Cheshire Medical Center’s chief official says the hospital is “on the precipice” of running out of beds in its intensive care unit, as COVID-19 cases continue to rise and pandemic-weary nurses leave their posts.
That trend is not yet a full-blown crisis, according to Cheshire Medical CEO Don Caruso, but he told The Sentinel Friday that the lack of available ICU beds has “significantly escalated” in the past week.
Whereas approximately half of the hospital’s ICU beds were typically in use at any time before the pandemic, Caruso said the ward is often at close to full capacity these days. Adding to the problem, Caruso said Cheshire Medical has recently had enough staff to maintain only eight of those 10 beds.
“The reality is that everybody’s tired,” he said. “The nurses are still doing that work, and they’re asking, ‘Is it really worth it anymore?’ ”
Amy Matthews, Cheshire Medical’s chief nursing officer and vice president of patient care services, said last week that reaching full capacity for any department in the hospital is normal and that ICU patient volume fluctuates quickly.
Matthews told The Sentinel last week that the ICU and emergency department were maintaining normal levels of care. No one had been turned away from the ICU over the prior week because of a lack of beds, she said at the time.
But since then, Caruso said, the hospital sent an intubated COVID-19 patient for treatment at a different facility because it didn’t have space in Keene. Most of the patients who Cheshire Medical has transferred to other hospitals, however, have required treatment not offered in Keene, he said, clarifying comments he made to WMUR earlier this week.
The total number of active COVID-19 cases in New Hampshire stands at 4,173, according to the state health department. Over the most recent seven-day period, from Sept. 11 to Sept. 17, the average number of cases per day was 456 — a 30 percent increase from the previous seven days.
This week, the number of hospitalizations in New Hampshire due to COVID-19 was highest on Monday, with 154 people. There were 122 people hospitalized as of Friday.
Cheshire Medical has also seen an influx in patients with emergency medical conditions that were either mismanaged or untreated during the pandemic, likely because people avoided visiting the hospital due to COVID-related concerns, Caruso said.
Patients in need of specialized care not provided by Cheshire Medical, whom it usually transfers to hospitals in Manchester and Lebanon, have recently been sent farther away because of a lack of beds at those places, too, he said. That included transferring one patient to Poughkeepsie, N.Y., earlier this week, he said.
“This isn’t all about Cheshire,” he said. “... In our state, there are just too many sick people to manage.”
Caruso was among a group of community leaders sounding that alarm in a joint news release Thursday.
Citing low vaccination numbers locally, particularly among people under 30, the release’s authors — Caruso, Keene City Manager Elizabeth Dragon, Keene State College President Melinda Treadwell and School Administrative Unit 29 Superintendent Robert Malay — urged a number of steps to curb the spread of COVID-19. Those include getting vaccinated, continuing to wear masks in public places and keeping a distance from strangers.
“Our shared actions now to slow the spread of COVID will also help to limit the demand on our medical system, strengthen our economy, and protect our children, family, friends, and co-workers,” they wrote.
In Cheshire County, the number of active cases is at 245, up from 139 reported by the state health department last Friday. Keene has 110 active cases — up from 54 last Friday.
The state says 56 percent of residents are fully vaccinated, with 61.6 percent having received at least one dose.
Caruso said Friday he’d also like local governments to require masking in public places. Keene officials have said in recent weeks that they don’t know of any plans to reinstate the city’s mask mandate, which expired in June.
“I think we’re naive not having a mask mandate,” Caruso said. “I think our politicians are just hoping this will go away. But we’re putting people at risk.”
Cheshire Medical has a plan to increase the number of ICU beds available, if necessary, a spokesman said Friday. Caruso said the hospital hopes to avoid that measure, however, since it would involve treating emergency-care patients in wards not meant for those procedures.
“The standard of care is not going to be the same,” he said. “We don’t want to take that step unless we exhaust every other resource around us.”
