” said Dr. Stephen Threlkeld, director of infectious disease for Baptist Memorial Health Care.

“In the beginning of the mask mandate, it was not just an issue with the science, there was an issue of equitable enforcement of the law, which is a problem I had with the first iteration,” he said.

How to manage masking, he says, is the latest opportunity for political posturing.

“It is just not the time for political posturing in either direction. It’s the time to practice common sense and obey the general rules of the science, whether there is a law for it or not,” Threlkeld said.

“We’ve always been able to get around the statutes; we’ve always been able to do that, but you can’t violate virology,” he said.

City plans ‘get out the vote’ type vaccine campaign

The City of Memphis has held pop-up vaccination clinics in Hickory Hill. It has fixed drive-thru site in Raleigh and Bartlett.

Threlkeld says it is critical to find out if people in low-vaccination ZIP codes aren’t getting the vaccine because it is not accessible.

“There is one unifying principle I think most people should agree on right now, that is, we need to make sure that anybody who wants the vaccine can get one. There is just no excuse for that not happening. Because that is the group that is going to pay the price for transmission,” he said.

Doctors also find it difficult to see the level of misleading information they say is easy to find on the internet.

“It breaks my heart to see how much misinformation is on the internet concerning these vaccines,” Warren said. “And the people who are doing it should be ashamed of themselves.

“It’s people trying to drive us apart politically, and they don’t care if people die from it. I think a lot of this stuff is coming from bad actors overseas. I really do.”

Memes that tell women who are pregnant or want to be pregnant that the vaccine will cause infertility or alter their DNA exasperate, Hijano says.

“That could not happen. It is not possible. ... It has been hard for the scientific community to prove them wrong.”