New Hampshire health officials announced two new cases of COVID-19 in Grafton County on Tuesday and said they were seeing evidence of community transmission.
A total of nine new positive cases of the new coronavirus were announced by New Hampshire officials, bringing the statewide total to 26.
The other new cases include four in Rockingham County and three in Hillsborough County. Grafton County now has seven identified cases of the respiratory disease first identified late last year in Wuhan, China.
“The increasing number of cases and new evidence of community-based transmission raises concern that the COVID-19 outbreak is intensifying in New Hampshire,” State Epidemiologist Benjamin Chan said in a news release.
Chan said that everyone needs to monitor themselves for symptoms of COVID-19 and practice social distancing. He recommended against testing for most people with mild symptoms, saying those people should stay home and self-isolate.
“As COVID-19 becomes more common in our communities, confirming infection for every patient presenting with fever and respiratory symptoms becomes impractical and does not change how a person’s illness is managed,” Chan said.
He warned that showing up for testing with mild symptoms that don’t require treatment can risk exposing other people, including health care workers and people vulnerable to the disease. He said testing supplies ought to be reserved for those who require hospitalization, for health care workers and for others who have contact with vulnerable people or large groups.
Vermont officials on Tuesday announced two new positive cases of COVID-19, bringing the statewide total to at least 17.
Health care providers in the Upper Valley ramped up screening and sampling efforts this week.
On Monday, Keady Family Practice began screening all patients at its locations in Claremont and Newport for symptoms and exposure to COVID-19.
Patients who have been screened by health care workers, either by phone or in person, and found to need testing can now get their noses swabbed in the parking lot of the practice’s Claremont location.
Workers wearing protective gear, including gloves, gowns, masks and face shields, now are collecting samples from patients in their cars.
“Everything changed last week when the state of emergency was called,” said Daniel Keady, the practice’s operations manager.
The practice, which has five clinicians on staff, was closed over the weekend to allow staff members to prepare for the outdoor testing. As of Tuesday afternoon, Keady said they had so far collected samples from between 15 and 20 people, and had requests from more who did not qualify for testing.
“We’re extremely busy right now,” Keady said.
Ammonoosuc Community Health Services, a Littleton, N.H.-based federally qualified health center, has the ability to collect samples from patients who qualify for testing at practice locations in Woodsville, Littleton and Warren, N.H., said Edward Shanshala II, the organization’s executive director.
But Shanshala said his organization’s collection capacity is limited by the number of test kits available.
“We have nowhere near the access to tests that some people would like you to believe,” he said.
He anticipates getting about 50 tests per week from commercial vendors and 25 per week from the state.
Valley Regional Hospital also announced that it would open a testing center outside Claremont Urgent Care on the Dunning Street side of the hospital campus beginning on Wednesday at 8 a.m.
To free up staff for the purpose, the hospital said it will close the Charlestown Urgent Care Center.
“Our goal is to keep our community safe and utilize our resources effectively during this difficult time,” the Claremont hospital said.
Valley Regional asks that patients call a hotline for screening before being tested: 603-542-7850.
Health care providers across the region have worked to limit the elective procedures they perform, in order to conserve protective gear and staff in the event that there is a surge of cases related to COVID-19. They also have placed limits on the number of visitors allowed in their facilities to reduce the risk of transmission.
Dartmouth-Hitchcock CEO Joanne Conroy said those who are known to be at a greater risk of developing serious symptoms from the disease, such as people over age 60 and those who have underlying health conditions, have in some cases opted out of coming to visit. D-H restricted visitors to its locations, effective Wednesday, with limited exceptions.
Planned Parenthood of Northern New England, which has Upper Valley clinics in White River Junction and Claremont, will keep its clinics open, but is prioritizing certain types of appointments and limiting schedules, spokesman Derek Edry said in an email.
“We do not have the facilities to treat patients with COVID-19, so any patients experiencing cold or flu-like symptoms should stay home,” Edry said.
Appointments can be scheduled, canceled and rescheduled by calling 1-866-476-1321, Monday through Friday from 8:30 a.m. to 4:30 p.m., he said.
Shanshala said that ACHS would likely be performing only emergency dental procedures for the next few weeks. Staff who can are now working from home, where he was when he spoke with the Valley News.
So far, Shanshala said his workforce has not been affected by the virus directly. He has one provider out with the seasonal flu, who is helping develop protocols for “televisits.”
Shanshala said he would like to move to more televisits, in which a provider interacts with a patient through some form of video technology, but needs some assurance from the federal government and insurance companies that they will reimburse health care providers at the same rate for such visits as they do for in-person ones.
“Financial sustainability is important,” he said.
Even as hospitals and other providers make these changes, they are trying to help patients find a balance between self-isolation and social isolation, which can have negative health consequences of its own, said Sara Simeone, head of quality and compliance for the Visiting Nurse and Hospice for Vermont and New Hampshire, in a Tuesday Facebook Live video.
Simeone said the VNH is working to increase phone calls for patients who may need some additional support and to ensure that those who relied on senior centers that are now closed for meals will still get the food they need.
“Our goal is to continue our operations while keeping patients (and) staff safe,” Simeone said.
To that end, VNH visiting nurses have begun screening patients for travel history, exposure to known cases and for symptoms of COVID-19, which include fever, cough and shortness of breath, she said.
Roger Small, who is 81 and has chronic obstructive pulmonary disease, is no longer able to receive visitors at Elm Wood Center nursing home in Claremont.
Like all nursing homes, visitors are no longer allowed.
Small, a frequent Valley News letter writer, said he feels “helpless” in the face of the coronavirus and is frustrated by the lack of encouragement from government officials.
“I don’t known if it’s going to end in eight weeks or two years,” he said.
Thetford resident Connie Snyder, who also is in her 80s, said she feels “a little more doomed” due to the fact that older people are more likely to develop serious symptoms associated with COVID-19.
She has been practicing social distancing for weeks, avoiding Town Meeting and other gatherings; and shifting her grocery shopping to Wing’s Market in East Thetford instead of the larger Co-op Food Stores.
Like Small, she said she was concerned that there’s no clear end in sight to the pandemic.
“You can stock up on groceries but then you keep eating,” she said.
She has also been trying in vain to understand how the disease works such as how long symptoms last and whether being infected once offers immunity in the future.
“We’re all struggling with something brand new,” she said. It’s a “lesson for us to learn to deal with the unknown.”
Conroy offered some encouragement in a Facebook Live video on Monday.
“This is really a disorienting time,” she said.
She urged viewers to take care of themselves by washing their hands, abiding by social distancing requirements, reaching out to older people, and stocking up on medical supplies and food.
“Life will get back to normal,” she said.
But Shanshala said he was bracing to support staff through what could be a long fight.
“We’re going to be working this down for a while,” he said.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
