October 7, 2020

Maricopa County Board of Supervisors
301 West Jefferson Street, 10th Floor
Phoenix, AZ 85003
Dear Members of the Maricopa County Board of Supervisors:
I am writing to you about the county regulations regarding the wearing of face coverings
in Maricopa County enacted by the Maricopa County Board of Supervisors, effective
June 20, 2020. These regulations, which have been in force now for more than 90 days,
have been the most effective tool available for the reduction in COVID-19 spread and
the ability of the County, its municipalities, businesses, nonprofit organizations, health
care centers, government agencies and educational institutions to manage COVID-19 in
a manner that both allows robust economic activity to continue while COVID-19 spread
is being mitigated.
As you know, Arizona State University is the largest public research university in the
U.S. located in and serving a single metropolitan area, which is roughly the entirety of
Maricopa County. ASU educates about 80,000 students and learners on our four
campuses and through charter schools in Maricopa County, and it is one of the county’s
largest employers, with approximately 13,000 benefit-eligible employees living in
Maricopa County. Measured in standard economic terms, ASU’s impact is significant;
the total 2019 ASU enterprise impact on Maricopa County was approximately $3.6
billion, and, as I’m sure you will agree, considering our social embeddedness and
research outgrowths, the overall impact was even greater.
In an effort to do our part at ASU, we have established the ASU Community of Care and
a set of expectations and requirements for members of our community, including
mandatory masking, that not only make it possible for ASU to continue its essential
mission of educating students and learners of all ages, but also to contribute to the
health and well-being of greater Maricopa County. As you know, ASU has developed
and is developing new forms of COVID-19 testing, and we are delivering that testing not
only to the ASU community but also to people throughout Maricopa County and the
State of Arizona. The health and well-being of our students and our workforce is
essential to our ability to remain fully operational and to help Maricopa County be
recognized as one of the places in the U.S. that has been able to successfully manage
its ways through these extraordinary times.
Despite the tremendous success of the regulations you enacted requiring the wearing of
face coverings, it is my understanding that the Board of Supervisors is now, only 90
days after having established the regulations, considering their repeal or modification. I
am writing to strongly suggest that the repeal or modification of these regulations at this

 time would not be in the best interests of the people of Maricopa County as we all work
together to develop and implement a steady, thoughtful and effective approach to
mitigate COVID-19 spread while also seeking to advance the economic and social wellbeing of the county’s 4.5 million residents. The continuing difficulty of balancing and
reconciling these objectives will require that we be consistent, wise and confident in our
leadership of the work necessary to make this so. Accordingly, I would like to address
several elements of our current environment that dictate a continuation of the current
regulatory framework put in place by the Board of Supervisors.
First, COVID-19 isn’t going away. COVID-19 is going to be with us for a long time to
come. If it were otherwise and we were looking forward to the eradication of the virus
and the illnesses it causes within the next 30 or 60 or 90 days, the plans we make and
the actions we take might be different. Instead, we are facing a scenario in which we
should be planning for the active spread and infection of people throughout Maricopa
County for at least another 18 months. Even if an effective vaccine becomes available
in the near future, it will do little to reduce COVID-19 spread and related illnesses for
quite a while because the vaccine will need to be produced in massive quantities,
distributed throughout the country (and the world) and accepted and embraced by the
people of the U.S., who will need to be vaccinated at very significant levels to prevent
further spread and illness. And perhaps we will, through the efforts of research
universities like ASU and health care providers like the Mayo Clinic, find new treatments
for COVID-19 once illness sets in, but that, while important and perhaps life-saving, will
not materially reduce the existence of the spread of COVID-19 in the county.
Second, masking works. Scientific evidence strongly supports the effectiveness of the
widespread use of masks in reducing the spread and management of COVID-19. While
research is still ongoing, there is already strong empirical evidence supporting the public
health benefits of masking. For example, a study published in the July 14, 2020, issue
of the Journal of the American Medical Association (JAMA) showed that a universal
mask-wearing policy in a Boston hospital system materially reduced the transmission of
SARS-CoV-2. And another recent study published in Health Affairs compared the
COVID-19 growth rate before and after mask mandates in 15 states. That study found
that masking requirements helped reduce the rate of growth in COVID-19 cases over
time. The first five days after a masking requirement, the daily growth in new COVID 19 cases slowed by 0.9 percentage points compared to the five days prior to the
requirement; at three weeks, the daily growth rate had slowed by 2 percentage
points. That’s why masking and the masking requirements established by the Maricopa
County Board of Supervisors are uniformly supported by health care providers and
health care organizations in our community, including the Arizona Medical
Association (and in tandem with the Arizona Chamber of Commerce & Industry);
the Arizona Nurses Association; and the Arizona Health Care Alliance, which stated
on September 29, 2020:
“The Health System Alliance of Arizona strongly supports maintaining existing mask
mandates within local jurisdictions across the state. The evidence is clear: wearing a
mask reduces the spread of COVID-19 within our community. Eliminating these mask

