Despite growing pressure and criticism from health experts, Gov. Tate Reeves on Tuesday doubled down on his opposition to a statewide mask mandate, instead adding counties piecemeal to his mask-wearing order as Mississippi’s COVID-19 cases and hospitalizations soar.

Reeves added 13 counties to his executive order for wearing masks in public and restricting social gatherings, bringing the total to 54 of the state’s 82 counties.

“We know what works,” Reeves said. “We know wearing a mask works … There are those who believe that if there are three words on a piece of paper — statewide mask mandate — that will solve everything … I just don’t believe having a statewide mask mandate and never replacing it has the same impact than if you add counties … The best way for us to get the most people to participate is going county by county.”

Reeves last week said he wasn’t going to cave to pressure from “so-called experts” calling for a statewide mask mandate. Those calling for such an order last week included Dr. LouAnn Woodward, who leads the University of Mississippi Medical Center, the state’s only academic health center and largest hospital.

The same day, Woodward issued a joint letter with the Mississippi State Medical Association (MSMA) and Mississippi’s chapters of the American Academy of Pediatrics and Academy of Family Physicians calling on a statewide mask order. After Reeves rejected the request last week, MSMA issued a second more urgent letter calling for a wider mandate.

“When leaders fail to lead, then we often see a poor performance from those who are attempting to follow,” said Dr. Mark Horne, the MSMA president. “The anti-mask, anti-personal distancing, anti-anything to slow the spread of the disease is an article of faith. And faith is not subject to fact…

“With the holiday season and winter weather approaching, we are certain that our state’s healthcare system cannot sustain the trajectory of the pandemic in its current state,” the letter continued. “To combat the devastating effects of COVID-19, we must act immediately and, in the best interest of the health of all Mississippians, by reissuing a statewide mask mandate through the remainder of the year.”

Reeves on Sept. 30 lifted a statewide mask mandate — making Mississippi the first state to rescind such a mandate — that he had issued on Aug. 4, and he relaxed restrictions on social gatherings. Since then, cases have risen.

During the span of the statewide mask mandate, Mississippi cases plummeted, dropping by 54%. Since then, though, Reeves has repeatedly said he wants as many people as possible to mask, but he just differs from medical experts on the best way to make that happen.

READ MORE: Gov. Tate Reeves has resisted statewide mask mandate despite warnings from health officials and alarming COVID-19 trends. 

Reeves told reporters Tuesday it was “fundamentally inaccurate” that the state is exceeding previous COVID-19 records. That statement from the governor is false: The rolling average number of daily cases — 1,410 cases as of Tuesday — has surpassed summer peaks, single-day cases hit an all-time peak Nov. 21 at 1,972, and total hospitalizations have hit single-day records as well.

The governor on Tuesday pointed to skyrocketing cases nationwide, saying, “We’re rising less rapidly than other states.” Though the state no longer contends for the nation’s highest per capita daily cases, only 11 states are currently rising faster than the Mississippi, according to The COVID Tracking Project data. While the state’s daily cases are not as high as other states, Mississippi’s growth in those cases over the last two weeks is outpacing most others.

Reeves has also said he is reluctant to use “the heavy hand of government” to tell people what to do in the pandemic. He has, in turn, been criticized by those who support statewide mask and other orders and by those who oppose any government mandates such as the county-by-county approach.

Reeves’ criteria for adding counties to the mask mandate are those who, over a two-week period, have over 200 new cases — as well as 200 cases per 100,00 people — or over 500 cases per 100,000 people. Meanwhile, Mississippi as a whole has met both those marks since last week.

The state on Monday and Tuesday set records for the number of people hospitalized with COVID-19, with 1,057 on Tuesday and 1,008 on Monday. State Health Officer Dr. Thomas Dobbs, who joined Reeves’ Tuesday press conference, said earlier in the day at a health department press conference that the state’s hospital system is stressed. Dobbs said 12 major hospitals across the state have zero ICU beds available.

“Patients cannot get transferred to a higher level of care when they need it,” Dobbs said, because of the ICU bed shortage. While some of the state’s largest medical centers have had tight ICU space for some time, the trend is pushing down the chain to regional and lower-level hospitals. As mid-level hospitals see ICU crowding, the state’s “one-way” trauma system — where patients should only go up to higher levels of care — risks disruption.

Though COVID-19 ICU-use is not currently at July peak levels, overall COVID-19 hospitalizations are peaking for single-day records and nearing peak average levels. Hospitalizations are compounding much faster than they did heading into the summer spikes.

On Oct. 3, average total hospitalizations were at their lowest point since the health department started tracking them. It took just seven weeks to grow by 85% — from the state’s lowest point to the end of November peak single day hospitalizations, approaching summer overall levels. The same average hospitalizations growth took much longer — 12 weeks — to get from low April levels to July peak.

University of Mississippi Medical Center is currently the only hospital in Jackson with ICU beds, and their COVID-19 wards are growing quickly. ICU patients with the coronavirus have grown by 57% there in the last week alone.

The counties Reeves added to his mask-wearing mandate on Tuesday are: Quitman, Jefferson, Franklin, Noxubee, Kemper, Amite, Coahoma, Sunflower, Scott, Adams, Oktibbeha, Monroe and Washington.

Counties that were already under the orders are: Alcorn, Attala, Bolivar, Chickasaw, Choctaw, Jefferson Davis, Jones, Lafayette, Lawrence, Lincoln, Lowndes, Neshoba, Panola, Perry, Prentiss, Stone, Tippah, Tishomingo, Union, Hinds, Madison, Pontotoc, Tate, Winston, Itawamba and Montgomery. Counties that were already under the mandate: Benton, Carroll, Covington, DeSoto, Forrest, Harrison, Humphreys, Jackson, Lamar, Lauderdale, Leflore, Lee, Marshall, Rankin, and Yalobusha.

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Geoff Pender serves as senior political reporter, working closely with Mississippi Today leadership on editorial strategy and investigations. Pender brings 30 years of political and government reporting experience to Mississippi Today. He was political and investigative editor at the Clarion Ledger, where he also penned a popular political column. He previously served as an investigative reporter and political editor at the Sun Herald, where he was a member of the Pulitzer Prize-winning team for Hurricane Katrina coverage. Originally from Florence, Mississippi, Pender is a journalism graduate of the University of Southern Mississippi and has received numerous awards throughout his career for reporting, columns and freedom of information efforts.

Erica Hensley, a native of Atlanta, has been working as an investigative reporter focusing on public health for Mississippi Today since May 2018. She is a Knight Foundation fellow for our newsroom’s collaboration with local TV station WLBT and curates The Inform[H]er, our monthly women and girls’ newsletter. She is the 2019 recipient of the Doris O'Donnell Innovations in Investigative Journalism Fellowship. Erica received a bachelor’s in print journalism and political science from the University of Southern California Annenberg School for Communication and Journalism and a master’s in health and medical journalism from the University of Georgia Grady College for Journalism and Mass Communication.