Capacity limits will be lowered across an array of businesses, some indoor recreation venues will again close, and rules around mask-wearing and dining out will be tightened starting Sunday, as Massachusetts rolls back its economic reopening in response to what Gov. Charlie Baker characterized as "disturbing" COVID-19 trends.
Baker announced Tuesday that the state will move back a step in his phased reopening plan -- from step two of Phase 3 to step one. Not every municipality had advanced to step two, but in those that had, indoor performance venues and "high-contact" recreational facilities like those involving laser tag, trampolines or roller-skating will be required to close.
The rollback comes a day after the Department of Public Health ordered hospitals to begin limiting elective inpatient procedures starting Friday, and as a second field hospital, like the one operating in Worcester, is being set up in Lowell.
"The rate Massachusetts residents are getting infected and the rate at which they are needing medical care, if all continues to move at this pace, is simply not sustainable over time, and our health care system will be put at risk," Baker said.
Baker said the new measures are aimed at preventing infection and viral spread, especially in indoor settings, reducing mobility and fostering "stronger mask compliance, more social distancing, and limits on the time spent with people outside of your immediate household."
The move will lower maximum capacity levels from 50 percent to 40 percent for houses of worship, offices, libraries and businesses including retail shops, health clubs, museums, arcades, golf facilities and movie theaters.
The cap on attendance at outdoor gatherings at event venues will be lowered from 100 to 50 people, and venues hosting outdoor gatherings with more than 25 people will be required to notify their local board of health in advance.
The Baker administration's reopening model, which launched in May, includes four phases, and a transition to the fourth is dependent on a vaccine. The first step of Phase 3 -- when movie theaters, fitness centers, museums and more were allowed to reopen -- began on July 6, when there were 603 COVID-19 patients in hospitals and the rolling average positive test rate was below 2 percent.
Municipalities, except for those deemed at the highest risk of COVID-19 spread, were allowed to proceed to the second step, involving indoor performance venues, recreational activities and retail-store fitting rooms, began on Oct. 5. At that time, the positivity rate stood at 1.1 percent and 473 COVID-19 patients were hospitalized.
As of Monday, the average positivity rate was 5.46 percent and 1,516 COVID-19 patients were hospitalized, and most available beds across the state's hospital systems -- 65 percent in intensive care units and 77 percent of non-ICU beds -- were occupied.
"The new infections and hospitalizations are showing disturbing trends," Baker said. "Once again, our health care workers and our health care system are being put at risk as the case count continues to rise. The days of most people doing most of the right things are probably not enough, but we're asking everyone to join us and step up their vigilance every day, in every setting -- work, home, school, everywhere."
Mask rules are also being tightened at offices and gyms. Masks will be required at all times in gyms -- under earlier standards, masks were not required for customers "engaging in strenuous fitness activity" when a 14-foot distance could be maintained -- and office workers will need to wear masks unless they are alone in their own workspace.
The administration is encouraging, but not mandating, that employers continue allowing employees to work remotely when possible and that people dine out only with members of their household.
For restaurants, new guidance will require diners to wear masks at all times when not eating or drinking, lower the maximum table size from 10 people to six, set a 90-minute time limit on tables and prohibit musical performances. Malls also must close their food court seating.
Baker relayed an anecdote he said was intended to drive home the risks around socializing with people from different households.
He said he heard from a friend who had been planning, with her husband, to join another couple for dinner and the restaurant was unable to seat their party outdoors. Baker said when his friends declined to take an indoor table and passed on the gathering, the other couple "gave them a lot of what-for about why they were being so silly with respect to how they were dealing with this issue, and then five days later they both tested positive for COVID."
Baker said his friend "heeded the guidance from us and others that said you really shouldn't be spending a lot of time indoors with people you don't spend time with, live with, on a regular basis."
"We're social people. We miss our friends," he said. "We get it. It's true for all of us, and there's no question that some of the decisions we're making today that will become effective this weekend will create hardship and difficulty for many small businesses and their families, which is why these decisions are hard."
Rep. Mike Connolly, a Cambridge Democrat who has been critical of the administration's approach to reopening, called Baker's actions "disappointing" in a Twitter thread that said the state needs "science-based polices that impose physical distance AND provide $$$ relief."
Connolly said he was "shocked this was the extent of the announcement."
"Why not say, then, that the rule is you can only go out to eat with people in your own household," Connolly, who thinks indoor dining should be fully shut down, said in a message to the News Service. "That would at least have some logic to it."
The state's casinos opened in the first step of Phase 3, so the rollback will not force them to close.
Massachusetts Democratic Party Chair Gus Bickford, in a statement, noted that Baker was allowing casinos to stay open while curbing elective inpatient procedures and described the restrictions the governor did impose as "extremely modest" and the product of mounting public pressure.
"No matter the issue, Baker only acts when pressured," Bickford said. "It's not leadership, it's negligence."
The Massachusetts Health and Hospital Association offered its support for the rollback.
"We are again seeing the direct and powerful effect that community transmission of COVID-19 has on the strength of our healthcare system, and we have arrived at a point where these stronger limitations on indoor gatherings are essential for preventing our hospitals from being overwhelmed," Steve Walsh, the association's president and CEO, said. "The actions of every resident have very real consequences on the ability of our caregivers to keep up with demand."