Cheshire Medical Center is continuing to break its own COVID-19 records, with the Keene hospital reporting its highest proportion of positive tests to date Tuesday.
The Dartmouth-Hitchcock Health affiliate reported a positivity rate of 23.5 percent during the week ending Dec. 30, compared to the week before when it was 19.7 percent.
Before the current COVID-19 surge, which began right after Thanksgiving, the hospital’s highest test positivity rate had been in September, at 11.3 percent, according to Dr. Aalok Khole, an infectious-disease physician at Cheshire Medical.
The number of inpatients with COVID-19 also remains high.
Cheshire Medical had 24 COVID-19-positive inpatients as of Tuesday morning, with six of them in the ICU requiring intubation, according to Khole. Of those, a majority (14) were unvaccinated, as has been the case in previous weeks.
The number of COVID-positive inpatients is down slightly from 27 last week — the highest number Cheshire Medical has seen at one time — but this is still a lot for the hospital to manage, hospital officials say, especially as it anticipates another surge throughout the next week caused by holiday gatherings.
“If there is a surge on top of the surge, we will struggle to provide the level of care the community is used to ...,” said Dr. Don Caruso, president and CEO of the hospital. “There will be more impact to care.”
Caruso said last week that the hospital had transferred about 30 nurses who work in outpatient departments to the inpatient settings to prepare. The hospital also converted more standard rooms to those capable of providing intensive care.
Cheshire Medical Center has the most COVID inpatients it’s ever had at one time, leading the Keene hospital Tuesday to convert more standard rooms to those capable of providing intensive care.
In addition to those still considered positive for the viral disease, Cheshire Medical has an elevated number of recovering COVID-19 patients, those who are no longer infectious but still require hospitalization to recover from the virus.
Cheshire Medical had an additional 16 patients who fall under this category as of Tuesday morning, according to Caruso. Most of them had experienced respiratory system or other organ failure, he added.
The strain Cheshire Medical Center is weathering is occurring statewide.
Data from the N.H. Department of Health and Human Services show that the number of hospitalized COVID-19 patients has dropped in recent weeks. At the end of last month, 353 patients with active COVID cases were in New Hampshire hospitals, down from more than 450 two weeks prior.
Caruso said this isn’t the first time Cheshire Medical has cared for recovering COVID-19 patients, but usually it was one or two at a time.
“But with the surge now, it’s a large number,” he said. “A lot of them, because they are really sick, are still requiring high levels of care.”
Cheshire Medical continues to urge people to practice COVID-19 safety measures, such as wearing a mask in public, staying home when sick and washing hands frequently, especially as New Hampshire sees very high case numbers.
Those who haven’t done so are also encouraged to get a COVID-19 vaccine or booster shot, as it’s the best way to protect yourself and others from the viral disease, health experts say.
To schedule a COVID-19 vaccine or booster appointment, visit vaccines.nh.gov or call 2-1-1.
The labor market’s record churn reached new heights in November, with 4.5 million workers quitting or changing their jobs, the highest number in the survey’s history, according to the Labor Department’s monthly report on job openings.
It was the fourth time in 2021 that the number of workers quitting reached a record, with previous highs in April, August and September. Workers took advantage of a hot jobs market, with employers reporting some 10.6 million job openings in the survey — down from recent records but still well above pre-pandemic averages.
The data provides yet another illustration of how profoundly the pandemic has transformed the dynamics of the labor market. Nearly two years after some 20 million workers lost their jobs in the wave of shutdowns in spring 2020, the imbalance between available workers and job openings has given many workers more leverage than they’ve had in recent memory.
“This is the tightest labor market ever,” said Julia Pollak, economist at the jobs site ZipRecruiter. “These are not quits from the labor force but quits from lower-paying jobs to higher-paying jobs, from less prestigious jobs to better, more prestigious jobs, from less flexible jobs to more flexible jobs.”
The changes began last year, as retail and restaurant employers reported trouble filling positions amid the country’s reopening after vaccines became available. Companies soon began to compete against each other to raise wages and offer generous cash bonuses to entice workers to fields including hospitality, restaurants, transportation and health care. Workers, too, have become more selective, putting new restrictions on the types of jobs they want to consider. The pandemic has reshaped the cost-benefit trade-off for in-person work for many workers, complicating the lives of parents and caregivers nationwide.
