COVID indicators remain high, even with hospitalizations lower than expected

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Granite State News Collaborative
Published: 1/21/2022 1:31:17 PM

COVID-19 indicators for New Hampshire have stayed near all-time highs for the past week, including daily case counts, though hospitalizations and deaths remain slightly lower than expected.

According to data from the state’s official COVID response dashboard, New Hampshire averaged 2,840 new cases per day for the week ending Tuesday, down two percent from a week earlier. The seven-day average for the share of antigen and PCR tests coming back positive was 21.6 percent, up slightly from 21.4 a week ago. A total of 566 people were hospitalized for the disease as of Wednesday, including 411 people with active infections and 155 who are no longer infectious but still need critical care. (This last type is referred to in NH Hospital Association data reports as ”COVID-recovering.”) The number of total hospitalizations is up slightly from 554 a week ago.

“The transmission of COVID in the state is at the highest it has been since the pandemic began,” says Dr. Kevin Desrosiers, Chief Medical Officer for Elliot Hospital. “We have seen record setting numbers in the number of new cases each day, the percentage of tests that return positive, and the number of active infections per 100,000 people in the community.”

“The infection rate is tremendous,” says Dr. Michael Gilbert, Chief Medical Officer at Catholic Medical Center. “Nearly everyone knows someone who has COVID right now or very recently had it.”

The latest numbers are far above previous records. The 5,511 new confirmed cases reported on January 15 is nearly five times the maximum number of new daily cases from the first wave, in late December 2020. This is a major increase from earlier this year. The seven-day moving average for new daily cases in NH had fallen in the first half of 2021, bottoming out at just 16 at the end of June, but has quickly risen since then. After dropping slightly in mid-December, the state is now averaging nearly 2,000 more cases per day than it was at the height of the first wave.

Case numbers in New Hampshire have risen slightly faster than in other parts of the country, which means that the state’s per capita case count of 232 per 100,000 is now above the national average of 227, according to analysis of national data by the New York Times. The states with the highest numbers are Rhode Island and Wisconsin at 404 and 398, respectively.

The increase in New Hampshire is being driven by the rapid spread of Omicron, which remains by far the most dominant strain in New Hampshire, as noted by Governor Chris Sununu in Wednesday’s press conference. According to the latest CDC estimates on each variant’s spread, Omicron now accounts for 99.2 percent of all new COVID cases across New England and roughly 99.5 percent nationally.

Doctors say that the main issue facing hospitals right now is a combination of more patients and fewer staff.

“The challenge is that our COVID-positive patients tend to stay in the hospital longer, which reduces the number of available beds for non-COVID patients,” says Dr. Donald Reape from St. Joseph Hospital. “People are still having heart attacks, strokes, and other serious conditions. If our Emergency Room and inpatient units are filled with COVID positive patients, it becomes more difficult to ensure appropriate care for everyone else.”

Having staff out sick makes these issues even harder to handle.

“We have had as many as 150 staff out on any given day because they are either sick with COVID or caring for a family member who is,” Gilbert says. “This is in addition to a high number of vacant positions, especially in nursing,” forcing the hospital to creatively reorganize its staff internally and increase its recruitment efforts to bring in new support from outside.

Because of issues like these, healthcare workers at Desrosiers’ hospital are working longer and taking extra shifts – and still they are having to add more beds wherever they can safely.

“We have used conference space to see low-acuity patients in our Emergency Department and we have created a second ICU on our telemetry unit in order to meet the demand,” Desrosiers says. “We have also cared for inpatients in our PACU (Post-Anesthesia Care Unit). At times of extreme surge, we have partnered with other hospitals in the state to transfer patients out. Similarly, we also accept transfers from other hospitals when our surge level allows.”

The doctors also noted that even though hospitalizations are high, they have not risen as quickly as overall case numbers. This is a bit of unexpected good news, they say, but which remains unexplained.

“Our hospitalizations have not increased to the degree they did after Thanksgiving,” says Dr. Justin Kim, regional epidemiologist at Dartmouth-Hitchcock Medical Center, adding that “the ICU admissions have not increased proportionally to other hospitalizations.”

“This either means that there is a lag and that hospitalizations will rapidly rise in the near future,” says Desrosiers, “or it could indicate that the people who are being infected are at a lower risk… due to vaccination, or the relative virulence of the Omicron variant compared to the ancestral and Delta strains.”

According to data from the NH Hospital Association, there are now 20 staffed adult ICU beds available in the state, up from 18 last week, out of a total of 230. The total number of hospitalizations for active COVID cases is roughly 22 percent higher than it was at the peak of the first wave. Ventilators remain plentiful, however. Slightly less than a quarter of the state’s inventory is currently in use. Unvaccinated patients made up 45.5 percent of all patients currently hospitalized with active infections, while patients with some level of vaccination made up a slightly smaller share, at 39.9 percent, split roughly evenly between those who had received their boosters and those who had not. (Vaccination status was unknown for 14.6 percent.)

An average of 2.9 Granite Staters were dying from COVID each day, according to a statement by state epidemiologist Dr. Benjamin Chan during Wednesday’s press conference. This is far less than the peak of 11.7 deaths per day during the first wave.

As of Wednesday, there were 18,986 active COVID cases diagnosed in NH. There have been 251,441 confirmed cases and 2,109 COVID-related deaths in the state since the pandemic began.

Vaccinations

Vaccination rates continue to rise, though state and federal vaccination data for New Hampshire remain out of sync. Data from DHHS shows that 63 percent of Granite Staters have received at least one dose, while the number from the Centers for Disease Control and Prevention is much higher, at 95 percent. Similarly, DHHS reports that 56 percent of Granite Staters are fully vaccinated, while the CDC’s number is eleven points higher, at 68 percent. The difference between DHHS and the CDC in terms of total doses administered is roughly 756,000.

The CDC continues to recommend that anyone over 5 years old get vaccinated. For adults, they recommend getting one of the mRNA vaccines (Pfizer and Moderna), rather than Johnson & Johnson, but the CDC emphasizes that any vaccine is better than being unvaccinated. For children between the ages of 5 and 17, the CDC recommends getting the Pfizer-BioNTech pediatric vaccine.

The CDC recommends that everyone who is eligible get a booster shot.

“Please take COVID seriously – even the Omicron variant,” says Gilbert. “Even if someone doesn’t have severe symptoms, they can still spread the virus and those who catch it still need to isolate. The cascading effect is serious and is hampering not only health care but many other industries as well.”

People can register for a vaccine or for a booster by visiting vaccines.nh.gov or calling 211.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.



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