STOCKTON, Calif. (Reuters) – The first wave of COVID-19 came slowly to San Joaquin County in the heart of California’s breadbasket, but the much-feared second surge is roaring through, sickening as many people in the two weeks since Memorial Day as in March and April combined.

Hospitalizations have spiked by 40%, and the county is one of ten in the most populous U.S. state put on a watch list of places that might be ordered to lock down their economies again after weeks of careful reopening.

But when Michael Tubbs, mayor of the county seat of Stockton, submitted an ordinance requiring residents to wear masks when they are in public, he did not get a single vote from the six other members of the city council.

It is “a political hazard to act in the interest of public health,” complained Tubbs, a liberal whose city has several conservatives on the council.

The pushback Tubbs experienced – and the spike in cases the county’s health director says was exacerbated when people celebrated Mothers Day and Memorial Day without following physical distancing rules – offers a glimpse into the complicated politics around lifting coronavirus restrictions.

Last week, the chief health officer for Orange County in Southern California resigned amid protests and personal attacks after she issued an order to wear masks in public. Four other health officers in California have resigned or retired in the last two months, as have two public health department directors, local media have reported as cases and deaths continue to rise in the state.

On Tuesday, the state reported nearly 160,000 confirmed COVID-19 cases and over 5,200 deaths.

Health directors and the U.S. Centers for Disease Control and Prevention say wearing face coverings in public is essential to slow the spread of the virus.

Public health restrictions run against the grain of individualism in American culture, and often generate resistance, said U.C. Berkeley epidemiologist Arthur Reingold. Chafing under rules requiring masks in public is reminiscent of prior health care emergencies, such as the uproar that followed efforts to close gay bath houses during the HIV epidemic, Reingold said.

Throughout the country, resistance to public health measures has also taken on a partisan tinge. A Reuters/Ipsos survey conducted last month found that just one-third of Republicans were “very concerned” about the virus, compared to nearly half of Democrats. Trump eschews wearing a mask in public, while his Democratic opponent in November, Joe Biden, generally wears one.

MAKING HAY

In California, Governor Gavin Newsom has loosened the state’s shutdown even as cases in some areas continue to rise. Stockton, which also has a number of conservative members of the county Board of Supervisors, is emblematic of places where wearing a mask has become politicized.

City council seats in California are non partisan, and San Joaquin County leans Democratic like much of California. But the percentage of voters here who are Republican is higher than the state as a whole. Tubbs is a Democrat.

“It’s quite normal during a crisis for political opponents to make hay out of the crisis,” said U.C. Berkeley political scientist Ann Keller, who studies the politics of public health. That 2020 is an election year has made the polarization worse, she said.

In San Joaquin County, Health Officer Maggie Park attributes the rise in cases to two cherry packing plants where people are working in close proximity, and to families and friends gathering without wearing masks or physical distancing, along with recent moves to re-open the economy.

Already, more people have been hospitalized with confirmed or suspected cases of COVID-19 in San Joaquin county than at its earlier peak on April 4, a Reuters analysis of state and county data show.

Not only are more patients being hospitalized, but patients who put off unrelated care in fear that they would contract the coronavirus are also filling up beds, said Scott Neeley, Chief Medical Officer at St. Joseph’s Hospital in Stockton. The hospital can handle a surge, but resources will be stressed if cases continue to mount quickly, he said.

If hospitals become overwhelmed, forcing another shutdown, that will wreak economic havoc and lead more people to postpone important care, said Daniel Wolcott, Chief Executive Officer of Dameron Hospital in Stockton and Lodi Memorial Hospital in Lodi.

The way to avoid that is simple, he said.

“Wear a mask,” Wolcott said. “It’s not a political symbol.”