Overall, the numbers of people quitting or leaving to start new jobs represents 3 percent of the workforce, the new government data said.
The 10.6 million job openings dwarf the numbers of people currently listed as unemployed, at 6.9 million. The sheer size of the imbalance — there are about 1.5 jobs for every unemployed worker — has helped give workers more leverage.
In the months before the pandemic, there were often about 2.4 unemployed people for every job, said Pollak. When the economy shrinks in a recession, that figure can rise even higher, as unemployment increases. But the pandemic has upended these old patterns.
Still, inflation throughout the economy, especially for food, housing and energy, has negated the wage increases for many workers, at least so far, and the ever-present threat of the coronavirus, particularly for in-person work, continues to complicate employment options for others.
The number of workers quitting in November was up from the 4.2 million who left or changed jobs in October and surpassed the previous record of 4.4 million in September.
The numbers of resignations and job changes were highest among restaurant and bar workers, retail workers, arts and recreation workers — all sectors that have been among the most severely affected by the pandemic. Additionally, professional and business services also see high numbers of quits.
Nearly 7 percent of restaurant and bar workers changed or quit jobs in November, as did 4.4 percent of retail workers.
In general, the industries that saw larger quit rates were also those that have seen larger wage growth over the past year, as businesses have raced to compete for available workers. Wages for leisure and hospitality workers, for example, rose more than 12 percent in the past year, according to the most recent Bureau of Labor Statistics data.
On surveys ZipRecruiter has done, many job seekers report they are looking for new types of work and particularly for remote work, due to family, child care or safety concerns.
Alexis Farris, 41, is one of the millions of workers who quit jobs for new positions in November. She had worked on a horse farm near her home in Vancouver, Wash., for four years but had tired of the low wages and lack of benefits such as health care and sick time. The pay was barely enough to sustain her and her 8-year-old daughter, she said. So she decided to look for a new job.
“I thought there were a fair amount of opportunities,” she said.
She targeted her search toward positions that would have better pay and allow her to work from home. Within a few weeks, she was able to find a new position, doing customer service remotely for a national gardening company. Her new job also came with a $5-an-hour increase to her wages and more generous benefits. She’s now able to pick her daughter up from school on her lunch break.
Ian Cohen, a marketing manager in his 40s near Chattanooga, Tenn., has changed jobs twice during the pandemic.
The number of open jobs that pop up on his LinkedIn profile, the contacts that have reached out to him and the regular pinging from recruiters has convinced him that this is the hottest labor market he’s ever experienced. He quit his job at a start-up the first week of December after working for less than a year and feeling like it wasn’t the right position from him.
He starts a new job, as a program manager for another tech company, next week.
“There’s just no shortage of opportunities in my space,” he said. He’s worked remotely for five years and said he was considering only remote positions because he doesn’t want to jeopardize his family’s safety or deal with a commute. He says the volume of remote-job offerings has grown exponentially in the past two years, giving him even more options.
Overall, the labor market recovery was strong in 2021, as the country added some 550,000 jobs a month through the first 11 months of the year. But the country is still below the level of employment it had in February 2020, as some workers have yet to return to work, while others have been prompted to retire early or leave the labor force for other reasons.
Policymakers and economists have been concerned about a job market slowdown after November’s employment figures came in below expectations. And the effects of the latest coronavirus surge may not yet be clear for weeks.
State data suggest the latest surge in COVID-19 patients at New Hampshire hospitals has started abating in recent weeks. But at some of the state’s busiest facilities, health-care workers say they’re still under intense strain as they prepare to enter a third year battling the pandemic.
At the end of December, 353 people were reportedly hospitalized in New Hampshire with active COVID-19 cases, down from a peak of more than 450 two weeks earlier.
But the N.H. Hospital Association says hospitals were also treating an additional 144 patients who were no longer deemed to have active COVID-19 cases but still required hospitalization as they recovered.
