Tag: 210826

To be continued

What to know about the Delta variant

Dr. Jose Mercado, associate hospital epidemiologist at Dartmouth-Hitchcock Medical Center, answered questions about the Delta variant of Covid.

How concerned should we be about the Delta variant?

The Delta variant [is] classified as a variant of concern [and] is now the predominantly circulating variant in the United States. One thing that we are quite sure of is the increased transmissibility of the disease — the likelihood of one person infecting other individuals who are so susceptible to the disease — compared to the original strain. The thing that we still don’t know is the likelihood of the Delta variant causing severe disease and hospitalizations. We assume that it is more likely, but we need more data around that.

How prevalent is it in New Hampshire?

We do not routinely test … each positive test to confirm the variant … [but] there is a proportion of [positive tests] that the state [has tested for the variant], just to confirm the epidemiology of the disease … and what we’re seeing thus far is consistent with what we’re seeing in the nation: The Delta variant appears to be becoming, if not already, the predominantly circulating variant in our communities.

Does it spread the same way as the original strain?

The belief is that it still is spread through respiratory droplets. You may catch it when you are close to an individual who has the infection who is breathing out air that you are then inhaling … or is coughing and sneezing around you … or if you have [infected] respiratory droplets in your hands that you then transfer to your nose and mouth. The debate is whether it has the ability to spread as an aerosol — the difference between droplets and aerosol is the distance of how the virus can spread between individuals — and I don’t think we have necessarily confirmed that.

Who is at the highest risk of contracting it?

Unvaccinated individuals are at highest risk for acquiring a virus … and our elderly population and those who may have a weak immune system remain at the highest risk of severe disease.

How effective is the vaccine at protecting against the Delta variant?

The most recent data that we have received [from] the CDC is that the vaccine [initially] provided greater than 90 percent protection, [but] for new infections over time, we did see a slight drop in vaccine effectiveness … to about 80 percent. What is reassuring is that vaccine effectiveness against hospitalizations and severe disease has remained above 90 percent over time and with the introduction of new variants.

Does that mean Covid cases are trending up overall?

Most counties in the state are … at high levels of transmission. If you compare where we were back in the spring, where we started to see a drop, we’re now seeing an uptick of cases as we go into the fall.

Should vaccinated individuals continue practicing mitigation strategies?

Yes. … Now is really not the time to completely relax our mitigation strategies. … Data [shows that] even vaccinated individuals have the same amount of viral loads, compared to unvaccinated individuals, meaning they can still transmit the disease. … Following the CDC guidelines of wearing our masks, [practicing] hand hygiene and physically distancing when we’re not able to wear our masks is important for protecting individuals who are not vaccinated or have weak immune systems.

What is the current data on positive cases among children?

We are seeing more cases as well as more cases that lead to hospitalizations in children. This may be driven by [the fact that] kids younger than 12 years old are still part of our unvaccinated population. The hope is that, as the vaccine is approved for the younger population, that will start to help curb the rise in cases in younger individuals.

Are you anticipating a spike in cases among kids as they return to school?

Not if we’re able to follow the mitigation strategies. … When we resumed in-person learning, we were successful in keeping our kids safe, and it didn’t really result in a lot of outbreaks. … Data [showed] that exposures [among children] really came from community exposures, not exposures at school. … That’s why it’s important to continue to follow those mitigation strategies to reduce your risk of exposing yourself [and] potentially bringing it home.

Featured photo: Dr. Jose Mercado. Courtesy photo.

News & Notes 21/08/26

Covid-19 update As of August 16 As of August 23
Total cases statewide 103,462 105,302
Total current infections statewide 1,704 2,324
Total deaths statewide 1,395 1,402
New cases 1,345 (Aug. 10 to Aug. 16) 1,840 (Aug. 17 to Aug. 23)
Current infections: Hillsborough County 457 635
Current infections: Merrimack County 144 185
Current infections: Rockingham County 345 483
Information from the New Hampshire Department of Health and Human Services

Covid-19 news

State health officials announced 174 new positive cases of Covid-19 in New Hampshire on Aug. 23. The state averaged 281 new cases per day over the most recent seven-day period, an increase of nearly 50 percent over those from the previous week. As of Aug. 23, there were 2,324 active infections statewide and 107 current hospitalizations due to the virus.

On Aug. 23, the U.S. Food & Drug Administration fully approved the Pfizer vaccine against Covid-19 for people ages 16 and older, according to a press release. The vaccine, which will now be marketed as Comirnaty, also continues to be available under emergency use authorization for people ages 12 to 15, and for the administration of a third dose in immunocompromised recipients. “While millions of people have already safely received Covid-19 vaccines, we recognize that for some, the FDA approval … may instill additional confidence to get vaccinated,” acting FDA commissioner Janet Woodcock said in a statement. “Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.”

