WEST LEBANON — Some municipal leaders in the Upper Valley are getting conflicting messages about whether it’s safe to lift masks mandates that have been in place for months due to the COVID-19 pandemic.
The Centers for Disease Control and Prevention, under new guidelines issued last Friday, still recommends that people continue to wear masks in three of the Upper Valley’s four counties.
In Sullivan and Grafton counties in New Hampshire, as well as in Vermont’s Orange County, the CDC still recommends that people wear masks indoors due to a “high” level of COVID-19 in the community.
“This updated approach focuses on directing our prevention efforts towards protecting people at high risk for severe illness and preventing hospitals and health care systems from being overwhelmed,” Dr. Rochelle Walensky said in a transcript of a Friday news briefing when the CDC announced the new guidelines.
But that guidance conflicts with New Hampshire Department of Health and Human Services’ new recommendation issued last Wednesday that Granite State residents no longer need to wear masks and the Department of Education’s requirement that schools drop mask mandates as soon as practical.
“Given the decreasing incidence of COVID-19 and continued decrease in COVID-19 related hospitalizations in N.H., masks are no longer recommended indoors across the state,” said Jake Leon, a DHHS spokesman. He declined to answer questions about how the state’s guidelines conflict with the CDC’s.
For now, mask mandates remain in effect in much of the core of the Upper Valley.
“We’ve stuck all along with the CDC guidelines,” Hanover Town Manager Julia Griffin said. “At the end of the day, thinking about physician and data-driven decisions, that’s where we’ll continue to stay as a community.”
Griffin said Grafton County’s numbers are primarily driven by cases in Hanover, where Dartmouth College sits, as well as Lebanon and Plymouth, N.H., which are the “three communities that have tended to generate the high numbers in the last 18 months or so.”
As of Monday, Hanover, with 380 active COVID-19 cases per 100,000 people, had the highest rate of active cases in the state.
But Upper Valley mask mandates may not last much longer.
The Lebanon City Council is slated to discuss the city’s mask mandate at its Wednesday night meeting and may set a public hearing for later in the month. Vermont communities with mandates are required to regularly revisit them. Hartford’s is slated to run through March 8. The state law allowing Vermont communities to mandate masks is set to expire at the end of next month.
It’s “entirely possible that you’ll see us shift mid-March,” Griffin said of Hanover’s mandate that’s been in place since August. “Depending on where the numbers are at that point.”
Dartmouth-Hitchcock Health also is sticking with the CDC’s guidelines “that continue to recommend indoor masking for Grafton County, along with Sullivan Country and Strafford County,” Dr. Michael Calderwood, an infectious disease specialist and chief quality officer at Dartmouth-Hitchcock Medical Ce.
In the Upper Valley, only Windsor County has a “medium” level of COVID-19, according to the CDC. There, and in other places with similar or fewer numbers of COVID-19 cases and hospitalizations, the CDC says it’s OK for people to stop wearing face coverings indoors.
In calculating the level of COVID-19 in counties, the CDC takes into account the seven-day average of new hospital admissions with COVID-19; the seven-day average percentage of hospital beds occupied by COVID-19 patients; and the seven-day average of new cases.
With a “medium” level of transmission, the agency recommends that people at higher risk for serious illness should they contract COVID-19 consult their doctor about whether or not they should wear masks indoors in public. A tool on the CDC’s website, cdc.gov, allows people to look up their county to determine whether the agency recommends masks there. People can also call 1-800-CDC-INFO.
The CDC’s new approach shifts the masking burden away from the community onto individuals, said Anne Sosin, a public policy fellow and public health researcher at Dartmouth. She said she’s especially concerned about what this will mean for immunocompromised people for whom vaccines may not be protective and for children younger than 5 who are not yet eligible for vaccination. She said she had hoped the agency would instead provide state and local policymakers with a framework for how they could make decisions about masks.
She said she hopes that in addition to the new CDC guidelines, community decision-makers also look at guidance from the American Academy of Pediatrics, which urges families to consider factors such as their child’s age, immune system and vaccination status, as well as the level of COVID-19 in the community when deciding whether to mask. She also said she hopes that policymakers who choose to drop masks now make a plan for bringing them back if COVID-19 conditions change.
“Those people who are most vulnerable need communities to protect them,” Sosin said.
Dr. Tim Lahey, an infectious disease physician at the University of Vermont Medical Center, said he thinks it makes sense to shift mask policies now that many people have some form of immunity due to vaccination and/or infection. But he said it’s important to remain flexible in the approach to masks as COVID-19 conditions continue to change.
“If this approach makes most people in town happy but at the expense of unacceptably high death rates in immunocompromised people, then of course we’ll have to change course,” he said in an email. “I’m not saying I expect that will happen, just that there remains uncertainty about the future so we have to keep a close eye on that most important piece of the local disease burden.”
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