This figure — what the hospitals refer to as “COVID-recovering” patients — isn’t reported as part of New Hampshire’s official coronavirus metrics. But the Hospital Association has started sharing it as part of its own daily pandemic updates in recent weeks, as they put it, “to better reflect the COVID-19 burden on hospitals.”
A spokesperson for the state health department says they have no plans to reproduce the Hospital Association’s data on their dashboard.
Patty Labrie, a nurse and unit director who’s worked at Catholic Medical Center for more than 33 years, said caring for recovering COVID-19 patients can still be intense. As of Monday morning, she said, her team was taking care of 16 COVID patients plus four who were recovering.
“The recovered COVID patients are still on oxygen, and they still require a higher level of care,” she said.
Dr. Kevin Desrosiers, chief medical officer at Elliot Hospital in Manchester, said the range of care required by these patients can vary.
“Some of the patients will be exceptionally ill and may still succumb to their illness and die from COVID while others may be toward the end of their recovery period,” he said.
As of Monday, there were seven recovering COVID patients at Elliot.
At Concord Hospital on Monday, the number of recovering patients was even more significant. There were 44 patients “officially” hospitalized who have COVID-19. There were an additional 22 still recovering from the virus.
Unvaccinated individuals continue to make up the majority of COVID-19 patients filling New Hampshire’s inpatient and ICU beds. According to the Hospital Association, more than 60 percent of those hospitalized as of Dec. 31 were unvaccinated. About 26 percent were fully vaccinated, and vaccination status was unknown for nearly 13 percent of the remaining patients.
Dr. Matthew Gibb, chief clinical officer at Concord Hospital, said the breakdown of vaccinated and unvaccinated patients is the sharpest at the most intensive levels of care. Overall, he said, the hospital is seeing more breakthrough COVID-19 patients than a few months ago, but “the ICU patients are maintaining a 90 percent or higher unvaccinated status.”
Health-care workers reported mixed feelings about what’s on the horizon heading into the new year.
At Catholic Medical Center, ICU Director Diane Kobrenski recalled the COVID patients that flooded her unit after Thanksgiving — and how many of those people ended up dying.
“Are we going to see the same thing? And there were two holidays — is it going to be twice as bad?” Kobrenski said during a Monday morning roundtable with hospital colleagues hosted by Sen. Maggie Hassan. “There’s a lot of anxiety. It’s almost like today, everybody’s just like waiting and, you know, what is going to happen? When is it going to happen? Because we know it is.”
On the other hand, Dr. Kevin Desrosiers at Elliot Hospital said, this year, widespread access to vaccines means fewer people who contract the virus will have a severe case.
Desrosiers also said, compared to last year, the holidays may not have as much of a clear impact on case rates and hospitalizations because people are already gathering so frequently.
“The reality is people are probably gathering more regularly and continuously, whether it’s at a high school basketball game or other things that last year they wouldn’t go to,” he said.
The other big unknown, he said, is the severity of an omicron surge in New Hampshire.
At the end of December, the CDC released new emergency guidance for health-care facilities to prepare for a potential omicron surge.
The guidance shortens the COVID-19 quarantine period for health workers who contract the virus but remain asymptomatic to seven days with a negative test. It also gives health-care employers discretion to cut that period down further if needed.
Desrosiers said Elliot Hospital has not yet implemented the new guidance, but the hospital is looking at how it could be put into practice. New Hampshire hospitals are also awaiting further state guidance, he said.
At Concord Hospital, Gibb said rates of staff out quarantining with the virus have been rising dramatically.
“We’re worried that’s going to have as much of an impact on our capacity to manage inpatient beds as the active COVID patients,” he said.
Reducing unnecessary quarantine time and bringing workers back will be good for the health-care system, Gibb said. He is in favor of measures “that can accomplish that and that are based in good science.”
Meanwhile, three New Hampshire hospitals were expected to receive federal staffers Monday to help administer monoclonal antibodies, an often labor-intensive COVID-19 treatment that can keep patients with the virus out of the hospitals.
The state has received word the teams are delayed, due to overwhelming demand across the country.
