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N.H. COVID-19 cases are at an all-time high. A Dartmouth researcher says it’s time for mask mandates.

A photo of a car driving by a sign that says "mask mandate" on a street.
Dan Tuohy
/
NHPR

New Hampshire is experiencing its most serious surge of COVID-19 since the beginning of the pandemic. As of Tuesday, New Hampshire has the highest per capita rate of COVID infections in the country, and one of the highest hospitalization rates.

Gov. Chris Sununu has long predicted and said he and his administration were preparing for a winter surge.

But Anne Sosin, a policy fellow at Dartmouth College, says that while the surge was predictable, it was also preventable. She says officials in New Hampshire aren’t doing enough to help stop the surge.

“We have public health tools that we can deploy to prevent and mitigate surges,” Sosin says. “And it's not clear that the state of New Hampshire has employed the full toolkit of policies that are at our disposal.”

Specifically, Sosin thinks indoor masking policies could have helped mitigate the surge.

“It's really important to accelerate vaccination efforts,” Sosin says. “But we also know at this time that a vaccine-only strategy is really insufficient to control the Delta variant.”

She is advocating for data-driven masking policies that could reduce community transmission and thereby relieve stress on hospitals that are buckling under the record number of COVID-19 cases in the state.

Sosin was part of a team of public health experts from across the New England region that called upon governors to implement data-driven mask policies.

These policies link to CDC guidance and metrics so they’d “turn on” automatically when community transmission reaches substantial levels and then they’d “turn off” when those levels subside. By linking to CDC guidance, Sosin says that states have a clear blueprint of when to implement mask mandates and when to lift them.

Sosin admits that there is resistance to mask mandates in New Hampshire, but she pointed to national polling that showed a majority of Americans were in favor of mask policies. And even if there isn’t 100% compliance, Sosin says that masking policies do lead to an increase in masking.

New Hampshire’s statewide mask mandate ended in April this year.


Transcript:

Rick Ganley: New Hampshire saw a rise in cases around this time last year as well. Was this surge inevitable with the winter weather and holidays getting people back indoors?

Anne Sosin: I would say that the surge was both predictable and preventable. There were several signs as early as mid-summer that we would experience a significant surge coming into the fall and winter months.

Rick Ganley: What were some of those signs?

Anne Sosin: Right now, we're dealing with a variant that's twice as transmissible as the ancestral strain of the virus. We have high rates of vaccination in New Hampshire, but we still see many people across the state who remain unvaccinated. And as we are heading into the fall, we're seeing increasing population mobility. We're seeing children return back to schools. We're seeing workers return to offices. We're seeing a resumption of travel and other activities. And we know that all of these things combined increase exposures and then transmission across the region.

Rick Ganley: Well, I spoke with Governor Sununu back in September, and he said that he was expecting a winter surge. He's since described this current surge as all but inevitable. Do you feel the state adequately prepared for the surge?

Anne Sosin: We have public health tools that we can deploy to prevent and mitigate surges, and it's not clear that the state of New Hampshire has employed the full toolkit of policies that are at our disposal.

Rick Ganley: What should the state have done, and what do you think the state should be doing now?

Anne Sosin: Vaccination continues to remain our primary strategy for controlling and ending the pandemic, and so it's really important to accelerate vaccination efforts, particularly to those communities across the state that have lower rates of vaccination. We also need to continue to deliver boosters to high risk groups. But we also know at this time that a vaccine only strategy is really insufficient to control the Delta variant, and I've advocated really strongly that we employ data-driven mask policies to amplify the protection of vaccines in our communities.

Rick Ganley: I'm wondering if you could point to other states that you think are handling this well or handling it better than we are here in New Hampshire?

Anne Sosin: Yes, there are six states that currently have a mask mandate in place, and all six of these states saw an immediate and significant increase in masking upon implementation of their mask policies. Their masking is far higher in those states than it is in New Hampshire and neighboring Vermont. And so I think that they provide us with an example of how masking is a tool that really complements our vaccination efforts.

The state of Nevada is a particularly good example. I was part of a team of public health experts from across the New England region that called upon our governors to implement data driven mask policies based on the model in place in Nevada. Data driven mask policies link to CDC guidance and metrics. And they turn on automatically when community transmission reaches substantial or high levels and then off again when it subsides. And they provide a tool for us to control community transmission and relieve some of the impacts on our community's health systems and schools.

Rick Ganley: I know New Hampshire is trying to address the surge by bringing in temporary health care workers, transferring some patients out of state and continuing to encourage people, of course, to get boosters and even a first dose. How do you think these measures are going to affect this current surge that we're seeing right now?

Anne Sosin: I think it's really important to pair increased support for our health systems across the region with a more aggressive public health response. The goal of our public health response needs to be to limit the pressures that we're currently seeing on our region's health systems.

We know that our health systems entered the Delta surge with significant underlying strains. Many have an acute and chronic workforce crisis. We know that hospitals are seeing record numbers of very sick patients right now, and COVID is exacerbating these strains. We can't easily predict or prevent heart attacks, strokes or traumas, but we can rapidly deploy evidence-based public health strategies to decrease COVID transmission and the subsequent pressures that this is having on our health system,

Rick Ganley: There are a lot of vocal people who are against any kind of masking mandates. Even if the government wanted to implement mask mandates again, would there still be an issue of people just actively not complying?

Anne Sosin: So I want to begin by saying that we have national polling data showing that the vast majority of Americans actually support mask mandates as a tool to control surges. And so while resistance to masking gets outsized attention in the public conversation, most Americans actually do support masking as a tool to control the pandemic.

We know that we're never going to achieve 100% compliance with mask policies, but our goal is to use policies to optimize masking across our communities. And what we see is that when mask policies are enacted, there is an increase in masking. Not to 100%, and often not to the previous high seen at other phases in the pandemic, but to significantly higher levels than before the time at which they were put in place.

Rick Ganley: I want to ask you about the Omicron variant. It's on everyone's minds right now, and of course, it's across the media. How should public health officials react to the new variant while we're still battling what really is a surge of the Delta variant?

Anne Sosin: We're still learning about the Omicron variants and what its implications might be in terms of our public health response. However, we know that we already have a problem with the Delta variant. The Delta variant, or the Delta surge rather, is having really significant impacts on our health systems, our schools and our communities, and all of the tools that we need to address this surge will also be important in responding to the Omicron variant as well.

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