NH's COVID-19 cases could be headed in wrong direction  

More than two thousand demonstrators rally on the plaza and lawn in front of New Hampshire's Statehouse Thursday, March 31, 2011 to protest proposed spending cuts and a provision that would strip public employees of their union protection when their contracts expire, in Concord, N.H.

Friday’s new COVID-19 cases were startling.

The number of new cases certified Friday was 59. While 11 came from an outbreak at a long-term care facility, the new cases had not reached that level since June 17 when there were 73 new cases, and on June 27 there were 51.

The nearly 60 new cases are more reminiscent of what occurred at the end of May and the first part of June as the state began “reopening” in earnest.

Daily totals are a snapshot in time, a seven-day average is a more meaningful indicator.

And the new cases have been increasing slightly since July 17, or two weeks after the July 4 holiday weekend and that is reflected in the seven-day average as well

The death rate from the coronavirus has also begun to tick up ever so slightly over the last week after a near flat line for a couple of weeks.

The death rate always lags the new cases as does the hospitalization rate which is also going up from a low of 17 people July 17 to 27 patients Friday.

From what has happened in Florida, Texas, Arizona and California, it is apparent that things can go from containment to out-of-control very rapidly.

Two months ago the coronavirus curve was flattened and with the exception of New York, New Jersey and Massachusetts, hospitals and health care systems were not overwhelmed.

But that has changed nationally.

The New York Times published an article July 2 on a Harvard researcher and his team who developed a model predicting COVID-19 outbreaks two to three weeks in advance.

The model uses an algorithm that monitors Twitter, Google searches and mobility data from smartphones in real time to predict future increases.

The article notes that the traditional benchmarks of hospital capacity and increases in cases and deaths “make a poor alarm system.”

The team, led by Mauricio Santillana and Nicole Kogan of Harvard, published a paper on their project last month, but it has not been peer reviewed.

The researchers note that the data they are tracking would have given health care professionals about a week’s advance notice to the explosion in cases in New York City earlier this spring.

The professors were asked to predict where the next increase in cases might be and they noted “Nebraska and New Hampshire are likely to see cases increase in the coming weeks if no further measures are taken, despite case counts being currently flat.”

Looking at the more traditional number of cases and deaths, the contrast between northern and southern New England couldn’t be more stark.

Looking at the rates per 100,000 residents, the more rural northern states have far fewer infections and deaths than the urban centers in the three southern states.

Vermont has the lowest rates, of 213 infections per 100,000 residents and 8.6 deaths per 100,000 residents. But Vermont has about 650,000 residents which is half the population of New Hampshire and of Maine which each have a little more than 1.3 million residents.

Maine’s rates are 282.2 infections and 8.85 deaths per 100,000 residents, while New Hampshire’s are much higher at 468.75 infections and 30 deaths per 100,000 population.

In contrast, Rhode Island, which has a population of 1.06 million people, has an infection rate of 1,719 per 100,000 residents and a death rate of 94.53.

Massachusetts has a population of 6.8 million residents. Its rates are 1,691 for infections per 100,000 and deaths at 125.

Connecticut’s population is 3.7 million with an infection rate of 1,318.3 and death rate of 119.3 per 100,000 residents.

While Maine and New Hampshire are about the same size their death and infection rates are quite different.

Maine had mandatory quarantine requirements for out-of-state visitors and has had them in place longer, mainly aimed at Massachusetts residents coming into the state. New Hampshire had voluntary quarantine requirements and has since ended the restriction for New England states.

Maine opened its beaches before New Hampshire, but not its restaurants and hotels. Maine, in light of what has happened around the country, has not reopened indoor bar service, which had been scheduled July 1.

Restaurants and bars in all but Rockingham, Hillsborough, Merrimack and Strafford counties are open at full capacity, while the facilities in those four counties are limited to 50% capacity.

Vermont also had stricter requirements than New Hampshire largely to discourage New Yorkers from coming to the state while the virus was ravaging its residents.

Vermont has a system based on counties — in-state and out-of-state — that prohibits people from the more infected counties from entering stores, restaurants etc.

Last week Gov. Phil Scott announced a mandatory face mask requirement beginning Aug. 1 when people are not able to maintain six feet of social distancing.

“Based on national and regional data on how the virus is spreading – and rather than waiting like other states have – I feel we need to act now to protect our gains, which have allowed us to reopen much of our economy,” said Scott. “That’s why today I signed an order, which will strengthen our current mask mandates, so that we do not take steps backwards and we can stay open into the fall as people move more of their interactions indoors.”

Maine Gov. Janet Mills has required face masks be worn for some time and July 8 issued an executive order requiring businesses, restaurants, outdoor bars, tasting rooms and lodging establishments in Maine’s more populous cities, to enforce the mask mandate.

In New Hampshire Gov. Chris Sununu has declined to issue a mandatory face mask order, the only governor in New England not to do so.

Sununu was cautious to open the state’s businesses slowly at first, but once he began, he and his reopening commission moved fairly rapidly to open most businesses and venues although some with capacity restrictions.

But the real test for New Hampshire is coming as the effects of many out-of-staters coming here for Bike Week in August, and the NASCAR race at New Hampshire Motor Speedway next weekend, may cause an uptick in cases.

These are not mask-wearing crowds and one or two “super seeding events” and New Hampshire could be heading in the wrong direction.

And the greatest test comes at the end of August and the first of September when many college students return to the state and elementary and secondary students return to classrooms, if they do.

The governor is fond of saying New Hampshire has done a great job flattening the curve, but that may have more to do with the state’s rural character above Concord, because the communities along the I-93 or I-95 corridors leading from Massachusetts have had high infection rates.

Even in Coos County, which had no certified cases for a long time, infections are increasing as people travel to enjoy the state’s rural areas.

It is way too early to celebrate, just asks the folks in Florida, Texas, Arizona and California.

For them it is worse now than it ever was and that is not reassuring.

Garry Rayno may be reached at garry.rayno@yahoo.com.

 

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