Elliot Hospital was one of those slated to receive a team. While the hospital is continuing to administer the treatment to their own patients, Desrosiers said the federal team will allow Elliot to reach patients outside their own health system.
The federal teams may arrive next week.
New Hampshire’s House of Representatives and Senate convene today in different cities for a yearly session likely to be dominated by COVID-19.
Response to the pandemic is a topic for dozens of bills, and concerns for the health of lawmakers and the public will alter the way elected officials conduct their business.
Public health experts said in a virtual news conference Tuesday that more than 30 bills have been introduced that could limit the state’s response to the disease.
Rep. Joe Schapiro, D-Keene, said he regards as the most extreme of these House Bill 255, which has an amendment that would prohibit any entity from requiring anybody to be vaccinated for COVID-19.
“I have concerns with that,” said Schapiro, a member of the House Health, Human Services and Elderly Affairs Committee.
Businesses and other entities should be allowed to determine for themselves whether to require their employees to be vaccinated, he said.
“For example, here in Keene, Dartmouth-Hitchcock’s Cheshire Medical Center has a mandate that employees have to have a vaccine to work there. Under this bill that would be illegal,” Schapiro said.
Republican Gov. Chris Sununu signed a bill last year that prohibits COVID-19 vaccines from being required of people accessing public facilities. Schapiro has a bill this year to carve out an exception to that for public colleges and universities, including Keene State College.
One bill to be considered in the coming session would affect the state’s vaccine registry, where information is kept when someone is vaccinated, unless that person opts out. Under the bill, the information would not be kept unless someone opts in. Every state has a vaccine registry. New Hampshire was the last state to do so.
Rep. William Marsh, D-Wolfeboro, a doctor, said this legislation would violate a federal prerequisite for the state to receive the COVID-19 vaccines. He also said the list is subject to federal law that prohibits public release of personal health information.
For her part, Rep. Jennifer Rhodes, R-Winchester, said she favors people not being put on the registry without their permission.
“It’s a slippery slope to make everybody’s health information your business. That’s not OK,” said Rhodes, whose district covers Marlborough, Richmond, Swanzey, Troy and Winchester.
She said people can keep track of their own vaccination record and that their doctors would also have this information.
Several bills seek to prevent face mask mandates.
The Centers for Disease Control and Prevention says face masks are an important tool to limit transmission of the virus and should be worn in indoor public places.
Rhodes said people should be allowed to decide whether they wear a mask.
“I think it is really easy for people to stand back and say, ‘Put this mask on. It won’t hurt you, and it may help someone else not be sick.’
“But I also know many reasons why some people can’t wear a mask, and it’s not right to make them feel like they are not welcome in a grocery store or to participate in society as a whole.”
Masks are optional for senators who are meeting in the House chamber in Concord today, and for representatives who are meeting at the exposition center at the DoubleTree by Hilton in downtown Manchester. There are 24 senators and 400 state representatives.
The locations are designed to allow for social distancing.
Each representative was given two at-home COVID tests that could be used before they go to the meeting, which is being livestreamed but not open to in-person public attendance.
Schapiro said that putting all the state representatives, some likely unmasked, in one place isn’t wise from a health perspective.
“It’s a danger for 400 people to travel to one place, to meet together and then travel back home around the state, potentially carrying COVID with them,” he said. “I will attend because I feel like it is my job and responsibility, but I don’t feel it’s the safest option.”
Lawmakers and the public should be allowed to participate in meetings remotely, he said.
When physical presence is required for participation, those who attend could pose a public health danger, he said.
“Committee meetings that have to do with vaccinations or masks attract a lot of people, many of whom are angry, many refuse to wear masks, and many are unvaccinated,” Schapiro said. “Not only does it create an unsafe environment, but the rest of the public is intimidated and understandably reluctant to come to those meetings. It’s really bullying.”
The House was scheduled to convene at 9 a.m. and Senate at 10 a.m.
The link for the House livestream is https://nhhouse.edifymultimedia.com
The link for the Senate livestream is: https://sg001-harmony.sliq.net/00286/Harmony/en/View/Calendar/20220105/2035