The idea to end outdoor activities near sunset to protect people from a deadly mosquito-borne virus is not new. This year’s public outcry about the measure is.
In 2005, 2012 and 2019, towns in Massachusetts and Connecticut asked residents to curb outdoor activities during outbreaks of eastern equine encephalitis, an infectionalso known as EEE, with little fanfare or attention.
Last week, however, when officials in Oxford, Massachusetts, announced a voluntary curfew and urged residents to finish outdoor activities before 6 p.m. through the end of September – and 5 p.m. in October until the first hard frost – some residents weren’t happy. About 200 showed up to a town meeting where the measure was discussed.
There wasn’t the same kind of protest over similar measures to prevent the spread of EEE in 2019, said Philip Davis, president of Oxford’s Little League.
“In my family, we were completely done when Covid ended. We were done being locked inside, being scared. Living scared is no way to live,” he said.
But with the 2019 EEE curfews in recent memory, followed shortly after that by Covid restrictions, he said, “I think everybody at this point in time was just, ‘Enough is enough. Let’s put the decision-making back to parents.’ ”
Eastern equine encephalitis is caused by a virus that’s passed to humans through the bite of infected mosquitoes. The virus often travels to the brain, where it causes swelling or inflammation. The first symptoms can include a sudden headache, high fever, chills and vomiting that may progress to disorientation, seizures and coma. Severe cases are rare.
About 11 human infections are reported in the US each year, according to the US Centers for Disease Control and Prevention. This year, the CDC has identified four cases: one each in Massachusetts, Wisconsin, New Jersey and Vermont. On Tuesday, New Hampshire health officials also announced that a person hospitalized with the virus had died.
The mosquitoes that spread EEE are most active at dusk and dawn.
“I would imagine the dusk-to-dawn curfew decision wasn’t taken lightly by the local and state health departments,” said Dr. Kristy Murray, an expert in mosquito-borne viruses at Emory University.
“The most horrific outbreak of EEE in the United States happened in Massachusetts in 1938, with 25 deaths in mostly children. I imagine public health authorities would want to do what they can to prevent another outbreak if data are concerning,” Murray wrote in an email.
Lori Freeman, chief executive officer of the National Association of County and City Health Officials, said a curfew does a few things: It gets people off the street when they’re most likely to be bitten; it gets people’s attention, alerting them to the threat in the first place; and in some cases, it makes it safer for people when crews need to spray chemical insecticides that kill adult mosquitoes to control the bug population.
Dr. Catherine Brown, the Massachusetts state epidemiologist, acknowledged that nobody likes the recommended curfews.
“It’s an unpopular recommendation, but we feel that it’s a really important part of a layered prevention strategy” that includes wearing insect repellent and protective clothing and spraying, Brown said.
She said she understands the public’s concerns that the curfew could be harmful to kids’ mental and physical health, too.
“Public health is bigger than just infectious disease. It’s also about making sure that kids don’t have too much screen time and that they get to play outdoors and do exercise. And so there is a balance. And I want to be clear that we understand that at the Department of Public Health. We don’t make this recommendation every year. We don’t make it lightly,” Brown said.
Oxford and three other towns – Douglas, Sutton and Webster – were classified as being at critical risk of EEE on August 16 after a person and a horse in the area tested positive for the infection, which kills about 1 in 3 people who get it and leaves about 50% of survivors with lasting neurologic problems, according to the CDC. There is no specific treatment for the illness.
Oxford Town Manager Jennifer Callahan wrote a public letter to the town’s board of health to tell them that the person who tested positive lived in Oxford. She wrote that the person’s family members had reached out and urged town officials to warn others.
That wasn’t enough to convince some parents and coaches, however. On Monday, a petition on Change.org to protest the proposal had more than 880 signatures.
“My children lost so much of their childhood already because of Covid. Playing football and cheering had provided them some sort of normalcy throughout the years. … Please don’t shut down the fields,” wrote Cambria Macki, an ER nurse and mother of four, adding that she understood the risk of EEE and thought it could be managed through other measures like spraying and wearing protective clothing.
In recent days, Macki has been getting into impassioned discussions with her neighbors on social media about where the greater risk for kids: a rare, serious infection or worsened mental and physical health. She noted federal statistics showing the steep increase in youth suicides in recent years and said she sees teens and preteens in the local emergency room while they wait for a bed in an inpatient psychiatric unit.
“One thing that some people don’t think about is that for a lot of these kids, they need sports to get away from their home life,” Macki wrote. “Some are insignificant at home, but on the field, they matter.”
Another commenter wrote, “Government overreach in the name of safety has upended the lives of our kids enough.”
Rike Sterrett, Oxford’s director of public health services, understands that the Covid-19 pandemic restrictions were deeply felt by both parents and kids and left a long shadow over public health. She stresses that the town’s curfew is a recommendation and is voluntary.
Public schools are following the voluntary guidance, Sterrett said. They aren’t canceling activities and sports but rescheduling them or moving practices indoors when possible.
The town even carved out an exemption for outside groups that want to continue to use city property. They can continue to play on city fields after hours if they sign a legal form saying they understand the risks and provide proof of adequate insurance.
“So you don’t have those evening under-the-lights games, and it’s just adjusting those practice schedules,” she said.
Sterrett said she worked for the town of Marlborough, Massachusetts, in 2019, which was also a bad year for EEE, with 12 human cases across the US. Officials there made similar recommendations to end outdoor activities shortly beforedusk.
“In 2019, I feel like there was a little bit less pushback about these recommendations, but there was still some,” Sterrett said, adding that she understands that people want to be outside enjoying the last bit of temperate weather for the year.
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At the same time, the call for restrictions on outdoor activities has helped lead to some much-needed public awareness about the infection and the need to avoid mosquito bites.
“The education, at least, I’m hopeful it’s getting out there,” Sterrett said.
Davis said he’s still working withlocal officials to try to make the recommendations more flexible.
Parents would like to see the town hew to the state’s recommendation, which is to restrict activity outdoors from dusk until dawn, “which is a huge difference,” he said.
On Tuesday night, for example, dusk is expected to be around 8 p.m., two hours after the recommended curfew.
Davis said his Little League organization plans to sign the town’s required waiver and has the insurance necessary to play on the fields after the curfew. He said he will advise his coaches to end practices a half-hour before dusk to get players off the fields and give them time to pick up equipment and get inside, themselves.
It will be well past 6 p.m.
“We felt as though this was just the wrong thing to do,” Davis said.