COVID-19 indicators for New Hampshire have fallen for the past three weeks, but the number of new cases per day is still higher than the peak from the first wave at the end of 2020.
According to data from the state’s COVID response dashboard, New Hampshire averaged 992 new cases per day for the week ending Wednesday, down 14 percent from a week earlier. The seven-day average share of antigen (rapid) and PCR tests coming back positive was 15.2 percent, up from 13.2 percent a week ago. There were 384 people hospitalized for the disease as of Wednesday, down slightly from 399 the previous week.
“The total number of inpatient admissions, although significant and abnormally high, have leveled in the last few days,” said Dr. Martha Wassell, director of infection prevention at Dover’s Wentworth-Douglass Hospital. “The Thanksgiving holiday prompted the recent surge, so it’s not unexpected to see a plateau or decrease in cases a few weeks after the holiday gatherings.”
At Cheshire Medical Center in Keene, though, coronavirus-related hospitalizations continue to rise. The Dartmouth-Hitchcock affiliate reported 27 COVID-19 inpatients, with nine requiring ventilation, as of Tuesday, the latest data available from the hospital. That marks Cheshire Medical’s highest COVID-19 inpatient volume to date, leading the hospital to convert several standard rooms to those capable of providing intensive care.
Dr. Justin Kim, regional hospital epidemiologist at Dartmouth-Hitchcock, said that most of the increase is still driven by transmission among the unvaccinated. He also noted that the delta variant is still far more prevalent in the region than the more-infectious omicron.
The seven-day moving average for new daily cases in New Hampshire had fallen in the first half of the year, bottoming out at just 16 at the end of June, but has quickly risen since then. That number peaked at 1,408 on Dec. 8. The average has fallen over the past three weeks, but the state is still averaging roughly 100 cases per day more than it was at the height of the first wave in December 2020.
New Hampshire’s per capita case count of 84 per 100,000 has dropped below the national average, which is 91. The states with the highest numbers are now New York and New Jersey, at 215 and 196, respectively.
Like all N.H. counties, Cheshire is still seeing substantial levels of community transmission, the highest of three tiers designated by the state health department. As of Wednesday, the latest available data, Cheshire County had a 14-day average of nearly 1,236 new cases per 100,000 people, down slightly from last week. The local test positivity rate over the previous seven days stood at 13.6 percent, up about three percentage points from a week ago, according to the state health department.
A pair of local towns, Winchester and Swanzey, are among the top five municipalities in the state with the most active infections, when adjusted for population. As of Wednesday, Winchester had 34 active cases, or 800 per 100,000 population, while Swanzey had 56 infections, or 775 per 100,000, according to the state health department. Only Windham, Wakefield and Bristol had higher proportional case counts.
Wassell cautioned that the state’s data on positive cases may be getting less accurate because more people are using home tests, but may not be reporting positive results.
“Additional home COVID-19 test availability is useful in reducing transmission, as it can help drive personal decisions related to travel or congregation,” she said, but it’s important for people to still report their results to their healthcare provider or the state.
As case counts in New Hampshire have dropped, the strain on hospitals has also lessened slightly. Even though the number of daily hospitalizations has more than doubled in the past five weeks, up from 186 on Nov. 2, more staffed adult ICU beds have become available in the past week: 8.5 percent of the state’s supply was still available as of mid-week, up from 6.7 percent a week ago.
Even though more beds are available overall, said Dr. Holly Mintz, chief medical officer of ambulatory care services at Manchester’s Elliot Hospital, these resources are still being overdrawn in some areas.
“Hospitalizations are still exceeding capacity, especially in the intensive care units,” she said. “There continues to be a shortage of available beds, causing many patients to have long waits in the emergency department awaiting a bed to become available.”
In addition to the count of patients with active infections, the New Hampshire Hospital Association now also reports the number of COVID-recovering patients. These are people who are no longer contagious but who remain in the hospital receiving inpatient care as a result of lingering COVID symptoms. There were 134 such patients in the state as of Wednesday.
Wassell, Kim, and Mintz are hopeful that newly approved antiviral pills from Pfizer and Merck will reduce the number of patients with severe illness requiring hospitalization. The pills are likely to become available in New Hampshire within the next few weeks.
The strain on hospitals may drop again in early January, when more help arrives from the federal government. Governor Chris Sununu and Health and Human Services Commissioner Lori Shibinette announced on Wednesday that FEMA will deploy three teams dedicated to administering monoclonal antibodies at three hospitals in New Hampshire: Elliot Hospital, Alice Peck Day Memorial Hospital and Concord Hospital. Those teams will arrive on Jan. 3.
As of Sunday, an average of six Granite Staters were dying of COVID each day, down from a high of 9.7 on Dec. 21. This is fewer than the peak of 11.7 deaths per day during the first wave.
As of Wednesday, there were 8,147 known active cases in the state. There have been 196,656 confirmed cases and 1,950 COVID-related deaths in the state since the pandemic began.
Vaccination rates continue to rise, though state and federal vaccination data for New Hampshire remain out of sync. Data from the state health department show that 62 percent of Granite Staters have received at least one dose, while the number from the Centers for Disease Control and Prevention is much higher, at 95 percent. Similarly, the state reports that 56 percent of Granite Staters are fully vaccinated, while the CDC’s number is 11 points higher, at 67 percent. The difference between the state and the CDC in terms of total doses administered is nearly 700,000.
Early studies released in the past few weeks have suggested that both Pfizer and Moderna offer strong protection against omicron. The Johnson & Johnson vaccine may also offer strong protection, according to a new study published on Wednesday by researchers in South Africa. The study found that one shot and a booster of the J&J vaccine reduced the risk of hospitalization from omicron by about 85 percent, as compared to unvaccinated people.
“Vaccines and boosters remain the best public health measure to protect people from severe COVID-19, slow transmission and reduce the likelihood of new variants emerging,” Wassell said.