ROCHESTER, Minn. -- In a unified appeal, the Minnesota Medical Association and 20 other medical societies joined together on Friday, June 26 in calling for state leaders to require the wearing of masks in all indoor settings.

The MMA did not specify if the proposed mandate should be extended, as numerous states have done, to outdoor settings where persons cannot maintain a 6-foot separation.

“Minnesota is seeing improvements in COVID-19 cases, but the threat of this virus is not over,” said Dr. Keith Stelter, president of the Minnesota Medical Association, in a statement.

“The medical benefits of wearing a mask are clear -– a mask helps reduce virus transmission, particularly by individuals who are sick but have no symptoms and by individuals who have been infected but do not yet show any symptoms. Masks are also safe to wear.”

In an afternoon press call, state health commissioner Jan Malcolm said state leaders are discussing the proposal, but she hedged on a full endorsement.

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"I think the evidence on the value of masks continues to grow," said Malcolm. "It's been one of the things that has frankly changed, over the course of the pandemic -- what we knew about masks and how valuable of a tool we thought they were. As the evidence has continued to get stronger about the benefits of mask-wearing, we certainly have always urged that, and strongly recommended it as we look to further reopenings."

"I know it is a logical question if ... actually making it a requirement for certain settings might make a logical companion to the reopenings," Malcolm said. "A number of localities have taken that initiative on their own, and that's certainly something we have been supportive of as well."

Currently, 16 states have issued orders requiring the use of masks in public places indoors and often outdoors if persons cannot maintain a distance of 6 feet.

Minneapolis and St. Paul mayors have ordered the wearing of masks indoors in public places and outdoors where distance cannot be maintained. The state of Minnesota has requirements for wearing masks in certain businesses, but aside for customers of personal care services, the public is currently under no requirements to cover their mouth and nose in the Land of 10,000 Lakes.

'We know that the governor has said many times for this to work, Minnesotans have to buy in and adopt these behaviors," Malcolm said. "We also understand saying something is required does matter. We're talking about that, and looking at that quite closely as we notice that more states and cities around the country are going to a requirement."

Minnesota has taken a patchwork response to mask recommendations, with restaurants, bars and small shops often showing uniform adherence among employees if not customers, contrasted with large retailers and customers flaunting the advice altogether.

The result is an unspoken tension created by the collision of those who see the wearing of masks as a pro-social activity -- the mask protects strangers more than the person wearing one-- faced with beneficiaries of their concern who walk within 6 feet and begin speaking loudly.

There is also a developing culture war over masks, with often mask-less GOP candidates for higher office like U.S. Senate candidate Jason Lewis wading into crowds bare-faced at political events that cluster attendees without masks.

President Donald Trump flouts the recommendation, while presidential candidate Joe Biden has said he would require masks of all Americans during the pandemic.

The issue has only taken on greater urgency as states which re-opened early are now seeing resurgences in cases.

“Statewide use of masks now in all indoor settings and on public transportation can help Minnesota avoid the resurgence of cases that is happening in many other states and avoid a backwards turn of the dial,” said the MMA's Stelter.

"We continue to evaluate and think further about how every turn of the dial that opens things up increases social interaction," said Malcolm, "that's just a fact. The more interaction we have, the more the value of any protective measure we could take."

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Minnesota Department of Health COVID-19 hotline: 651-201-3920.

COVID-19 discrimination hotline: 833-454-0148

Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.