STODDARD — More than a year since his trailer burned down, Jon Hicks is still working to rebuild.
The Stoddard resident has temporary housing on his property to get by, but is in need of financial assistance to finally have a permanent home.
“I just try to keep smiling,” said Hicks, 69, “and try to learn patience.”
In June of 2020, his trailer on Tigola Trail caught fire due to an electrical issue, and despite his best efforts to save it, only the soot-covered frame was left behind.
His wedding ring and charred dog tags that belonged to him (an Army veteran), his brother and father were the only things to survive.
Hicks — who retired after 30 years as head of security at Crotched Mountain Rehabilitation Center in Greenfield — had been living in the trailer until he could finish building a home on the same property. But he said at the time that money issues, coupled with the death of his wife, Mary, in 2017, kept pushing him further away from that goal.
After the fire, Hicks stayed in the home’s previously built cement basement, which he’d formerly used for storage, during the winter. The cramped quarters — equipped with a small old stove and sink — have a shelf for canned goods, a few chairs and a couch restored from the town dump, along with an old TV.
Since May, he has lived in a trailer donated to him by Mike Hayes of Hayes Car and Truck Repair.
The trailer is “twice the size” of the one that burnt down, Hicks said, but because it isn’t winterized, he’ll have to stay in the basement again once it gets colder.
The wood stove in the basement, he added, “heats it up and keeps it nice and warm.”
Both living situations have no plumbing or septic, but Hicks does have access to fresh water for bathing and drinking until those services can be installed.
In the meantime, the town has rallied behind him, donating clothing, food and other necessities throughout the past year.
The Stoddard Congregational Church, where Hicks is a deacon, has spearheaded fundraising efforts. As of Wednesday, the church had raised about $10,000 — a dent in what Hicks needs to rebuild, despite local connections helping bring construction costs down.
“Ball park, the list price on [putting in a] well is $10,000, the septic is around $12,000, and if we can get the labor from Habitat [for Humanity] and the local folks ... we can probably do it all for around 55 to $60,000 to build a one-story cottage,” said Alan Moulton, a friend and church member.
And in addition to his struggles to fundraise for housing, Hicks has health issues to take care of.
He’s had eight surgeries for various forms of cancer — colon, lymphoma and bladder — in the past decade, with the latest happening in the past year.
Now, he’s in remission.
“But I’m still pretty healthy. The doctors told me for a sick person, I’m the healthiest person they’ve seen in a long time,” Hicks said.
Yet despite all of this, Hicks remains optimistic.
“Jon is full of the Holy Spirit,” Moulton said. “It’s his religion, and his outlook is very good.”
Donations can be sent to Stoddard Congregational Church, P.O. Box 334, Stoddard, NH 03464, to the attention of Treasurer/Jonathan Hicks Fund.
Just over a week after President Joe Biden announced plans to institute a federal COVID-19 vaccine or testing mandate for all employers with 100 or more workers, large businesses in the Monadnock Region say they’re still waiting to see how this requirement will affect them.
“As you can imagine, President Biden’s mandates have been a topic of conversation here in our Peterborough facility, and in fact, all three of our facilities, for a few days now,” said Robyn Nattila, a spokeswoman for the Peterborough-based N.H. Ball Bearings, which also has locations in Laconia and Chatsworth, Calif. “Where we’ve landed is that the ‘devil is in the details’ and, unfortunately, we haven’t seen the details yet.”
Biden said last Thursday he was directing the Occupational Safety and Health Administration (OSHA) to develop a rule requiring large private-sector employers, covering about 80 million workers nationwide, to mandate coronavirus shots or require unvaccinated employees to be tested weekly. But that rule will take time to write, and likely will face a wide array of legal challenges. According to The Associated Press, the OSHA rule might not be published until November. Penalties for non-compliance could go up to $13,600 per violation, according to the AP.
