By PAULA TRACY, InDepthNH.org

WASHINGTON – More than 10,000 Granite Staters, desperate for answers about COVID-19, got on the phone Friday to hear what the state’s two U.S. Representatives and one of state’s leading epidemiologists are doing about the situation.

Representatives Annie Kuster of Hopkinton, a Democrat from District 2, and Chris Pappas of Manchester, a Democrat from District 1, held a telephone town hall with Dr. Michael Calderwood, Dartmouth-Hitchcock epidemiologist and infectious disease expert.

Also on the call were officials from the New Hampshire District Office of the U.S. Small Business Administration.

Kuster and Pappas underscored the importance of people staying home and washing their hands to slow the growth of COVID-19, while Calderwood addressed the real and present need for more equipment to support healthcare providers.

Calderwood said there is “a desperate need” and urged anyone who may have bought large amounts of face masks and other protective equipment to offer it to health-care providers as soon as possible.

“We do all have to do our part and recognize we are in this together,” Pappas said, urging constituents to call 285-4300 but avoid any in-person visits to his office.

Kuster said she knows there is going to be some substantial economic dislocation and disruption to lives and urged everyone to have patience moving forward.

The two went over bipartisan action in Congress to get more than $8 billion to the states to deal with the pandemic (New Hampshire received $5 million), the passage of the Families First Coronavirus Response Act to make sure there is free testing for COVID-19 for everyone, paid family leave, and expansion of food assistance.

They said that next week, the plan is to focus on an economic stimulus package to get checks into peoples’ bank accounts to pay for food, rent, and other expenses and to help stimulate the economy.

Kuster said for the past several weeks, the delegation has been in frequent contact with Republican Gov. Chris Sununu, whom she praised for taking bold action to close schools and other actions such as closing nursing homes to visitors.

The most solid action this week in Washington, Kuster said, was President Trump signing the Families First Coronavirus Response Act, which will ensure COVID-19 tests are free. It will also give access to paid sick leave, expand emergency medical leave, provide enhanced unemployment insurance and bolster food security for American children, families, and seniors.

Kuster said access to school lunch is important and there is work being done to make sure that food is accessible for all. The passage of this act and the $8 billion demonstrate that Democrats, Republicans, and the Trump Administration can work together, but she stressed: “Time is of the essence.”

Calderwood, speaking on the call from the state’s largest hospital in Lebanon, said this virus has “upended our lives.” In New Hampshire, he said new positives are being reported daily and he expects that number will increase “significantly.” Just how many, he said, we don’t know but some models indicate that as much as 50 percent of the world population could be impacted.

“Really, what we need to do is flatten the curve or bend the curve,” Calderwood said, and that means taking drastic measures.
The best thing people can do is focus on staying home when they are feeling ill.

“Those measures can reduce it by 20 percent which is a huge reduction,” he stressed.

Calderwood said the focus now is on hospital capacity, noting that likely one in every five COVID-19 cases will require hospitalization and 1 in 20 could require Intensive Care Unit admission. Those are scary numbers, he said.

The goal, he said, is to spread things out over time.
“It is really a time for all of us to step up and change our daily practices,” said Calderwood.

Speaking on the economic front of COVID-19 was Rachel Roderick, deputy district director of the United States Small Business Association for New Hampshire.

She said the SBA has issued a disaster declaration for the whole state, which opens up a loan program. These loans will allow for working capital directly from the U.S. Treasury to cover the fixed expenses that businesses have, from payroll to rent to other monthly obligations for an extended period of time.

The application process, Roderick said, is open and the SBA is hosting daily webinars at 8 a.m. and 2 p.m. to help business owners through the process. Resources are available at https://www.sba.gov/offices/district/nh/concord.
She also noted resources at sba.gov/disaster.

Caller Questions

From East Kingston, Nick asked about testing capacity for COVID-19. Is there a plan for getting more testing kits in the area?

Dr. Calderwood said it is not just the test kits themselves.

“We need the swabs, the transport media and sufficient PPE (protective equipment) for those doing the collection,” Calderwood said. “Nationally and internationally we are having shortages of all those elements.”

He said at Dartmouth-Hitchcock they have innovated a new test to do 100 COVID-19 tests per day. But, he added, “we are still going to be facing the shortages of the critical supplies.”

Testing right now should focus on hospitalized patients and frontline care providers, he said. For the community as a whole, the focus is on self-isolation at home if you are ill.

In Nashua, James said he is at home with one family member known to be exposed. It took three days to get a test.
He said when you see asymptomatic athletes on television getting the test, he gets angry.

“I got a problem with that,” he said. There are quite a few homeless people in Nashua, he said.

He suggested the city open up a gym to care for them and allow for a bit more social distancing.

Kuster said she would call Nashua Mayor Jim Donchess about that idea and said she shared his frustration on testing.

Calderwood said that contagion can occur 24 hours before symptoms. In general, he said, it is expected that one person with the virus will infect two to three others, and thus the exponential growth.

“We are in an unprecedented time in terms of shortages of critical health care equipment,” Calderwood said.

Kathleen asked for advice for students, parents and teachers as they embark on distance learning. Kuster said people should be patient with each other.

“This all happened rather dramatically,” Kuster said of the past week’s school and college closures. “Obviously there is going to be an adjustment period.”

Kuster said she is working in committee on rural broadband access and expects the stimulus bill to be considered next week in Congress will include money to make sure every child can get access to distance learning.

“In the meantime, I think we have to give our teachers the support…to step up and offer instruction in a meaningful way to students across the state,” Kuster said.

She also noted other opportunities for learning including getting outdoors. “Children can learn so much about nature and the beautiful state we live in,” Kuster said, adding we all can become curious learners.

Wayne who was calling from the North Conway area said he had just been laid off this past week and does not have a computer. Applying for unemployment insurance is challenged by the closure of the library and other ways to get online to continue to get unemployment.

Pappas said he knows the unemployment security system has been overwhelmed this week but in absence of access to a computer, he suggested calling his office at 935-6710 for help.

Steve in Manchester asked if the Veterans Administration Medical Center in Manchester might get access to some malaria drugs that may or may not be helpful in treating symptoms of the virus. It was widely discussed at President Trump’s press conference on Friday.

Calderwood said there is a shortage and need for it to treat other things like Lupus. In the hospital, for critical patients, “this is one of the drugs we are going to need.”

Right now, there is insufficient hydroxychloroquine for maintenance therapy and he said doctors should not be prescribing it as a prophylactic now.

Becky called to say she was “freaked out” as a small business owner and asked what happens when she starts to run out of money. What about real estate taxes?

Pappas said he is looking for relief in the tax codes but in terms of property taxes, as a federal official he could not answer those questions. He said he would continue to urge Sununu to look at other tools to help small businesses survive through these times.

Sean, in New London, asked about personal protective equipment for primary care clinicians who are struggling to get access.
He asked whether there was a chance of getting such equipment through the strategic reserves. And he also asked about access to health care for those who are laid off.

Kuster said in terms of health insurance for the unemployed, they are looking to have open enrollment on Medicaid expansion in New Hampshire and noted that “thankfully we do have that” in New Hampshire. She urged folks to call her office at 226-1002.

Calderwood said the issue around personal protective equipment and the strategic stockpile keeps coming up.
He said early states that faced this crisis have used up a lot of the equipment and states will face a larger and larger number of issues.

“It is a struggle. We know the shelves are bare,” Calderwood said.

But before the run on toilet paper, some people were stockpiling gloves and masks which may be in individuals’ homes.
“We are at a point of asking those people if they have those items in your home that we are in desperate need,” Calderwood said. “We are all one.”