Charleston City Council voted Thursday to require people wear masks in public places beginning July 1.
"It keeps rolling in like waves at the beach," Dr. Robert Ball of the Medical University of South Carolina told council members before their vote.
"One reason has to do with the virus, the other has to do with human behavior. (Requiring masks) is low-hanging fruit," he said.
The majority agreed and voted overwhelmingly to pass the ordinance.
People will be required to don masks in public indoor spaces like grocery stores or restaurants, as well as while interacting with people outdoors and on public or commercial transportation. They will also have to wear them while walking anywhere that's too crowded to keep 6 feet apart.
Exceptions for people who can't safely wear or remove masks are included in the ordinance, as well as for those actively eating, drinking or smoking.
Any unmasked person who ignores a warning about the ordinance is subject to a $50 fine and businesses are responsible for keeping their employees in compliance.
Only council member Harry Griffin opposed the measure, saying residents shouldn't face any more regulations until the city has answered all their concerns about the vandalism on King Street after a protest following George Floyd's killing.
Council member Keith Waring voted "aye" from his truck as he waited for his turn at a drive-thru testing site. He'd come into contact with a person who had tested positive, he told council, and felt fine but was getting swabbed to make sure he didn't pass it on.
The vote comes as Charleston's weekly new case rate led the state with an average of over 164 positive tests each day and especially high rates among downtown residents.
MUSC has eight patients on ventilators, Ball told council, and its ICU is nearing 60 percent capacity. Hospital leaders will have to reevaluate operations if occupancy reaches 80 percent.
"Most of us think the worst is yet to come, month after month after month," Ball said.
Similar ordinances have been passed in Columbia and Greenville and one is under consideration in Mount Pleasant. Attorney General Alan Wilson said Wednesday that local ordinances are legal, even as Gov. Henry McMaster declines to issue statewide mandates.
Goose Creek on Thursday night rejected a similar ordinance.
The city-specific regulations are too piecemeal to quash the statewide spike in infections, state epidemiologist Dr. Laura Bell said Wednesday, but any additional precautions are necessary to stem the pandemic's flow.
Hospital capacity is a priority, the Charleston council agreed, but several members said that businesses have approached them about increased restrictions in hopes of easing the difficulties of operating during a pandemic.
"The whole objective is to get us back to a place where we can be successful," Councilman Mike Seekings said.