 mandates will only increase the potential for community spread and place additional
burden on our health care delivery system. We urge Arizona leaders to maintain
existing mask mandates and COVID-19 mitigation efforts.”
If you have questions or need additional information about the science of COVID-19 or
the most recent research related to COVID-19 public health management practices,
we’d be pleased to set up a panel discussion with ASU faculty, researchers and
scientists. Please let me know if that would be helpful to the Board.
Third, masking is strongly supported by the people of Maricopa County. The vast
majority of people in Maricopa County have done a remarkable job of accommodating
themselves to the masking requirements. While there will be a continuing need to be
diligent about the implementation and enforcement of such regulations, for the most
part, we have all learned much about how to modify our behaviors, operational
environments and business practices to address the challenges of COVID-19. And it is
simply the case that the vast majority of people of Maricopa County are ready and
willing to continue to carry out a very simple and inexpensive practice that protects them
and their families, friends and colleagues from a virus that we otherwise can’t control. In
a time of massive technological transformation, it is both ironic and invaluable that such
a simple behavior and practice could have such a tremendous impact on public health,
the economy and the social well-being of the community. But, the very high levels of
acceptance and practice of masking tell us as a matter of common sense that it works
and should be continued.
Fourth, masking is an economic development strategy. We should be pleased in
Maricopa County that we have a lower unemployment rate than most of the rest of the
country at the same time that Maricopa County has seen a significant decrease in
COVID-19 spread, related illnesses, hospitalizations and deaths. This is exactly the
balance that we need to continue to pursue, and our primary tool for doing so is to
maintain the masking requirements that the Maricopa County Board of Supervisors so
wisely put in place. While many of our cities have demonstrated great leadership in our
collective efforts as well, the countywide requirement established by the Board of
Supervisors is essential to the continued advancement of the highly integrated economy
that exists in the county. Our economy, our jobs and our economic prosperity are not
defined by the boundaries of the municipalities; we are all linked in the complex web of
economic and social interaction that takes place across and throughout the Valley.
Fifth, the consequences of letting our guard down are clear: Renewed spikes in COVID19 cases are not only possible but likely. Recent events in other cities and regions of
the U.S. and in other countries point to the result of attempting to return to a “normal”
that is not likely to exist again for many months and perhaps years. Wisconsin and
Georgia — and Spain and Italy — are struggling with renewed outbreaks and spikes in
COVID-19 cases after political leaders developed a false sense of confidence that all
was well. It is essential here in Maricopa County that our plans, our implementation of
those plans and our leadership be firm and resolute. Achieving the balanced objectives

 of economic success and a healthy community requires that we stay the course rather
than relax our response.
In conclusion, I am asking you on behalf of the 100,000 people who make up the ASU
Community in Maricopa County to continue the masking regulations as you enacted
them only three months ago. I do understand there are those in our community who are
loud and vocal in the assertion of dogmatic views about the inconvenience and
annoyance of contributing to the greater good of their fellow citizens and the
advancement of the Republic. But, this is certainly a time in which those of us who have
agreed to lead organizations, institutions, businesses and governments must be
committed to finding the right balance to advance our economic and social well-being,
and masking is one of the primary means of achieving such balance.
Thank you for your consideration of this very important matter. I would be glad to talk
with you at any point about this issue and to provide you with further information about
ASU’s COVID-19 management strategy, as well as the scientific and public health basis
for continuation of masking at this very crucial juncture of our COVID-19 management
efforts. ASU stands ready to assist you and Maricopa County in the vital work it is doing
on behalf of the people of the county.
Sincerely,

Michael M. Crow
President

CC:

Governor Doug Ducey
Cara Christ, Arizona Department of Health Services