With COVID-19 infections once again surging, Governor Charlie Baker on Monday announced a series of restrictions aimed at containing the highly contagious disease.
The governor tightened the state’s face-covering mandate to require anyone over 5 to wear a mask in public, even if social distancing can be maintained. Citing house parties and informal get-togethers as potential spreading events, Baker also limited private indoor gatherings to 10 people, ordered restaurants to stop table service at 9:30 p.m., and urged the public to stay at home between 10 p.m. and 5 a.m.
Baker said Tuesday that the measures "send a message about how important it is for people to stop gathering in big groups . . . [and] basically encourage people, strongly, to be home with the people they spend every day with by 10 o’clock at night.”
But some public health workers have said the administration’s moves don’t go far enough in staunching the rising tide of cases. The Boston Globe asked three epidemiologists to assess the new restrictions, their potential effectiveness, and what other steps state officials should be taking.
1. Will the new requirement that people wear masks outdoors at all times help reduce transmission?
Helen Jenkins, assistant professor at Boston University School of Public Health: “I don’t think in and of itself it will do anything, particularly. I think that we know outdoor transmission is very low, so if you’re more than six feet away from somebody, I don’t see a strong reason to make [people wear] a mask.”
Julia Marcus, epidemiologist and associate professor at Harvard Medical School: “Governor Baker and other elected officials, not just in Massachusetts, have said that indoor social gatherings are driving new infections, so it may be more effective to actually address that than to tighten mask restrictions outdoors. It’s basically targeting something that’s not actually causing infections.”
2. Will forcing bars and restaurants to close earlier have any impact?
William Hanage, associate professor at the Harvard T. H. Chan School of Public Health: “It’s definitely not going to be game-changing . . . It’s implausible to suggest that shaving off the last hour of potential contacts in the restaurants is going to have an out-sized effect. It will have some effect, sure. And it might even reduce it. Or it might prompt someone to go back to someone’s house . .. and not be wearing masks there.”
Marcus: “If there’s evidence that risk in those settings is being driven by things that are happening late in the evening, maybe there is some rationale there. But if that data exists, I think it would be good to share with the public. The danger here is enacting policies that seem arbitrary, because that’s how the public will lose trust in public health efforts.”
Jenkins: “I think it sounds like a good idea, but we have no evidence that it will do anything. And several European counties tried doing that over the last month or two . . . and clearly that didn’t have any impact there. We don’t have any evidence that it will work, and the concern is if we replicate the mistakes that Europe has made over the last couple of months, then we risk just delaying an another inevitable shutdown.”
3. What is the rationale behind the stay-at-home advisory?
Jenkins: “It depends how much transmission is going on after 10 o’clock at night. I assume the presumption is people are gathering indoors at night, drinking. Obviously the virus doesn’t only come out after 10 o’clock at night. It depends on how much people would even adhere to a restriction like that.”
Hanage: “If you look at what’s happened in Europe, Europe is now thoroughly in the grip of a second wave, and a number of places there sort of tried to do curfews of this kind . . . but it certainly doesn’t seem to have done much to slow the virus down. It could be delaying stronger interventions, and when those interventions become necessary, they will need to be stronger and last longer.”
4. Will people actually comply with any of this? What about enforcement?
Jenkins: [I wish] that there was better information made available for where transmission is actually happening. It’s tempting to say we should close indoor dining, and other activities that are indoors. It would be nice to have some data to support those actions as well.”
Marcus: “I also worry about inequitable enforcement. Any time policing is on the table for a mandate like this, it tends to play out in a way that disproportionally harms people who are already marginalized. And there are those who lack private outdoor space, and those will be the people most affected.”
5. What else should the state should be doing?
Marcus: “In addition to paid sick leave and safer isolation spaces, a moratorium on evictions is another example of a policy that can help ensure people are able to distance, quarantine, and isolate as needed. It expired a couple weeks ago.”
Hanage: “What we need to do is we just need to get people to avoid the three c’s: closed, poorly ventilated spaces; close contact; and crowds.”
Jenkins: “Another thing [Baker] could’ve done was advise anybody who can to work from home. I also wish . . . that there was better information made available for where transmission is actually happening. It’s tempting to say we should close indoor dining, and other activities that are indoors. It would be nice to have some data to support those actions as well.”
Dugan Arnett can be reached at email@example.com.