Dr. Fauci wanted masks on planes forever. Since last January I’ve said the mask mandate would end before the November 2022 midterms, because control of both the House and Senate hang in the balance. Amidst high inflation and Russian’s invasion of Ukraine driving up food and energy prices, the Administration needs to declare victory over Covid-19.

The current transportation mask mandate runs through April 18. Airlines have been expecting the mandate to expire. Their lobbying group . American has planned for the return of alcohol sales in coach April 18, to coincide with the lifting of the mask requirement.

A month ago I wrote, though, that one thing could throw a monkey wrench in this plan: an expected uptick in cases by the B.A.2 variant. Europe was already seeing case growth, although experience there suggests it tops out at much lower levels than the recent wave. If cases are growing right as the Administration has to decide whether to lift the mandate, that makes it harder for them to do so.

And cases are just starting to grow, mostly confined to the Northeast. Even Eric Topol isn’t especially concerned.

There are counties in upstate NY, Colorado, Texas and Alaska with 70-130 new cases/100K —very high levels that reflect this variant's hyper-infectious potential /2 pic.twitter.com/XFeAnhmrha

— Eric Topol (@EricTopol) April 10, 2022

We’re a week away from the expiration of the transportation mask mandate, and masks are generally required only on planes, trains, buses and automobiles (and in certain backward parts of the country, preschools).

• However Philadelphia just imposed an indoor mask mandate and that potentially makes it more difficult for the Biden administration to take a more permissive (albeit purely symbolic) stance.

• And the new White House pandemic advisor said today that extending the mandate is on the table. That’s a trial balloon, and since he’s been criticized for ‘potentially’ downplaying the pandemic (unfairly, in my view) it would burnish his credentials with the public health establishment.

We are, however, no longer in a place where public mandates are needed. Despite the tick up in cases, reported positives remain low.

Most importantly, hospitalizations and ICU admittances are at their lowest level since the start of the pandemic, far lower than in the summer of 2021.

And we’re simply better able to address the current virus than at any point in the pandemic.

• Vaccines and boosters are available, and hold up against bad outcomes from Covid-19

• B.A.2, like B.A.1, presents as less severe

• And it spreads more quickly, masks that meet the regulatory requirement (like cloth masks) probably don’t do much anyway. Masking was important in 2020 both to delay infection (until we had vaccines and treatments) and delay hospitalizations (to preserve capacity) – not so much right now

• Treatments are available from Paxlovid to Fluvoxamine to Peginterferon Lambda (TOGETHER 3 TRIAL)

Now is the time to wear a good mask properly if you’re concerned – if you’re immunocompromised, elderly, or potentially if you have relevant comorbidities. It’s not the time to impose broad public mandates. We have tools we didn’t have earlier in the pandemic, and enough background immunity from the Omicron wave that we aren’t likely to put pressure on hospitals now.

It is possible of course that we could see a new variant of consequence that is fast-spreading (like Omicron), more virulent (like Delta), and that escapes prior immunity. That would be a huge concern and reason to re-address public health policy from good-quality masks, to variant-specific and pan-coronavirus vaccines, to ramped up treatments.