July 22, 2020

As we enter the ninth month since the start of the COVID-19 pandemic (the first case has been traced back to November 17, 2019) it is becoming increasingly clear that wearing masks is a critical tool in our toolkit to combat the spread of this novel coronavirus. That’s why the Medical Society took on the role of convening the Mask Up New Hampshire! collaborative of NH businesses and hospitals that aims to raise awareness around the basic safety precautions we can all take to help limit the spread of COVID-19 across the state and keep New Hampshire healthy and open.

Studies of prior outbreaks of influenza and SARS had shown masks to be part of an effective strategy to reduce the spread of respiratory viruses, which are typically spread by exhaling, coughing, or sneezing out virus-laden droplets, but initial guidance on mask wearing in the United States in the current pandemic was unclear and at times conflicting. However, on April 3, 2020, the White House Coronavirus Task Force and the CDC issued a recommendation for all Americans to wear cloth face coverings in public to help slow the spread of COVID-19.

A recent analysis presented in the CDC’s Morbidity and Mortality Weekly Report (MMWR) shows that after the CDC’s mask wearing recommendation, the prevalence of mask wearing increased significantly across the country, even without a mandate and even with some public officials continuing to call the recommendation into question. Within a month, as evaluated by survey data, the prevalence of reported use of face cloth face coverings was higher in all socioeconomic groups in the population, from 61.9% in April to 76.4% in May.

Since that time, new studies have provided additional evidence that wearing masks is critical to reduce transmission of the SARS-CoV-2 virus. An additional MMWR study looked at two hairdressers in Springfield, Missouri, who continued to see clients in May despite both having active COVID-19 symptoms. Eventually both were tested for COVID-19, found to be positive, and stopped work and were quarantined. Together they exposed 139 clients during the time they were both actively symptomatic. Both stylists, and all of the clients, wore face masks throughout, and not a single client was found to have developed COVID-19 subsequent to that exposure. It seems quite clear that mask use was the key factor in preventing transmission of the virus in this case.

Another study done at Mass General Brigham, the largest health care provider in Massachusetts, showed that implementation of universal masking of all health care workers as well as all patients led to a significant reduction in COVID-19 positive cases among health care workers, while the case rates in the community continued to increase for some additional time, suggesting that masking specifically was the critical intervention that helped to protect health care workers and reduce SARS-CoV-2 transmission.

Clearly the evidence from prior outbreaks and the accumulating evidence from the current COVID-19 pandemic shows that mask use decreases the incidence of COVID-19. Mask use, along with continued physical distancing and hand washing are simple, inexpensive, yet profoundly effective public health measures that can help reduce the spread of this novel coronavirus in NH and across the country.

As physicians, we ask you to join with the Medical Society, NH Hospital Association, Business and Industry Association, and many others to promote Mask Up New Hampshire! using resources at https://www.maskupnewhampshire.com/. By taking these simple steps, we can assure that the huge sacrifices that Granite Staters have already made – economic, social, and emotional – during the Governor’s stay at home order were not made in vain.  The stay at home order allowed the health care system to avoid being overwhelmed by COVID-19 and ‘flatten the curve’—it worked!  We’ve been able to slowly reopen parts of our state and our economy, and get to a ‘new normal’ that looks a little bit more like the ‘old normal’ than it has for some time. So let’s continue to encourage Granite Staters to wear masks, physical distance as possible and wash our hands, to protect ourselves and our communities, and preserve these hard-fought but tenuous gains that NH has made.

In health,

John Klunk, MD
NHMS President

Please send comments or questions to john.klunk@nhms.org