Milwaukee officials are telling residents they should start wearing masks again — an advisory, not a mandate — as COVID-19 cases are beginning to climb. The mayor of New York City says he won’t be issuing a new mask mandate despite a jump in cases. And Seattle officials are recommending but not requiring face coverings.

In all three areas — and many other parts of the United States — the level of COVID-19 community spread has been deemed “medium” or “high.” The Centers for Disease Control and Prevention says COVID-19 spread is concerning enough that a third of Americans should consider wearing masks indoors again.

But so far, no one seems to be requiring it.

The Milwaukee Sentinel Journal reported its local health department on Friday suggested residents return to masking inside public settings, regardless of whether they’re vaccinated or previously had COVID-19.

“Masks such as KN95s and N95 respirators offer additional layers of protection but the department said any mask that is worn consistently and snugly is better than no mask. Those without access to the recommended respirators can wear two masks to increase protection,” the article noted.

Milwaukee health officials also recommend a return to other advice first offered in 2020: Practice physical distancing. Avoid crowds. Wash, wash, wash your hands. And a bit of advice not available then: If you’re not vaccinated, get vaccinated.

Seattle is in King County and that health department told KOMO it’s monitoring case counts to decide what mandates might be needed to protect public health. Mask mandates are not on the table right now. But KOMO found a lot of people taking their own precautions, including wearing masks.

New York Mayor Eric Adams told The New York Times that he’s focusing on antiviral treatments and at-home testing as cases start to surge again. He said his own recent case was mild, and credited being vaccinated and taking an antiviral medication.

The New York Times wrote that “Adams, a Democrat who took office in January, appears to be weighing several factors: He has not called for mandates because hospitalizations and deaths have risen more slowly than in previous waves, because of a possible political cost to embracing restrictions that have fatigued the public, and because he is concerned about the impact on restaurants, tourism and the city’s economic comeback.”

As of Tuesday, New York had more than 4,000 cases a day and more than 770 people in the hospital, 84 of them in intensive care with COVID-19.

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Public health officials have repeatedly said that being vaccinated helps prevent the most serious, symptomatic cases and will help keep businesses open and mandates at bay.

The Centers for Disease Control and Prevention has set the standards for what amounts to high community spread of the novel coronavirus that has claimed more than one million American lives since the pandemic began. The federal health agency considers new COVID-19 hospitalizations, the percent of staffed inpatient beds occupied by COVID-19 patients and the total number of new COVID-19 cases per 100,000 population, all within seven days.

In communities with 200 or more cases of COVID-19, less than 10 hospitalizations is considered medium spread, as is fewer than 10% of beds used for COVID-19. Anything above that amounts to high levels of community spread. It’s based on the higher of the new admissions and inpatient bed metrics.

According to the CDC map, transmission in most of the country is low, but there are many high-transmission communities in the East and around the Great Lakes, along with a growing number scattered throughout the country that are deemed medium, including Summit County in Utah. Wheatland County, in Montana, is the sole county in the West with high community spread as of Friday.

For those choosing to wear masks, experts say that a good fit is essential to get the most protection. Masks should be snug and cover the mouth, nose and chin, without gaps.

“You should feel warm air coming through the front of the mask when you breathe out. You shouldn’t feel air coming out under the edges of the mask,” according to a Mayo Clinic guide to masking.

The Mayo Clinic notes that masks with more layers offer more protection and that the type with bendable nose strips prevents air leaks.