By Sen. Tom Sherman and Rep. Bill Marsh, both physicians
As Omicron hits New Hampshire, COVID case counts are again hitting record highs, and we anticipate hospitalizations and deaths will soon track this rise, as they have in other states. Last month, we urged that New Hampshire act to minimize this predicable tragedy, but Governor Sununu labeled our concern as “silly and partisan.”
Over the next few weeks, we are about to find out just how prepared New Hampshire actually is. We can only hope Governor Sununu won’t find himself echoing Governor Larry Hogan of Maryland, who just today had to admit “we can’t manufacture doctors and nurses who don’t exist” as he declared another state of emergency. So how did we get here?
Following January’s peak, the guidelines established by the ReOpening Task Force were rolled back and then subsequently converted into recommendations. Despite the fact that now COVID infections are among the worse they’ve ever been, despite that on Dec. 1 New Hampshire reported the highest number of COVID cases per capita in the country, and despite our hospitals being on the verge of collapse – precisely the scenario the state of emergency of March 2020 was intended to prevent – there has been no plan to reinstate any of the ReOpening Task Force’s recommendations.
When the Delta variant began to take over in early August, we suggested that DHHS increase the number of mobile units and specifically reach out to underserved communities with their vaccination efforts. Several good studies had been released on effective ways to reach out to underserved communities using trusted community leaders as well as effective means for vaccinating people who are either reluctant because of misinformation or who had difficulty making the effort. However, any efforts at this point were largely unsuccessful or perhaps under-resourced.
In the early fall, the Executive Council tabled a vote on $27 million in federal CDC funding to enable enhanced vaccination. This meant the contracts to get booster shots and vaccines for children did not get signed. Governor Sununu has said that he tried to intervene, but a party line vote to deny the federal funding indicates otherwise. On October 29 emergency use authorization of the Pfizer vaccine for children between 5-12 was approved but without the federal funding, we could not act.
Finally on November 19, after the Executive Council relented and the Fiscal Committee approved funding, New Hampshire could move forward. However, $4.7 million dollars of funding for the state’s vaccination efforts was only approved after the source changed from CDC money, which every other state accepted, to American Rescue Plan funds which were delivered to NH by our federal delegation.
Last month, the state hosted a single Booster Blitz, funded by federal FEMA dollars, which vaccinated and boosted about 10,500 New Hampshire residents. While the event helped to get shots in arms, in many ways it was too little too late to prevent the spread of the virus. This would be the equivalent of waiting until the middle of a hurricane to put plywood over your windows. As of January 5, the CDC still reports NH as dead last among the states in booster coverage at 9.8%
Recently, officials at Exeter and DHMC note that they were at 115% of capacity. Medical care is being compromised, and health care providers cannot sustain this effort. Joanne Conroy, CEO of DHMC, and NH Citizen of the Year, said “Our hospitals are running out of beds to treat patients.” Alec Walker of Catholic Medical Center says “the unvaxxed are grinding healthcare in New Hampshire to a halt.” Staff is demoralized because the sickest patients could have prevented their disease by getting vaccinated or boostered. People with treatable diseases like just diagnosed cancers or heart disease can’t schedule the treatment they need because hospital beds are unavailable.
Failure to prepare for the delta variant has compromised our clinics and hospitals just as the omicron variant beginsspreading exponentially across NH, infecting both the unvaccinated and the un-boostered and further overwhelming our healthcare system. We have learned some basic lessons – Covid 19, especially in those without immunity (the unvaccinated, un-boostered, and/or not previously infected), mercilessly creates new variants which may be more contagious or result in more severe illness.
The way out of this surge and this pandemic is clear:
1) Wear masks when indoors. We have already seen the impact of this simple intervention in Berlin, with a return to manageable levels of infection within two weeks of required indoor masking. We are thankful that local leaders in Keene, Manchester and Nashua have taken this precaution. We should be encouraging our schools and businesses to take the steps that will best protect their students, employees, and customers and keep their doors open.
2) Ensure universal availability of vaccines for the unvaccinated, for eligible children, and boosters. One or two Booster Blitzes is not enough, and waiting until January allows more time for delta and omicron to spread further. Outreach to communities typically underserved including people of color, immigrants and the homeless is essential to stop further spread.
3) For those already infected, making available the promising new drugs from Pfizer and other manufacturers as soon as possible, intervening early and avoiding hospitalization as a result.
4) Ensure that reported data on DHHS website includes all patients hospitalized due to COVID, including those the NH Hospital Association calls “COVID-recovering” as well as patient vaccination status on admission.
5) Changing the metric that we follow from vaccination rate to immunization rate – DHHS should be tracking the number of NH residents likely immune to Covid – those who have had initial vaccination, booster, or infection that they have survived in the last 6 months.
6) Act now. We should have acted last month. The rapid rise of Omicron in other statesunderscores the importance of New Hampshire taking action now to relieve the strain on our overtaxed healthcare system.
As tired as we all are of the pandemic, keeping up our guard and this massive effort both individually and as a state is the only way we will emerge minimizing the anguish of preventable illness and death, and ensuring that we have done everything possible as a state to protect our residents and keep our schools and businesses open.