A large group of New Hampshire lawmakers are now calling on Gov. Chris Sununu to impose a “stay-at-home” order in an effort to stem the spread of COVID-19.

On Wednesday, 200 Democrats from the N.H. House of Representatives sent a letter to Sununu asking him to follow the lead of neighboring states including Vermont and Massachusetts, by ordering residents to stay at home and ordering that all non-essential businesses close their doors.

“As our hospitals and the mayors of our largest cities (Manchester and Nashua) have noted, every day that passes without a stay-at-home directive brings exponential growth to the health risks faced by Granite Staters, and unsustainable pressure on New Hampshire’s healthcare services which will lead to unnecessary loss of life,” the letter reads. “As you have acknowledged, we likely remain far from the peak of COVID-19 infections in New Hampshire.”

The letter’s signatories empathized with small business owners, saying many of them are small business owners themselves, but emphasized that taking stricter action now will help to contain the spread of the disease. They said that existing steps taken by Sununu, like directing N.H. residents to keep gatherings to under 10 people “are simply not enough.”

The following local representatives have signed the letter: Majority Leader Douglas Ley, Cheshire District 9; Deputy Majority Leader Marjorie Porter, Hillsborough District 1; Rep. Dick Ames, Cheshire District 9; Rep. Chris Balch, Hillsborough District 38; Rep. Paul Berch, Cheshire District 1; Rep. John Bordenet, Cheshire District 5; Rep. Barry Faulkner, Cheshire District 12; Rep. Donovan Fenton, Cheshire District 8; Rep. Peter Leishman, Hillsborough District 24; Rep. John Mann, Cheshire District 2; Rep. David Morrill, Cheshire District 4; Rep. Henry Parkhurst, Cheshire District 13; Rep. Will Pearson, Cheshire District 16; Rep. Dan Pickering, Hillsborough District 3; Rep. Joe Schapiro, Cheshire District 16; Rep. Sandy Swinburne, Cheshire District 10; Rep. Bruce Tatro, Cheshire District 15; Rep. Craig Thompson, Cheshire District 14; Rep. Sparky Von Plinsky, Cheshire District 7; Rep. Lucy Weber, Cheshire District 1.

But the governor is not without support from the House. House Republican Leader Dick Hinch, R-Merrimack, responded to the letter by reminding its signers that Sununu has issued advisories telling residents to stay home, particularly those with a high risk of contracting the disease.

“It’s discouraging to see that New Hampshire Democrats have chosen to play politics rather than spend their time working collaboratively with Governor Sununu and public health officials at DHHS to protect New Hampshire families,” Hinch said in a news release. “Governor Sununu has demonstrated leadership every step of the way during this crisis, and I am not going to sit around second guessing him, nor should others.”

Dr. Don Caruso, head of Cheshire Medical Center, has also called on the state to issue such an order. In an op-ed in Thursday’s Sentinel, Caruso wrote: “Postponing the decision to dramatically change our socializing patterns is causing the disease to spread quickly which will mean more deaths here in Cheshire County and our surrounding communities.”

A member of the N.H. Executive Council has also joined the growing list of people urging Sununu to consider more aggressive social-distancing policies.

Debora Pignatelli, who represents the council’s fifth district — including several towns in the Monadnock Region — said a number of her constituents have asked her to push for a shelter-in-place order. The Nashua Democrat pointed to New Hampshire’s large percentage of residents over the age of 60 as a reason more stringent actions should be taken.

“It’s not often that we are in a position to save lives,” Pignatelli said during a meeting of the council with Sununu Wednesday. “But I am certain that if you take this action, this will save a lot of lives.”

Coronavirus cases are expected to peak in New Hampshire sometime between the end of April and early May, the state’s health commissioner told the Executive Council at that meeting, according to The Associated Press.

Pignatelli’s is the latest of several pleas for Sununu to consider more drastic measures to contend with COVID-19. A petition calling for a “mandatory lockdown” in the state has been circulating, and as of early Wednesday evening, had gotten nearly 4,600 signatures.

A group of two dozen medical professionals, professors and former and current lawmakers sent a letter to Sununu Monday, urging him to consider imposing a “shelter-in-place” order. Those who signed it — including several Keene State professors and the director of the Surry Village Charter School —expressed concerns that New Hampshire’s health care system would otherwise become overwhelmed within a matter of weeks as the coronavirus that causes COVID-19 continues to spread.

