Our Turn: Governor, please issue shelter-in-place order immediately

For the Monitor
Published: 3/23/2020 5:46:13 PM

Dear Gov. Sununu: We the undersigned physicians, epidemiologists, clinicians, nurses, scientists, other health care professionals and elected officials implore you to issue a “shelter-in-place” order immediately to slow the spread of the COVID-19 virus in New Hampshire.

Although the state has identified only 101 positive cases as of March 23 and one death, the new case rate is following the same early exponential growth trajectory that has occurred in China, Italy, South Korea and other countries, as well as the U.S.

New Hampshire is entering a phase where the new case rate will double every two to four days.

According to published reports, New Hampshire currently has only just over 3,000 hospital beds. Based on our projections and those prepared by Harvard, our hospital system will be overwhelmed within three weeks.

In addition to our request for a shelter-in-place order, we are suggesting the following important actions:

1) Follow New York state’s shelter in place guidelines closing nonessential businesses and strict social distancing immediately.

2) Develop consistent messaging and modeling to help the public understand the gravity of this threat. Messages include: This is not the flu. Stay home to stay out of the ER. Protect our health care workers at all costs. Do your part to protect New Hampshire’s vulnerable.

3) Aggressively implement additional testing to test every single case, even those with minor symptoms, as recommended by the WHO. Implementing drive-through testing like in South Korea and parts of New York will provide the most rapid testing while limiting transmission. About 2,341 (or 0.2%) tests have been done of the 1.3 million residents in New Hampshire. This is a critical piece of understanding mitigation strategies that can be implemented at the community level to allow New Hampshire to get back to work.

4) Acquire critical medical supplies (PPE and ventilators) from federal stockpiles and suppliers, such as N95 respirators and personal protective gear, to treat patients and protect health care workers.

5) Prepare staffing plans for hospitals and health care professionals for the eventuality that our health care system will be overwhelmed in less than three weeks.

6) Construct temporary health care facilities to treat high rates of infected individuals in less than three weeks.

7) Request help from the federal government to identify locations and set up emergency health care treatment centers to handle the critically ill, as well as obtain stockpiled equipment.

8) Set up SWAT-like team of N.H. Hospital Association, N.H. Homeland Security, N.H. Hospital Association to plan and to communicate plans to the public.

9) Segregate COVID care facilities from routine care to limit transmission, preserve our health care facilities and staff.

10) Place the N.H. Air and Army National Guard on alert for an immediate activation to support medical and other vital needs.

11) Limit liquor store sales to drive-up pickup.

12) Close all DMV offices and extend current vehicle registration and inspections until July.

13) Work with the BIA to identify industries that can manufacture medical PPE.

The situation in South Korea indicates that quick, consistent, and clear early containment, aggressive testing, and social distancing campaigns will likely flatten the curve and lower incident cases to prevent deaths. However, the health care system will be overwhelmed in less than three weeks and steps need to be taken right now in New Hampshire to prepare for the eventuality.

Thank you for your work protecting New Hampshire during this challenging time.

(The above letter is signed by Mindi Messmer, CG, PG; Dr. Nora Traviss, Environmental Health; Richard Dipentima, former N.H. state epidemiologist and former state representative; Dr. Michael Dowe; Jeffrey Salloway, Ph.D., and state representative; Dr. Gary Woods; Shanika Amakaroon, environmental engineer; Dr. Joseph Norman, applied complexity and data scientist; Dr. Thomas Webler, environmental studies and risk analysis; Dr. Margaret Henning, public health; Dr. Rebecca Dunn, public health; Dr. Loren Launen, biology; Dr. Susan Whittemore, biology; Dr. Jason Pellettieri, biology; Dr. Denise Burchsted, enviro nmental studies; Dr. Christopher Brehme, geography and GIS science; Dr. Matora Fiorey, chemistry; Dr. Marie Duggan, economics; Sarah Smith, MS, environment health science & policy; Dr. Victor Lazaron; Laurie McCray, RN, MS; Dr. James Zuckerman, health officer, New Castle; Ida E. McDonnell, retired environmental engineer; Dr. C. David London, former Stratham health officer; Dr. Jesse Ambrose; Dr. Christine Bussiere Ambrose; Dr. Alain Ades; Dr. Leonard Korn, past president, New Hampshire Medical Society, 2017-2018.)

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