After Indiana’s Mask Mandate Expired, COVID-19 Cases Statewide Increased

Apr 26, 2021

Credit Centers for Disease Control and Prevention

COVID-19 cases in Indiana are on the upswing again after decreasing for nearly three months.

Data from the state’s COVID-19 dashboard shows the recent increase in cases and hospitalizations coincided with Gov. Eric Holcomb’s dismissal of many public safety restrictions, including the statewide mask mandate. Hoosiers were required to wear face coverings in public since July, but Holcomb allowed the mandate to expire on April 6.

The Indiana State Department of Health (ISDH) does not directly attribute the uptick in cases to the relaxation of restrictions.

“Case counts have fluctuated throughout the pandemic,” ISDH spokesperson Megan Wade-Taxter told WFPL News. “Although social distancing and the wearing of face masks are no longer required, they are still recommended. We continue to urge individuals to practice preventive measures to help stop the spread of COVID-19.”

Indiana reported 2021’s highest daily COVID-19 case total on Jan. 6: 7,223 new diagnoses. The number of daily cases decreased significantly in the weeks that followed, dropping as low as 419 on March 14.

But since Holcomb announced plans in late March to let the mandate expire, daily COVID-19 figures have slowly ramped up again. The state reported an average of 830 cases a day in March. In the first three weeks of April, that daily average jumped to about 1,150 — a nearly 39% increase.

Daily COVID-19 case totals reached 1,000 just four times in March. So far this month, Indiana has exceeded that 15 times. 

The state reported 2,337 new cases on April 16, ten days after the mask mandate expired, making it the first day with more than 2,000 cases since early February.

Health Leaders Predicted Mandate’s End Could Cause Uptick

Dr. Tom Harris, Floyd County’s health officer, said he expected the upward trajectory of COVID-19 case totals after Holcomb’s decision.

“The real question [is], is that spike in cases significant? Will it have traction in the population? I think it’s too early to call that point,” he said.

Harris said “COVID fatigue” is likely playing a role. Too many people have gone back to normal, pre-pandemic behaviors in recent weeks, he said.

“That’s not really the intent,” Harris said. “The mandate went away, but, still, all the public health agencies are encouraging people — especially if they’re not vaccinated — to continue using the masks, to continue social distancing, handwashing and all the measures that we’ve been talking about for over a year now.”

Southern Indiana health leaders said the case numbers alone aren’t necessarily cause for concern. Instead, they said the severity of the infections caused by the virus should take precedence.

Dr. Eric Yazel, Clark County’s health officer, said he anticipated an uptick in cases by mid-April due to potential mass-spreading events like Easter celebrations and spring break vacations. Decreased masking has only added to the issue.

But Yazel said he’s more focused on monitoring the medical resources required to treat severe COVID-19 infections.

“If you notice your [case] numbers going up, but your hospitalizations are staying the same, that’s not as worrisome,” he said. “If you start to see your ventilator usage, your ICU usage and your hospitalizations go up, that’s a whole different scenario that, obviously, you need to respond more aggressive for.”

Statewide hospitalization figures have increased alongside daily case totals this month. Nearly 850 Hoosiers were hospitalized with COVID-19 as of April 21, up 300 from just one month earlier.

COVID-19 patients occupied 3.6% of ICU beds and 1.3% of ventilators in the state on March 20. Those rates were up to 8.6% and 2.8%, respectively, as of April 21.

“We’ve seen a little upswing, but nothing on par with what we saw in January after New Year’s or back last summer or anything like that,” Yazel said. “I do think that tells us that community wide, I can’t say we’ve reached herd immunity, but we’re getting to the point where the wildfire type [of] spread is just not a thing anymore.”

Southern Indiana COVID-19 Cases Plateau

Despite increases elsewhere in Indiana, Harris and Yazel said COVID-19 figures in Clark and Floyd counties are “stagnant.”

The two counties together averaged 23 cases a day in March. But unlike the state, their combined daily average is lower this month, down to about 20. Hospitalizations in Indiana’s Public Health Preparedness District 9, which includes Clark and Floyd counties, have also decreased since March.

Yazel said an increase in local cases is possible in the near future, but he doesn’t expect it to be significant enough to disrupt the local health care system.

“The weather’s getting nice, [and] everybody’s getting outside,” he said. “I think you’re going to start seeing more and more events, so I do think you’ll start to see a little upward trend in cases. Nothing dramatic. But I think our hospitalizations will stay relatively stagnant, or maybe go up just ever so slightly.”

The ISDH measures coronavirus spread at the county level with a color-coded map that factors in weekly cases per 100,000 residents and 7-day test positivity rates. Floyd County is one of more than 40 counties in the state in the blue category, the lowest level of the color-coded system. Clark County is in the yellow category, one tier above blue.

Though no Indiana counties are in the red category anymore, seven counties in the northern part of the state are in the next-highest tier, orange. 

Harris said part of Clark and Floyd counties’ success could be due to their vicinity to Louisville, which still has a mask mandate and other restrictions in place.

But he worries the situation could worsen if more people don’t get vaccinated. He said at least 50% of the population must be vaccinated to “have a chance at herd immunity.”

“We know that 30% of the population, more or less, in several different polls has said that they’re not going to get the vaccine because they’re conspiracy theorists,” Harris said. “There’s a lot of reasons people will have not to get the shot, but we want people to get the shot, as many people as possible.”

Nearly 1.7 million Indiana residents, or about 25% of the population, were fully vaccinated as of Friday. More than 2.2 million had received at least a first dose of a vaccine.