A syringe half full?… (via google image search & official city iconography)

Springfield has instituted a new indoor mask mandate , effective September 13, amid high case rates and hospitalizations. The mandate will expire November 1, but could last longer depending on conditions. According to vaccination data, only 47% of the city’s population is fully vaccinated. Hampden County has consistently had one of the lowest vaccination rates in the state. Mayor Domenic Sarno announced the decision at a press conference with city and local hospital officials.

Unlike some communities which rushed to reimpose masking based on debatable metrics, Springfield faces specific challenges. For example, Baystate and Mercy have high COVID-positive patient counts and the city’s population is especially vulnerable. City Hall politicos say officials have been lobbying the mayor to act on masks for weeks. However, thee have conceded that the true issue is how poor vaccine uptake has been. Both the state and city share responsibility.

“This is not forever, but it is the right thing to do,” Sarno said at a City Hall briefing of the new mandate.

While some councilors have been asking about masks at the weekly COVID Committee briefings, the mayor has been mulling the issue. Though he has resisted vaccine mandates for city employees, he landed on the masks for now at least.

Springfield Health & Human Services Commissioner Helen Caulton-Harris laid out the mandate’s details. While covering virtually all indoor spaces open the public, the order technically includes crowded outdoor spaces where distancing is not possible. As a practical matter, the indoor component is more significant.

Back in March, the city trumpeted the acquisition of vaccines to distribute. However, that came only after months of pressing the administration of Governor Charlie Baker to distribute doses to local health authorities. Springfield was not alone in this regard, but Sarno appeared to avoid confrontation with the governor.

On the city side, initial clinics were successful at reaching at-risk populations. However, moving beyond the more vaccine-eager populace has proven a challenge. Outreach efforts have been hobbled due to the historically insular nature of City Hall and the mayor’s office. A youth outreach group formed weeks ago had yet to hit its stride.

Earlier in the vaccination campaign, city councilors called on the state to release vaccine to local health boards, as post-9/11 emergency vaccination plans called for. However, the Baker administration chose to focus on since-closed mass vaccination sites. It ended up becoming a missed opportunity to establish trust early and on-the-ground in urban neighborhoods.

The state has continued its vaccination campaign, but no particular focus has been made on Hampden County. The much more conservative, outer fringes of the county remain particularly vaccine-averse. This is somewhat reflected in disproportionately high hospitalizations on Noble and Wing hospitals in Westfield and Palmer respectively.

Dr. Mark Keroack, the president & CEO of Baystate Health, said the system was treating over 100 patients or 1/6 of all COVID patients state. That is many times Baystate’s share of Massachusetts hospital beds. According to Baystate’s daily COVID patient announcement, its has 103 patients who tested positive for the coronavirus systemwide. All but three are in its Hampden County hospitals. Eighty-four are at the mothership in Springfield.

“The problems with vaccination in Hampden County are very much behind the surge we have seen,” Keroack said at City Hall. He added that vacancies both at Baystate and in nursing homes are exasperating the stress by clogging discharges.

Mercy’s Chief Medical Officer Dr. Robert Roose said his facility had 14 patients who tested positive for the virus.

Springfield had earlier established a mask mandate for municipal buildings. West Springfield is weighing a general mandate, mostly in light of the impending Big E.

Sarno has continued to resist mandating vaccinations for city employees, but that may change. As he announced his mask mandate, President Joe Biden implemented an executive order mandating vaccination of the federal workforce and contracts. Hospitals and healthcare facilities that receive Medicare or Medicaid must have fully vaccinate workforces or risk losing federal funding. Those federal programs are essential to nearly all medical systems’ financial health. Private employers will be expected to implement vaccination or testing programs pending a new Occupation Safety & Health Administration rule.

The decision to put in an end date likely reflects Sarno’s own reluctance. However, it also suggests a desire to underscore the temporary nature of the measure. Other localities with mandates have done little to establish offramp because of the nature of current CDC guidelines.

Federal metrics themselves have not meaningfully changed since the early days of the pandemic and may not adequately describe risk when vaccines are widely available. Presumably if Springfield were able to vax up and hospitalizations stay low, it could get out from under this mandate regardless of raw case numbers.