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PORTSMOUTH, N.H. – The news that President Donald Trump will hold a rally in Portsmouth, New Hampshire, on Saturday, July 11 has raised concerns among some local medical experts about what his visit will do to the relatively low COVID-19 numbers in the area.
Compared to other states, like Florida and Texas, the Northeast seems to be managing the pandemic fairly well. Some fear a large, crowded rally will reverse that positive trend.
New Hampshire Gov. Chris Sununu urged residents to wear masks and practice social distancing at the outdoor rally.
“It is imperative that folks attending the rally wear masks,” he said.
From the outset of the pandemic, the state has not stopped or prevented individuals from peacefully assembling, including marches led by Black Lives Matter and protests from Reopen NH, Sununu said.
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Perception, influence play a role, expert says
Dr. David Itkin, infectious disease expert at Portsmouth Regional Hospital, said he looks at the upcoming rally from two perspectives.
“The first is perception,” Itkin said. “He’s here. He is our leader. A lot of people, including me have been working hard to keep our numbers low, to educate people about the best way to be safe. So, I worry that the rallies give the perception that our president will be seen as a negative role model. I also worry his visit could undo what we have accomplished here.”
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Vice President Mike Pence defends Trump campaign rallies as health authorities warn people to continue to practice social distancing. “Even in a public health crisis, the American people don’t forfeit their constitutional rights,” he said. (June 26)
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Itkin said his second worry is for the people of southeastern New Hampshire.
“I am not sure we have the ability to control infection in a really large crowd where some people will choose not to wear a mask,” Itkin said. “Will there be the ability to do social distancing, or do they want that appearance of a packed house?”
Itkin said his concerns are based solely on the science of infection control. He advises if people choose to attend they should bring their own masks and hand sanitizer. He said to watch where you are in a crowd and leave if you do not feel safe.
“I am looking at the ability to protect the individual, the person who is going to leave there and go to the grocery store, to the pharmacy,” Itkin said. “Will that lead to a spike in cases? I guess we’ll see.”
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‘Crowds of any form inherently increase the risk’
Martha Wassell, director of infection prevention at Wentworth-Douglass Hospital in Dover, New Hampshire, said any planned public gathering regardless of size during a pandemic is concerning from a public health perspective.
“Crowds of any form inherently increase the risk of coronavirus transmission,” Wassell said. “The Centers for Disease Control and Prevention released additional guidance on June 15 with a few questions to ask if considering attendance at a large gathering.”
Wassell said people should consider how many people they will interact with, and for how long, because interacting with more people raises your risk or the risk you pose to others if you are asymptomatic.
“Being in a group with people who aren’t social distancing or wearing cloth face coverings increases your risk,” she said. “Engaging with new people raises your risk. Some people have the virus and don’t have any symptoms, and it is not yet known how often people without symptoms can transmit the virus to others. Can you keep six feet of space between you and others? Will you be outdoors or indoors? The closer you are to other people who may be infected, the greater your risk of getting sick.”
Keeping distance from other people is especially important for people with increased risk for severe illness. Itkin said people 60 and older, and those with cardiovascular diseases or compromised immune systems should probably choose to stay home.
Mask mandate? Not yet
Dr. Ben Locwin, part of a group that has been advocating for mandatory masks in the state, said he thinks Gov. Sununu could mandate masks for the event.
“But given his political affiliation, and the enormity of the pressure amid the scenario’s optics, make that unlikely,” Locwin said. “I’m guessing the Pease Development Authority could make any private property or zoned areas subject to their mask requests, should they choose to do so.
“As I was the first to say back in February, cleaning surfaces is symbolic theater, and the principal transmission risk is droplets and aerosols in the air. Attendees on either side of the political divide can try to be as distanced as possible within the gathering and wear well-fitting masks/face coverings. Depending on the weather and the layout of the location, the receiving site could also put large industrial fans in place to force the fresh air exchange to limit the residence time of infectious particles in the air.”
State Sen. Dan Feltes, who is challenging Sununu for governor, released the following statement.
“Given the impact of prior Trump rallies on public health, like the uptick in COVID-19 cases after Trump’s Tulsa rally, Gov. Sununu should issue an order to require social distancing and masks and cancel the event if the Trump campaign will not comply. Gov. Sununu has kept the ‘state of emergency’ in place and has the authority to do this. Public health of Granite Staters should take priority over politics.”
People from Maine may choose to attend, and Dr. Evangeline Thibodeau, an infectious disease doctor at York Hospital, said she finds that concerning because Maine has done well to control COVID-19.
“Any situation where people will be at risk of not being able to stay at least 6 feet apart poses a risk,” Thibodeau said. “The crowds attracted to such a rally is concerning. The fact that many who attend choose not to wear a mask is concerning.”
To the argument that Black Lives Matter protests did not create spike in cases, Thibodeau said there are differences between a march and a rally.
“The protests often have people moving, marching,” Thibodeau said. “People standing together closely, with no mask for a long period of time, more than 15 minutes raises risk. We are doing well in Maine and in the Seacoast in general. I’d hate to see us lose that.”
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Dr. Kenneth Cohen, a psychiatrist who lives in Kensington, New Hampshire, said he has been watching the spread of COVID and does not think a Trump rally is a good idea.
“New Hampshire has been working hard to mitigate the COVID virus spread and we have been cautiously wary, guarding against the uncertain course of this novel, lethal virus,” Cohen said. “The airborne droplet spread of the virus is certain and the current national surge of cases and hospital admissions is alarming. Donald Trump’s contempt of the science regarding this virus and his willful defiance against masks and holding large gatherings inflicts direct harm and escalates the spread of contagion.
Wassell urged attendees of the Trump rally to maintain at least six feet distance from others and to wear a mask.
“Even if six feet can be maintained, for the sake of those around you, please choose to wear a mask to help control droplets and to prevent transmission,” she said. “Mask use is a kind, unselfish gesture of caring for the health and well-being of those around you. Please remember the hand sanitizer, and use regularly, especially before and after adjusting your mask.”
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