As of 5 p.m. Wednesday, the Centers for Disease Control and Prevention had counted 54,453 confirmed cases of the respiratory disease in the U.S. and 737 deaths. Of that total case load, 108 were in New Hampshire, although the state’s own most updated official tally Wednesday was 137.

Health officials announced the state’s first death from the disease, a Hillsborough County man over 60 with underlying health conditions, on Monday.

Sununu has remained steadfast in defending the measures his administration has taken thus far, which include prohibiting social gatherings of 10 people or more and halting in-house restaurant service. He has stated repeatedly that restrictions placed on New Hampshire residents are similar to those in neighboring states and said Wednesday that New Hampshire “is not in the position” to order people to stay in their homes.

“Right now, we in New Hampshire have a position very similar to that in [surrounding states],” he said during Wednesday’s meeting. “... the idea of forcing people to stay in their homes, we have issues of how that would be enforced. Essentially, that would be calling for not tens, but hundreds of thousands of people to be put on unemployment; that carries its own very serious issues.”

He also said the state is following guidelines set by the CDC and urging the most at-risk members of the community to avoid leaving their homes if possible. He said these people should try to find help getting groceries or meeting other needs that would require them to go out into the community.

Pignatelli explained that she isn’t requesting a complete lockdown. She said that to her, a shelter-in-place order refers to the closure of nonessential businesses and prohibits employees from leaving their homes to work. People shouldn’t be going to get their hair or nails done, she said, they shouldn’t be traveling or physically spending time with friends or family, but they ought to be able to buy groceries, go to the laundromat or go for a run, as long as they stay 6 feet away from one another.

Local officials have given some consideration to issuing a shelter-in-place or stay-at-home order.

“I have discussed the possibility of such an order with Governor Sununu’s office. I am not against it,” said Keene Mayor George Hansel in an email to the Keene City Council Wednesday. “COVID-19 poses a serious threat to New Hampshire citizens and our best way to combat this virus is through extreme social distancing. Such an order is one tool in the toolbox. It would not absolve us of our responsibility to consistently remind our citizens to practice appropriate social distancing.”

Effective Wednesday, Vermont Gov. Phil Scott has instructed residents of his state to stay at home, leaving only for essential purposes, and halted in-person operations at most businesses. Vermont’s Department of Public Safety says state officials “expect the vast majority of compliance to be self-regulating” and that law enforcement officers may use education as a means of enforcement.

At Wednesday’s Executive Council meeting, Second District Councilor Andru Volinsky, D-Concord, whose district includes Keene and several other nearby towns, noted that Ohio Department of Health Director Amy Acton estimated that 1 percent of Ohio’s population is already infected with the coronavirus.

Volinsky, who is running for governor, asked N.H. Health Commissioner Lori Shibinette whether this is a figure her department should be paying attention to. Shibinette said no, describing the estimate as “an arbitrary number,” and saying it’s not feasible for anyone to come up with a realistic number of total cases at this time.

She also said that, based on what has happened in other parts of the world that have already experienced peak infection counts, 30 percent reflects the portion of the population that is likely to contract the disease if no preventative measures are taken.

But there has been some disagreement in the medical field on this issue.

Marc Lipsitch, a professor at Harvard University’s Departments of Epidemiology and Immunology and Infectious Diseases, has estimated that 40 to 70 percent of the population could ultimately become infected. Lipsitch’s estimate was made prior to the disease being classified as a pandemic by the World Health Organization on March 11.

However, Shibinette warned against taking aggressive prevention measures too quickly, as she said this could increase the risk of a second outbreak when restrictions are lifted.

“What we’re trying to do as a country is develop herd immunity,” Shibinette said, using an epidemiological term that refers to widespread immunity to a contagious disease within a given community.

“That’s what has to happen. We just don’t want to develop herd immunity in 60 days; we want to drag that out so that it’s over many months and probably until a vaccine is developed,” she said. “The problem that you have when you go too restrictive too soon with your measures is that the rate of infection drops to the point that when you come out of those restrictive measures ... you then have a new outbreak.”

Mia Summerson can be reached at 352-1234, extension 1435, or msummerson@keenesentinel.com. Follow her on Twitter