NH Coronavirus: Eyeing Infection Models To Stem The Spread: Watch

CONCORD, NH — Using charts and graphs, New Hampshire's state epidemiologist outlined modeling and strategies health officials are using to stop the widespread outbreak of the new coronavirus. The presentation, entitled "The Future of the Epidemic in NH," gave Dr. Benjamin Chan, the state's epidemiologist, the chance to visually explain COVID-19 modeling officials were using, in more detail. He said there had been "a lot of questions" about modeling, expectations, data, and other information by the public so they put the presentation together.

Mathematical models, Chan said, can help health officials predict the spread of the new coronavirus and it appeared as if the state was "starting to control COVID-19 by flattening the curve … in an effort to protect everyone in the state." The time period, he said, was "critical."

Currently, the state is using "community mitigation," a strategy, Chan said, that was "a package of actions" which don’t involve medicines or vaccines and are "essential to stopping" the new coronavirus. The six focuses of the mitigation were everything officials had been stressing to the public for weeks: Staying at home, keeping at least 6 feet from others, remote learning for students, tele-work for businesses, the cancellation of mass gatherings, and the closing of non-essential businesses.

"All of these have been early interventions and intended interventions," Chan said.

The five goals of community mitigation were to slow the spread; spread out when people get sick; reduce the number of infected; decrease deaths; and prevent the collapse of the health care system, Chan said.

Chan said community mitigation's focus was to "combine layers of interventions with the goal of slowing COVID-19" — with each action, or combination of actions, affecting the outcome.

The early models, he said, showed 40,000 infections and 800 deaths at the peak in New Hampshire. This model assumed no interventions and was based on an approximated 2 percent death rate — which is what the data in other countries has shown. Peak community mitigation was presumed to be 20,000 infections and 400 deaths. Chan called the numbers "hypothetical" but "consistent with earlier studies." Health officials believe the peak will be less than these numbers though.

"Outbreak suppression," Chan said, could occur if the social distancing and other strategies were strong enough. Unfortunately, he said, the models were not completely accurate — but they advise of the potentials.

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The outbreak nationally is expected to peak next week, Chan said.

Health officials were looking at "many different models" but none of them could predict the outcome. There was a high likelihood of a potential peak in New Hampshire in the next few weeks.

"I'm hopeful we can be successful to minimize the outbreak of COVID-19 in our communities," he said.

New England state rates per 100,000 people showed New Hampshire fifth out of the six states — with slightly higher infection rates when compared to Maine, the least infected state based on per capita data.

State were also looking at an epidemic curve which showed an incubation period for the virus lasting two weeks and then, there is a delay in recording or testing of about a week. Chan expected "a period of uncertainty" of two to three weeks but, "we are not seeing a dramatic increase in the number of daily cases based on date of illness onset."

Testing, Chan admitted, had declined "a little bit," but was still averaging about 400 cases per day while adding that confirmed cases can be biased by testing. Hospitalization numbers could be more reliable now because when patients are admitted, they are guaranteed a test. Hospitals are also testing their patients daily, he said.

The attempt by health officials to contain the spread of COVID-19 would "last many more weeks" but the strategy of trying to slow the virus "seems to be working," Chan said. Now is the "critical time" to break the outbreak under control, he added.

Gov. Chris Sununu said infections could "spike at any moment … if we get too lax so we have to be incredibly careful." The peak could be in the next few weeks but it could also be unknown.

The state announced three more deaths bringing the count to 21. Ten were from the long-term care facilities. Of all the deaths, all were in the high-risk group of either older than 60 or having underlying health conditions. Chan said the last few days, with the increasing number of deaths announced in New Hampshire and so many at nursing homes, "was hard on the families."

Chan was asked about the epidemic curve, and the incubation and reporting periods, which appeared to show cases before information about the first known case was released in late February.

Chan said health officials expected ups and downs with the positive chart and symptoms. It was difficult to say, he said, exactly how every person became infected although the public investigatory process did gather a lot of information. Some states, Chan said, have stopped the public investigation process due to being overwhelmed by cases. They are, he said, in the pandemic mitigation stage not the investigatory stage.

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The public health process attempts to make the connection between patients and how they became infected. The state was continuing to investigate every case, Chan said.

Watch Chan answer the questions by Patch below:

The New Hampshire Division of Public Health graphics presentation can be found here in .pdf format.

Other Information

Sununu also announced Thursday the appointment of Jerry Little, a former state Senator from Weare who was also appointed banking commissioner by former governor and now Sen. Maggie Hassan to lead oversight of the state's relief effort. Little said he was "humbled and honored" by the appointment calling it "an immense task" but he would "guarantee transparency" and make sure federal funds were going where they should.

Sununu also highlighted a number of successes during the COVID-19 fight including a call for donations which had raised more than $3.2 million.

"It really is awesome and speaks to the charitable nature of the Granite State," he said.

The call for volunteers two weeks ago led to more than 1,300 people signing up to date, to help others, Sununu said. Many of the volunteers have already been assigned tasks in various communities where there is a need, he said. Sometimes, Sununu said, it might just be grocery shopping; in other places where the virus has not spread as badly, volunteers weren't as busy.

"We are a great state," Sununu said, "with amazing people. It's not just about hope; it's not about false hope. It's about coming together … we are truly in this together. These sacrifices we are making … all of these add up in an incredible way, with real results."

Also, there was a fund available for nonprofits including up to $100,000 for equipment purchases. Nonprofits, he said, play a "very critical role in our communities."

Sununu said there would be no issues with absentee ballots in the state if people didn't want to go to the polls in person presuming the pandemic was still active in the state. New Hampshire, he said, "had a lot of flexibility" when it came to absentee ballots. The elections, though, "are months and months off," he said. Guidance will be offered by the Secretary of State and the Attorney General later on but identification will still be required even if there is physical distancing, Sununu said.

Stop The Spread Of COVID-19!

COVID-19, not unlike the flu and other respiratory illnesses, is spread through respiratory droplets, usually through coughing and sneezing, and exposure to others who are sick or might be showing symptoms.

Health officials emphasize residents should follow these recommendations:

• Avoid any domestic and international travel, especially on public transportation such as buses, trains, and airplanes.
• Practice social distancing. Stay at least 6 feet from other people, including distancing while in waiting areas or lines.
• Anybody who is told to self-quarantine and stay at home due to exposure to a person with confirmed or suspect COVID-19 needs to stay home and not go out into public places.
• If you are 60 years or older or have chronic medical conditions, you need to stay home and not go out.
• Avoid gatherings of 10 people or more.
• Employers need to move to telework as much as possible.
• There is increasing evidence that this virus can survive for hours or possibly even a few days on surfaces, so people should clean frequently touched surfaces, including door handles, grocery carts and grocery basket handles, etc.

Take the same precautions as you would if you were sick:

• Stay home and avoid public places when sick (i.e., social distancing).
• Cover mouth and nose when coughing and sneezing.
• Wash hands frequently.
• Disinfect frequently touched surfaces.

More information from the New Hampshire Department of Health and Human Services about coronavirus can be found here on the department's website.

• Guidance to schools can be found can be found here.
• Instructions for returning travelers to self-observe for symptoms of COVID-19 are available are available here.
• For more information on COVID-19 in NH, visit its site here.
• For the latest information from the CDC, visit its site here.

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• Nashua Coronavirus: Having Problems With Rent? Reach Out Now
• NH Health Commissioner: 5 New Coronavirus Deaths Announced
• NH Coronavirus: 91% Negative: False Tests, Flaws, Something Else?

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