PHILADELPHIA — The city of Philadelphia has become the first major American city to reinstate an indoor mask mandate this spring, responding to sharply rising numbers of new coronavirus cases. The reinstatement, announced last week, took effect Monday.

The mandate requires masks in all indoor public places, though businesses have the option of choosing instead to require proof of vaccination from their employees and customers. It was reimposed a little more than a month after the city lifted it in early March.

The response has been mixed. Some public health advocates applauded the move. A group of business owners and residents on Saturday sued to stop it. The leading Democratic candidate for governor of Pennsylvania, Josh Shapiro, called such mandates “counterproductive.” Many Philadelphians were not entirely sure what to make of it all.

“There’s really no sense of stability with regards to business,” said Shane Dodd, who co-owns a bistro in the Fairmount neighborhood of the city. Like other restaurant owners, he said it would be a hassle to once again have to confront the occasional stubbornly anti-mask customer. He feared losing business to restaurants in the suburbs, and worried that a nervous public would interpret the mandate as a sign that it was not safe to go out to eat for the indefinite future. “It’s a never-ending story,” Mr. Dodd said.

Philadelphia’s decision to reinstate the mandate comes at a strange time in the pandemic. The Omicron subvariant known as BA.2 has reversed the decline in new-case counts throughout the Northeast. But it is spreading in a country that is better vaccinated now than it was when the Delta variant arrived around this time last year, and one that has more antiviral medication options available than before.

Still, many people have long since lost their appetite for vigilance, and even some of the most cautious have grown weary. Philadelphia, a city that has been broadly compliant with public health directives for the past two years, is a case study in how thin patience has worn for pandemic restrictions, even in a place where thousands of people have died from Covid-19.

“From the kind of larger public health perspective, this is a constant dance that we are in, especially here in the United States, of when to put things into policy,” said Dr. Megan Ranney, an emergency physician and associate dean of the Brown University School of Public Health.

Philadelphia’s reinstated mask requirement is based on its own Covid mitigation guidelines, which differ from those of the federal Centers for Disease Control and Prevention. The mandate kicked in automatically because the average number of new cases reported in the city had risen above 100 a day, and more significantly, had increased by more than 50 percent in 10 days.

The latest C.D.C. guidelines place more emphasis on hospital admissions and occupied hospital beds, which are measures of the strain on health care systems rather than direct gauges of infection risk; those metrics tend to lag several weeks behind the trend in new cases. By the C.D.C.’s lights, Philadelphia was still solidly in the “low” category when the mask mandate was reinstated.

“The thing is, I could be wrong — people two weeks from now could be laughing at me,” Cheryl Bettigole, the city’s health commissioner, said in an interview. “But if I manage to save lives because I’m right, that’s worth the risk.”

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