NH's winter COVID surge is receding, but experts urge continued caution

Paul Cuno-Booth, The Keene Sentinel, N.H.
·5 min read

Feb. 20—The pandemic's devastating winter surge has ebbed over the past several weeks, with fewer New Hampshire residents catching and dying from COVID-19.

But the state is still seeing hundreds of new cases per day, and medical experts warn that public-health precautions are as important as ever.

"This is encouraging," Dr. Jose Mercado, the associate hospital epidemiologist at Dartmouth-Hitchcock Medical Center in Lebanon, said of the recent trends. "This is what we're hoping for."

But with the virus still circulating — including a new, more contagious variant — "now is not the time to kind of relax and change behavior," Mercado said.

A receding surge

Cases in New Hampshire started rising sharply around late October, peaking at more than 800 new infections per day for stretches of December and January.

The rise in cases was followed by increasing hospitalizations and deaths. The state's coronavirus death toll doubled in just two months, from 526 on Nov. 30 to 1,057 at the end of January.

Those metrics have all been declining for weeks now. New Hampshire is averaging around 350 new cases per day at present. The percentage of tests that come back positive has also fallen, from above 10 percent in early January to below 5 percent this month.

Made with Flourish

Hospitalizations are down, too, from their high point in early January, when New Hampshire hospitals held more than 330 COVID patients at one time. On Friday, that number was 116.

Made with Flourish

Deaths have also slowed significantly and are now averaging about two per day — down from more than 10 per day at times during late December and January.

Made with Flourish

Those figures mirror nationwide trends, which show a similar, steep drop in new cases over the past month.

"I think we are in a much better place compared to where we were in Nov-Jan.," Dr. Aalok Khole, an infectious disease specialist at Cheshire Medical Center in Keene, said via email Thursday. "We are all being cautiously optimistic. Numbers are trending down across the state and the nation but we are definitely not out of the woods yet."

He and Mercado cited several factors that may have contributed to the decline. A small but increasing share of the population has been vaccinated, and many others have already recovered from COVID-19, meaning more people have at least some level of immunity. Both doctors also mentioned the end of the holiday season and increasing compliance with mask wearing, social distancing and other mitigation strategies.

Even with the recent decline, case numbers are still much higher than they were in the summer and early fall, before the winter surge began; more than 3,000 people were considered actively infected as of Friday.

And hospitalizations are about where they were during the worst of last spring's surge.

New Hampshire's hospitals held exactly as many COVID-19 patients on Thursday as they did on May 13 — which set a springtime record, State Epidemiologist Dr. Benjamin Chan pointed out at a news conference Thursday afternoon.

"Just of note, this number, 126, was the number of people hospitalized at the peak of our first wave of the pandemic back in April and May," he said. "So an improvement from where we were, but still high levels of hospitalizations, high levels of community transmission still throughout the state."

Chan said new cases had ticked up over the past week, driven partly by testing at colleges and universities. Of the 461 new cases the state announced Thursday, 141 were linked to higher-education institutions, he said.

Vaccination and variants

For many, the deployment of vaccines has offered a glimmer of hope. At the same time, new, more contagious variants of the novel coronavirus are spreading in the U.S.

While cautiously optimistic, both Khole and Mercado said there's a long way to go before life returns to anything like normal.

Two months into New Hampshire's vaccination campaign, more than 150,000 people — about 11 percent of the state's population — had been at least partially vaccinated as of Thursday, Elizabeth Daly, chief of the N.H. Bureau of Infectious Disease Control said at the news conference. Around 72,000 of them had been fully vaccinated, having received their second dose.

Daly added that first doses have been administered at every New Hampshire long-term care facility enrolled in a federal partnership with retail pharmacies, and 75 percent have also gotten second doses. Gov. Chris Sununu said vaccinating residents of those institutions — who have been especially vulnerable to the virus — may partly explain the sharp decrease in new deaths.

But it will still be some time before enough people are vaccinated to reach herd immunity, and in the meantime, experts said it's essential to keep wearing masks, practicing good hygiene, avoiding gatherings and taking other protective steps to reduce viral spread.

That's especially important with the arrival of more contagious variants, experts said. A week ago, state health officials announced New Hampshire's first known case of the B.1.1.7 variant. First identified in the United Kingdom, B.1.1.7 spreads more easily than other strains, according to the Centers for Disease Control and Prevention.

"It is key to ensure that vaccination outruns the spread of these variants," Khole said.

Even those who have been vaccinated should continue to follow public-health protocols, Mercado said, partly because scientists aren't sure yet whether people who have been vaccinated can still infect others asymptomatically.

"It's not really a guarantee that you won't spread the infection," he said, even if the vaccine keeps you from getting sick.

Mercado said the rollout of vaccines and falling case numbers should not lull people into complacency. Easing up on precautions now could spark another surge, he said.

"I'm hopeful that we are on the path to back to normal, that there's light at the end of the tunnel," Mercado said. "But I think that tunnel is still very long."

Paul Cuno-Booth can be reached at 352-1234, extension 1409, or pbooth@keenesentinel.com. Follow him on Twitter @PCunoBoothKS