Dr. Benjamin Chan has been closely watching the number of new COVID-19 cases and hospitalizations in New Hampshire creep up this summer. But that’s not his biggest worry.

“What concerns me is the divisiveness that we’ve seen with this pandemic,” said Chan, the state epidemiologist at the Department of Health and Human Services.

“And that has made everybody’s job harder to control the spread.”

A lot of misinformation, doubt and skepticism is out there, Chan said, about the illness itself and the vaccinations that can protect people from it.

“I think the focus has shifted from protecting people, protecting communities, to discussions of individual rights and personal freedoms,” he said.

“I’m not trying to minimize any of that, but it concerns me that I think some have lost sight of the goal, the objective that we should all have, which is our collective responsibility to care for and protect people in our communities.”

Even as caseloads have exploded in states such as Missouri and Florida, New Hampshire continues to have one of the lowest rates of COVID-19 in the country, Chan said.

“But I think the increasing trend should raise concern and highlight the need for continued steps to prevent and control the spread of this virus, especially with the more infectious delta variant spreading and increasing in New England and New Hampshire,” Chan said.

Chan calls it a “stress test” of the state’s vaccination effort. “We’re seeing if the level of vaccination we have in New Hampshire is going to be adequate enough to control the spread of this virus,” he said.

Gov. Chris Sununu said last week he sees no reason to reinstate a mask mandate now.

New Hampshire has done well overall, Chan said, but he cautioned that vaccination rates vary widely across communities.

As a result, he said, “there are places in New Hampshire that remain more susceptible to outbreaks and more dramatic increases in infection.”

Those who are not vaccinated are at highest risk for infection, hospitalization “and potentially even death,” Chan said.

Where the vaccine is

The director of the Centers for Disease Control and Prevention recently warned that COVID-19 was becoming “a pandemic of the unvaccinated.”

As of June 23, some communities, such as Exeter, Littleton and Wolfeboro, had seen at least 80% of their residents get at least one dose of vaccine.

In other communities, such as Deering, Jefferson and Sutton, the rates were less than half that.

Here’s the worry: “Those lower vaccination numbers are what have been seen in other areas of the country that are now seeing new surges of infection and outbreaks,” Chan said.

The state health department has identified 23 cases of COVID-19 involving the more contagious delta variant, Chan said. Eight of them were in the past week.

Chan said he understands that a certain number of people just do not want the vaccine “and nothing we do or their provider says will convince them to get that vaccine.”

That’s not who public health officials plan to target with further outreach, he said.

Instead, he said, the state will continue to promote the safety and effectiveness of the vaccine, and work with regional public health networks to make vaccines available.

For those who are still hesitant or have questions about vaccines, Chan said, “the best advice that I can give is to have a conversation with their health care provider. That’s what the provider is there for, to have those more difficult conversations and hopefully relay accurate, scientifically based information and to help try and counter the misinformation that is out there.”

Since the beginning of the year, 10 people in New Hampshire who were fully vaccinated have died from COVID-19, he said.

No vaccine is 100% effective at preventing infection, Chan said. But he said, “these vaccines remain very, very effective in all age groups at preventing not only symptomatic and asymptomatic infections but at preventing serious complications of COVID-19, including hospitalizations and deaths.

“The best way to protect oneself, to prevent somebody with COVID-19 from needing to be hospitalized or even dying, is the vaccine.”

Chan said he expects the case numbers to go up this fall, if not sooner, as people move indoors in more crowded environments. It’s what happened last year, and people need to be flexible and ready to adapt.

“Everybody needs to remain flexible and ready to adapt to what happens in this ever-changing pandemic,” he said.

Back to school

One pressing concern for many New Hampshire families is what will happen when schools reopen in the fall.

Last Wednesday, Chan and other health officials held a conference call with educators and child care agencies, sharing recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics about keeping students safe.

Chan said the New Hampshire health department does not plan to issue new state guidance for schools. “We are trying to support our schools in helping them think through the guidance that’s already out there,” he said.

School districts should make decisions such as whether to require face masks for students and staff based on local infection levels and rates of vaccination, Chan told those on the call.

So when does the state epidemiologist wear a mask these days?

“I still wear a mask when I’m going into public locations and I’m around other people who I don’t know,” he said.

Even at the grocery store? Yes, Chan said.

One reason for that is that one of his children is too young to get a COVID-19 vaccine, currently only authorized for those 12 and older.

“Until my children can be all fully vaccinated, I will still take precautions to prevent potentially picking up the virus and then bringing it home to my kid,” Chan said.

Face masks are meant to be a “bridging” measure until more people, especially schoolchildren, can get vaccinated.

Chan said he expects the Food and Drug Administration will authorize vaccines for younger kids sometime this fall, though probably not in time for the start of school.

Once those are available and children get vaccinated, he said, “The goal is to be able to pull back on face masks and these mitigation measures even more.”

Past, present and future

Back in April 2020, Chan prepared a presentation titled, “COVID-19 The Future of the Epidemic in New Hampshire.”

“This epidemic will last many more weeks,” he warned then.

The report recommended six “community mitigation” steps to prevent the spread of the virus: staying home, social distancing, remote learning, encouraging tele-work, canceling mass gatherings and closing non-essential businesses. Such interventions would reduce the number of infections, hospitalizations and deaths from the new virus, it stated.

“We need to continue to work together to protect each other and those most vulnerable in New Hampshire,” it concluded.

Fifteen months and 100,000 cases of COVID-19 later, the message hasn’t changed.

“The virus will be with us for the foreseeable future,” Chan said last week.

Increasing levels of community transmission will lead to more infections in schools and child care centers this fall, which will put more vulnerable people at risk, Chan said.

That’s why, he said, “I don’t think it’s as simple as saying vaccinated people can do one thing and unvaccinated people can do another thing.”

“What one person or a group of people do in a community affects everybody,” he said.