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Reporter debrief: New Hampshire faces off against the COVID-19 surge

The exterior of City Hall in Lebanon, New Hampshire, at sunset.
Hospital staffing shortages, data tracking issues and the omicron variant pose serious problems for the Granite State.

COVID-19 cases continue to surge across the Northeast. In New Hampshire, the omicron variant was detected last week, and federal health workers have been sent in to assist overburdened hospital staff.

Vermont Edition co-host Mikaela Lefrak spoke with NHPR health and equity reporter Alli Fam about the current state of the pandemic in New Hampshire. Their conversation below has been edited and condensed for clarity.

Mikaela Lefrak: Let's talk New Hampshire. VPR and NPR have been reporting this week about the latest COVID surge and the toll it's taking on health care workers across the country. In New Hampshire, how have cases and hospitalizations trended over the last month?

Alli Fam: In so many metrics, this is just the worst COVID-19 surge that we've seen here in New Hampshire. Although I can say when I go out grocery shopping, it doesn't always feel like it in terms of mask wearing or social distancing. But we really are seeing record COVID case numbers. I mean, New Hampshire broke 10,000 active cases for the first time ever in the pandemic during this surge and record hospitalizations that have been nearing 500.

Fortunately, largely thanks to vaccines, we're actually still seeing slightly fewer deaths than we did during the surge last year. But one interesting thing we've seen is that the demographics of those deaths have been changing. This year in 2021, unlike in earlier phases of the pandemic, more people are now dying from COVID-19 outside of long-term care settings. And that trend was the opposite last year. Then in the past few months, the share of younger people who have died has been growing. Since the start of September, the number of people under 60 who have lost their lives to the virus has effectively doubled.

Public health officials in our region and across the country are putting a renewed emphasis on the importance of testing, particularly before any holiday gatherings, to try to contain this virus. In New Hampshire, are tests readily available? I'm thinking here of both the at-home rapid tests and the more involved PCR tests.

They're around, it may take some hunting, especially when it comes to those over-the-counter, at-home tests. Those, like in other parts of the country, are just absolutely flying off the shelves here. We did have a program at the end of last month where Granite Staters could order free at-home tests sent to their homes. But that was actually so popular that the tests were gone within 24 hours.

Dartmouth-Hitchcock is an important hospital in the region — it treats many people in the Upper Valley area. What is the situation there with COVID-19?

Generally speaking, they're seeing something very similar to the rest of the hospital system. So really feeling the strain of an increase in COVID-19 patients along with really high demand for traditional services. And they're suffering from staffing shortages. Right now there are 63 COVID-positive inpatients at Dartmouth-Hitchcock and 23 COVID patients that they're visiting nurses and hospice services for Vermont and New Hampshire are working with. Last week they had to inform patients that they may be delaying some surgeries and procedures due to this high volume of patients and staffing shortages.

They are a really big health system, and their leaders and staff have been very vocal to the public about the challenges that they've been facing, whether that's struggling to transfer patients to other hospitals, or just the toll, the wear and tear that this surge is having on their staff, the people who have tried to bring it under control.

Much of what you're saying about Dartmouth-Hitchcock kind of echoes what we've been hearing out of UVM Medical Center as well, and particularly around the the staffing shortages and the strain that this virus is putting on existing staff. Now, I know that federal first responders have been in New Hampshire helping out in hospitals for a bit now. And it's also my understanding that there's a federal surge response team that's heading there, now. One's also headed to Vermont, by the way.

So what kind of outside help has New Hampshire been getting to handle this phase of the pandemic?

In the last few weeks, New Hampshire's basically overwhelmed health care system has been propped up by federal staffing. The situation in hospitals that necessitates this response is basically a hospital in crisis. One of the hospitals here in New Hampshire that received a 24-person team from the National Disaster Medical System was Elliot [Hospital, in Manchester].

I spoke with their president the day before they got that team and their ICU was at 150% capacity. They had patients who were waiting over 20 hours in the [emergency department] for beds. That team came on Dec. 10 ...and they helped Elliot open up 10 beds. But this is really kind of a Band-Aid solution, because that team is leaving, and those 10 beds are going to have to be decommissioned.

This is maybe a Band-Aid that's getting pulled off before the wound is healed.

More from VPR: Reporter debrief: Massachusetts governor issues mask advisory, calls on National Guard as COVID surges

Here in Vermont, there has been a lot of back-and-forth between the Scott administration, legislators and local officials about mask mandates, guidance around the holidays and what the administration should or should not be doing to manage this virus. In New Hampshire, how has Gov. Sununu responding to the increasing cases? Has there been any talk of mask mandates, or pressure for the state government to put in place more vaccine requirements, things like that?

When it comes to mask mandates, the governor has been exceptionally consistent in his responsethat he is not considering a statewide mask mandate or declaring a state of emergency. It was interesting hearing President Biden speak [Tuesday], because I think Gov. Sununu and President Biden talk about this virus very, very differently. They do have opposing views on vaccine mandates. But outside of that, I think a lot of the policy steps that the two of them are taking are actually very much aligned.

We have the federal staffers who came to New Hampshire — that was something that President Biden mentioned — they’re going to be doing more of. We have the free testing program ... we're actually going to see something similar at a federal level. Another point President Biden made [Tuesday] was that we're going to be opening up more vaccination sites to increase the opportunity for folks who want to get a booster or vaccine. That's something that Gov. Sununu has been doing as well this month. So, actually, a lot of similar approaches, minus their very strong opinions on vaccine mandates.

You've also recently reported on tracking issues with the booster shot program. What is the current state of the booster shot program?

Those tracking issues have been really significant in New Hampshire. There has been some national reporting in the last couple of weeks that [shows] this tracking issue at the CDC level is widespread, that a lot of booster shots are being tracked as first shots. It’s particularly acute here in New Hampshire. If you are browsing the CDC map (as I often do) ... and you look at New Hampshire's vaccination rates, it actually looks like we are leading the country, when it comes to first shots, it appears that 95% of our population has gotten a first shot, and that only 10% of our fully vaccinated population has gotten a booster shot. That is just not accurate.

Kind of what’s going on here is that New Hampshire has a lot of issues with its own data system due to the fact that we basically rolled out our immunization registry amidst the pandemic. As you can imagine, kinks are being worked out in real time.

That's really leading the CDC to have an acute mistracking issue here in New Hampshire. It also means that our state can't currently accurately track our vaccination rates. We can estimate, but it's far from the data we would like to have.

Speaking of that tracking, I did want to ask you about one specific and one very tragic case in New Hampshire. This week, health officials announced the first pediatric COVID death in the state. What do we know about that case, and why did it take so long for it to be announced? I believe the child died back in September, is that correct?

We do know a few details, which was that the child was between 0 and 9, and too young to be to be vaccinated at the time. We found out about this death this week, but it occurred in September. State health officials say that it was identified on the recently-finalized death certificate.

It’s not completely unusual for us to be finding out about deaths that took place weeks or months ago. We often get reports from the state on a weekly basis that will include COVID-19 related deaths from months prior. It just felt particularly striking because this was someone so young.

Have questions, comments or tips? Send us a message or tweet us @vermontedition.

Mikaela Lefrak is the host and senior producer of Vermont Edition. Her stories have aired nationally on Morning Edition, All Things Considered, Weekend Edition, Marketplace, The World and Here & Now. A seasoned local reporter, Mikaela has won two regional Edward R. Murrow awards and a Public Media Journalists Association award for her work.
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