LEBANON — As federal and state governments declared states of emergency due to COVID-19 on Friday, health care providers braced for more patients and worked to conserve supplies.
As of Friday afternoon, New Hampshire had just six known cases and Vermont had two. But given the global spread of the novel coronavirus first identified late last year in Wuhan, China, Upper Valley health care providers said they’re expecting the number of cases in the region to rise.
“It’s just a matter of time before our health system is going to be inundated with sick people,” Dr. Antonia Altomare, a Dartmouth-Hitchcock Medical Center physician who specializes in hospital epidemiology and infection control, said in a Facebook Live talk on Friday.
Lebanon Fire Chief Chris Christopoulos told municipal and business leaders at a meeting on Friday morning that more than 40 people had shown up at DHMC’s emergency department on Thursday, requesting to be tested for COVID-19.
Alice Peck Day Memorial Hospital, in collaboration with the New Hampshire Department of Health and Human Services, set up a mobile collection unit for COVID-19 specimens in front of the Robert A. Mesropian Center for Community Care on APD’s campus in Lebanon on Friday, according to D-H spokesman Rick Adams. The collection was conducted for patients who have been assessed by APD providers and state health officials.
“This is not a walk-in collection unit,” Adams said in a Friday email.
Patients were to remain in their cars during collection, which would take only a few minutes and be handled by APD staff using appropriate precautions, including use of protective personal equipment, Adams said.
The response in the Upper Valley came as federal and Twin States officials on Friday announced states of emergencies to free up money, stockpiles of supplies and staff to focus on the response to COVID-19.
Neither Vermont Gov. Phil Scott nor New Hampshire Gov. Chris Sununu announced plans to cancel schools in separate news conferences Friday evening. But educators in both states were preparing for the possibility of moving to online classes.
Both states will restrict access to long-term care facilities in an effort to protect the elderly, who are at a greater risk of developing serious illness due to the disease, the governors said. Scott said events including more than 250 people in Vermont would be canceled. Sununu, however, said that because the risk of infection in New Hampshire remains low, he is leaving decisions about gatherings up to local communities.
Mask supplies were running low at DHMC and other of the D-H system’s member hospitals, Altomare said during the Facebook Live event earlier in the day. As a result, hospitals are working to conserve supplies including masks by saving them for situations such as when providers are seeing immunocompromised patients or for those who are ill, she said.
“It’s really important that we across the board intentionally try to protect everyone,” she said.
Valley Regional Hospital interim CEO Deanna Howard said she was monitoring supply levels of masks and other personal protective equipment.
“Our levels are low but not critically so,” Howard said via email. “The State has requested a shipment of (personal protective equipment) from the national stockpile so we’re hopeful there will soon be a supply available when needed.”
The Vermont Health Department also emphasized that providers and patients not rely on the emergency department of their local hospitals.
“If you are sick or concerned about your health: Call your health care provider by phone. Please avoid going to the hospital, except in a life-threatening situation,” the department said on Friday.
Dartmouth-Hitchcock has also implored providers and patients to do the same. On Thursday, it told providers to give patients masks and send them home to self-quarantine, unless they are sick enough to require inpatient treatment. D-H asked that patients exhibiting the symptoms of COVID-19 — a fever, cough and shortness of breath — first call D-H’s COVID-19 hotline at 603-650-1818 for screening.
Urgent care facilities such as ClearChoiceMD, which has a location on Miracle Mile in Lebanon, do not have the ability to do testing for COVID-19 and they don’t want patients who may be infected to transmit it to staff or other patients, said the New London-based company’s CEO Marcus Hampers.
“There’s a lot of confusion out there about the coronavirus,” Hampers said in a phone interview. “Our urgent care and pretty much all urgent care are not equipped to safely diagnose a coronavirus patient.”
Unlike hospitals, urgent care facilities do not have negative pressure rooms to use to isolate infected patients. In addition, Hampers said, urgent care facilities don’t have personal protective equipment on hand to protect staff members from infections such as COVID-19.
If patients are acutely ill, Hampers said they should call 911.
ClearChoice has signs on the doors of its more than a dozen facilities across Vermont, New Hampshire and Maine, as well as a web alert on its website that say: “ClearChoiceMD does not offer testing for the Coronavirus.”
