By Sen. Tom Sherman
New Hampshire is now facing perhaps the most serious healthcare threat in its history. We are joining the rest of our country and the world in confronting this new coronavirus, which causes the illness called CoVID-19. While producing minor flu-like symptoms in the majority of those infected, CoVID-19 may cause a fever and cough which can progress to severe pneumonia with the acute respiratory distress syndrome in a smaller percentage of patients. The death rate is variable depending on the patient’s age but may range from 3-15%, highest especially in the elderly. Failure to act to prevent transmission could well result in a large enough population of people with CoVID-19 illness requiring hospitalization to overwhelm our state healthcare system and especially our hospitals.
We know from the experience in other countries and thus far in the United States that this virus is highly contagious, being carried from person to person by airborne droplets from coughing and sneezing. Some studies have shown that it can live on countertops and surfaces for up to 2 to 3 days. Once it is in a community, its spread may be exponential, meaning that one person can spread it to multiple people who can then each spread it to multiple others. This explains South Korea’s approach of testing up to 10,000 residents a day so that they might know who in their country needs to be isolated from people who are not yet sick. When someone is infected, they may not become actually sick on average for four to five days. In that period of time, they may look and feel healthy, but they may still be contagious, able to spread the coronavirus to their close contacts.
In New Hampshire, as has been the case throughout the United States, our ability to test for the virus was sharply limited by the initial relatively small number of available test kits for the virus. While healthcare workers across the state and especially in our own Department of Health and Human Services (NHDHHS) have been working tirelessly to address this issue, we still do not have enough test kits. Because we have not had enough test kits until this week, healthcare workers have had to limit who can get tested. NHDHHS has followed guidelines from the CDC that limit testing to those who have symptoms and a history of either travel to an infected area or direct contact with another infected individual. This means that we do not have a clear picture of people in the community who may be infected. We will not know until we have enough test kits and can test a larger number of people. It is critical that we work to limit the spread of the virus because at this point we cannot know who has the virus among our family, friends, coworkers and neighbors.
This is why New Hampshire has now taken steps to prevent this spread of CoVID-19 including declaring a state of emergency, limiting access to nursing homes and assisted living facilities, closing all schools, limiting public gatherings, banning utilities from shutting off any customers, closing bars and restaurants to eat-in dining, extending unemployment benefits to displaced or quarantined workers, banning evictions by landlords, and directing insurance carriers to waive copays and cost sharing on tests for CoVID-19. These measures will almost certainly slow the transmission of the virus and, as a result, save lives. However, there is still much more to do to continue our aggressive fight to reign in the virus, treat the ill and support the state in this time of crisis. This effort should include consideration of the following actions:
* Provide emergency funding relief to our small businesses impacted by the coronavirus so that they will be able to stay open or reopen when the crisis has passed.
* Ensure that our most vulnerable populations including the homeless, our children, the elderly, those in recovery from substance use disorder, and those suffering from mental illness, are fully supported.
* Provide statewide guidance to healthcare providers, encouraging them to test for coronavirus in all patients with appropriate symptoms such as fever and cough who have also tested negative for other possible causes such as influenza as well as their direct contacts. This will require a vast expansion of the number of available test kits both from the CDC and commercially.
* Facilitate rapid development of telemedicine capability in every willing outpatient healthcare facility across the state so that even quarantined providers can continue to support their patients during the crisis.
* Create a statewide inventory of available hospital beds, ventilators and other essential services and supplies, presented as a daily dashboard, so that health officials will know immediately where there is additional capacity if one region of the state is at the limit of their available resources.
* Determine whether there are facilities that might be converted temporarily to serve in health care delivery should demand for hospital beds outstrip our current supply.
While we work in Concord and our districts to enact these and other measures to support Granite Staters through this crisis, there are several steps each of us can take individually in our daily lives and in our communities to prevent transmission of the virus:
* Follow strict personal hygiene with frequent handwashing for at least 20 seconds or using hand sanitizers after every contact.
• Avoid touching your face, including ears and nose, with your hands.
• Cover a cough or a sneeze with the inside of your elbow.
• Keep your physical distance from others (at least 6 feet).
• Avoid social gatherings, including play dates.
• Protect elderly friends and family from any unnecessary contact with others.
• Avoid visits to hospitals, nursing homes, retirement homes or assisted living facilities.
• Work from home if at all possible.
• Avoid domestic and foreign air travel.
• Avoid public transportation if possible.
If you develop symptoms including fever, cough or shortness of breath, call your doctor or provider immediately. The state has also set up a hotline that is open 24 hours a day, 7 days a week, which you can reach by dialing 211.
This is a time of great uncertainty and hardship for many. Recognize in yourself, your family, your friends and your neighbors how stressful and frightening these next few weeks or months may be, but realize we are all in this crisis together. If you are healthy, go outside for a walk, a bike ride or a climb. Wave to your neighbors from a distance. Stay in close touch with friends and family by phone or on the internet. Make sure those in need in your community are supported (and let us know if they need help).
The people of New Hampshire have always shown that they have the resolve required to overcome even the toughest of challenges. Together, we will again demonstrate that same collective support and strength to make it through this difficult time.