“Until these important clarifications are published, we don’t feel it is appropriate to speculate on the types of responses that will be required,” Nattila said in an email. “Once we have had a chance to review these documents, however, NHBB will implement the necessary policies in order to comply.”
In the meantime, Timken Super Precision, which operates a facility at 7 Optical Ave. in Keene, is taking a similar wait-and-see approach.
“We are analyzing the recent announcement by the President and awaiting details on the final requirements,” the company said in a written statement. “In the meantime, we continue to encourage our workforce to get vaccinated.”
Timken, an Ohio-based company that produces precision ball bearings for aerospace and other uses, declined to say how many people work at its Keene facility, and how many of those employees are immunized. According to the N.H. Department of Employment Security, the company has about 267 employees in the Elm City.
N.H. Ball Bearings employs about 450 people in Peterborough, Nattila said. And while she did not provide specific figures, she added that, “based on information that employees have volunteered to us, the percentage of those fully vaccinated is substantially higher than both the National and NH state rates, when looking at the age 18-64 demographic.”
According to the state, 61.7 percent of those eligible for the vaccine — people as young as 12 — are fully immunized. Nationwide, that figure is 63.5 percent, according to the Centers for Disease Control and Prevention.
At a news conference Wednesday, Gov. Chris Sununu encouraged more Granite Staters to get vaccinated as coronavirus cases continue to surge in New Hampshire and nationwide, driven by the more contagious delta variant. But he also sharply criticized the forthcoming federal requirement, and said he’s working with other governors and state attorneys general to pursue legal action against it.
“The president unilaterally decided this,” Sununu said. “And again, making people choose between their livelihood and their job or getting the vaccine, all of that, it’s just the wrong approach. We want folks to get vaccinated. It works. But having this one size fits all with the swoop of a pen forcing it, that’s not good government, frankly.”
But, Sununu said, since the OSHA rule requiring vaccines hasn’t been written yet, states cannot yet file lawsuits challenging it. On Thursday, N.H. Attorney General John Formella was one of 24 state AGs nationwide who signed a letter threatening to sue the Biden administration if it does not walk back the announcement of the mandate.
“Your plan is disastrous and counterproductive,” the letter reads. “From a policy perspective, this edict is unlikely to win hearts and minds — it will simply drive further skepticism. And at least some Americans will simply leave the job market instead of complying. This will further strain an already-too-tight labor market, burdening companies and (therefore) threatening the jobs of even those who have received the vaccine.”
Nattila, the N.H. Ball Bearings spokeswoman, said the company will keep a close eye on that aspect of the vaccine mandate.
“Certainly we are hopeful that the forthcoming details from [federal officials] ... will not increase the difficulty in retaining and attracting talent in this extremely tight labor market,” she said. “Time will tell.”
And while local large employers await further clarity on the federal mandate, and legal challenges wait in the wings, several organizations in the Monadnock Region have already instituted their own COVID-19 vaccine mandates.
All three area hospitals — Cheshire Medical Center in Keene, Monadnock Community Hospital in Peterborough and Brattleboro Memorial Hospital — have implemented employee vaccine requirements. Genesis Healthcare — a Pennsylvania-based nursing home company with area locations in Keene, Winchester and Peterborough — also implemented its own mandate last month.
Franklin Pierce University, a private school that has about 1,200 students and 235 faculty and staff at its Rindge campus, is requiring all students and employees to be vaccinated against COVID-19.
Meanwhile, Keene State College — one of the city’s largest employers with about 600 workers — is not requiring vaccination this fall due to a new state law that makes it illegal to require a COVID-19 vaccine “in order to secure, receive, or access any public facility, any public benefit, or any public service from the state of New Hampshire,” including the state’s public schools.
But the college is still encouraging students and employees to get a coronavirus shot, and share their vaccination status with the school. As of Wednesday, 78 percent of Keene State faculty and staff and 62 percent of students have submitted proof of vaccination, college spokeswoman Kelly Ricaurte said, though those figures continue to grow.