The company is urging those who have traveled to known hotspots such as most of Europe, China, South Korea and Iran, or had close contact with a person confirmed to have the coronavirus and have symptoms to contact their state’s health department.
Hampers noted that the situation is “fluid,” so it’s possible that ClearChoice will eventually end up setting up testing in the parking lot as some urgent care centers elsewhere have. However, he said he thought that it was more likely that the nearby Dartmouth-Hitchcock would be the one to do the testing.
“D-H has more resources to hit this head-on,” Hampers said.
Altomare said that she expects that within two weeks DHMC will have the ability to conduct testing there, rather than relying on the state’s public health laboratory or commercial vendors.
That is “going to be huge,” she said.
In New Hampshire, 94 people had tested negative for COVID-19 as of Thursday morning, according to the Department of Health and Human Services. State health officials were monitoring 275 for symptoms and 21 tests were pending at the public health laboratory.
In Vermont, 142 people had tested negative for COVID-19, as of Friday afternoon. State health officials were monitoring 208 Vermonters for symptoms.
In the meantime, governments, schools and other organizations in the Upper Valley and beyond aimed to prevent the spread of the virus by canceling large group events or moving them online.
Leaders of the Vermont Legislature decided Friday to suspend the current session through at least March 24 due to COVID-19 concerns. In New Hampshire, state government leaders on Friday moved to shore up state finances and delay legislative deadlines if necessary.
The Royalton Selectboard has scheduled a special meeting to discuss the community response to COVID-19 for Tuesday at 6 p.m. at the Royalton town offices.
Several schools across the Upper Valley canceled school-based community and public gatherings until further notice.
Colby-Sawyer College in New London joined the ranks of colleges and universities around the country in moving to an online-only format beginning March 23, following an extended spring break.
“During this time, residence halls and campus housing will remain closed,” according to a Friday update to the school community. Faculty and staff are expected to continue their regular work responsibilities.
The Rivendell Interstate School District will be closed on Monday for extra cleaning and to allow teachers to prepare for online instruction in the event that schools need to be closed for an extended period, Superintendent Barrett Williams said in a Friday message to families. The district also has canceled large group gatherings at least through the end of the month.
Windsor Southeast Supervisory Union Superintendent David Baker also canceled all after-school activities and said that school buildings will be locked at 5:30 p.m. on weeknights and on weekends.
“We feel we need to control access and we need to have access to all areas for our maintenance staff to continue the daily deep cleaning,” Baker said in a message to the supervisory union community.
In addition, Baker said, school officials encourage all students and staff who are sick to stay home, and IT staff are working to develop a system for online learning, should school be closed for an extended period.
Orange Southwest School District Superintendent Layne Millington said in a Facebook post on Friday that Randolph-area school officials aim to keep the schools open.
“The closure of schools, unless, absolutely necessary, can cause more problems for a community than it solves,” Millington said.
To stay open, Millington said, he needs all members of the school community to do their part by staying home when sick and washing their hands.
“How things unfold in our community is in our own hands, so we are beholden to one another to make the best choices we can,” he said.
Thetford Academy Head of School Carrie Brennan announced on Friday that school would be canceled on Monday, in order to allow time to prepare for online learning should it be necessary and to give more time for custodial crews to clean and disinfect buildings. The school also has a planned in-service day next Friday.
“We are taking this approach for next week as a cautionary and preparatory step,” Brennan said. “We are not doing it in response to any specific health concern at our school.”
Woodstock-area schools will start practicing social distancing for at least the next week, according to the athletic department Twitter account. Meetings, field trips and after-school activities have been canceled. The school district is preparing for all possible scenarios and is following the direction of the Vermont departments of health and education.
Community organizations such as the Thompson senior center and Zack’s Place, both in Woodstock, announced on Friday they would be closed starting on Monday.
The Thompson staff will serve patrons at home by delivering meals and grocery necessities; offering “drive-by” meal pickup at The Thompson; providing daily phone chats; coordinating regular programs online or via conference call; continuing Aging at Home support services with medical equipment and referrals to service providers, according to an email.
The Lebanon Opera House on Friday canceled events through April 30.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213. Material from the AP was used in this report.