Affordable housing

The New Hampshire Housing Board of Directors approved funding for 16 affordable multi-family rental housing developments during the fiscal year ending June 30, which will produce or preserve almost 1,000 units of affordable rental housing in the state’s communities. According to a press release, Low-Income Housing Tax Credits — a federal program that encourages developers and investors to create affordable multi-family housing for low- and moderate-income families by using tax credits — and other federal and state funding will support these projects. LIHTC-funded housing accounts for about 95 percent of publicly funded workforce housing produced in New Hampshire, the release said. Other funding sources that New Hampshire Housing administers for affordable housing include the federal HOME program and Housing Trust Fund, the state Affordable Housing Fund and tax-exempt bond financing. “The state and federal funding sources that New Hampshire Housing provides are essential financing tools for public and private developers to create and renovate affordable rental housing throughout the state,” Dean Christon, executive director of New Hampshire Housing, said in the release. Local projects include 42 general occupancy units in six townhouse-style buildings on Village Street in Concord, with; 74 general-occupancy units in Woodland Village in Goffstown; and 11 supportive housing units in the Nashua Soup Kitchen and Shelter, an adaptive reuse of a former school into units that will provide housing for people experiencing homelessness.

Drive sober

New Hampshire has rolled out this year’s Labor Day impaired driving high-visibility enforcement campaign, where drivers can expect to see increased law enforcement on the road now through Sept. 6 specifically targeting impaired drivers. The Drive Sober or Get Pulled Over initiative includes education efforts like messages on highway message boards, radio advertisements and social media public service campaigns, according to a press release. The New Hampshire State Police will work with 63 police departments for the border-to-border, statewide saturation patrol effort to reduce the number of crashes, injuries and fatalities due to impaired driving. Last year, 39 people died in alcohol-related crashes on New Hampshire roads, the release said. The New Hampshire Office of Highway Safety has several recommendations, including calling 911 if you see an impaired driver on the road; designating a sober driver or using a ride service; acknowledging that buzzed driving is drunk driving; and taking the keys of a friend who is about to drink and drive and making arrangements to get them home safely. The campaign is being funded by the New Hampshire Office of Highway Safety and grants from the U.S. Department of Transportation’s National Highway Traffic Safety Administration.

Granite Tax Connect

The third and final phase of Granite Tax Connect — the New Hampshire Department of Revenue Administration’s new online user portal and revenue management system — is now up and running. According to a press release, Granite Tax Connect provides an improved online experience to approximately 148,000 New Hampshire taxpayers, tax preparers and customers of the Tobacco/Smokeless Tobacco Tax, Real Estate Transfer Tax, Private Car/Railroad Tax, Utility Property Tax and Low to Moderate Income Credit. The system allows people to complete tasks online, such as filing taxes electronically, scheduling automated online payments, checking on the status of returns, payments, refund and credit requests and more. It also allows customers of certain tax types to complete additional tasks; wholesalers, manufacturers, taxpayers, practitioners and all DRA customers associated with the Tobacco/Smokeless Tobacco Tax, for example, can renew licenses, pay taxes electronically, view reports such as the Tobacco License lookup and License Additions/Deletions and more, according to the release. The state’s e-file for counties will no longer be available as of Jan. 1, so it is imperative to create an account prior to that date, the release said.

Police oversight

A commission at the New Hampshire State House has formed to try to create an independent police oversight body that would process reports of police misconduct in the state, according to WMUR. The effort has been backed by Gov. Chris Sununu and the Law Enforcement Accountability Commission established last year, but has not yet made it through the Legislature. Chaired by Attorney General John Formella, the commission has until Nov. 1 to work on the proposal.

Cyberthieves

The Town of Peterborough had $2.3 million stolen in two cases of cybertheft, according to NHPR. First $1.2 million was intercepted while being transferred from the Town to the ConVal School District. Investigation by the U.S. Secret Service Cyber Fraud Task Force revealed that the thieves had posed as school district staff and used forged documents and email accounts to access the transfer. Several weeks later, the thieves used a similar tactic to intercept funds being transferred to contractors for construction on the Main Street Bridge project. The money cannot be recovered by reversing the transactions as it was converted to cryptocurrency, and it has not yet been determined whether insurance will cover any of the losses. The Town’s total budget for this fiscal year is a little over $15.8 million, according to the article.

Downtown Concord has two new art pieces on North Main Street. According to a press release, “Into the Wind” and “Sunflower from Mars,” both created by Chris Plaisted, have been installed in front of The Works Cafe and near The POST Downtown and Parlor Salon, respectively. The sculptures are part of the 4th Annual Outdoor Sculpture Exhibit, Art on Main, a free, open-air, 24/7 year-round outdoor art exhibition, the release said.

All online processing fees, including fees for vehicle registrations, taxes and parking tickets, will be waived for Manchester residents for the next year, according to a press release. “By waiving online service fees, we’re hoping more residents who may be nervous about the rise in Covid cases take advantage of the convenience of engaging in city services online, rather than coming into City Hall in person,” Mayor Joyce Craig said in the release.

More than 275 children swam, biked and ran in the annual Kid’s Try-athlon at the Bedford Town Hall and Bedford High School on Aug. 15, according to a press release. The event benefited Friends of Aine, a nonprofit organization providing bereavement support services to grieving children, teens and families.

New Hampshire’s first finding of West Nile virus this year was detected in a mosquito batch in Salem on Aug. 3. According to a press release, the New Hampshire Department of Health and Human Services has elevated the risk from the baseline level to low.

Primary care

Some of us may remember Marcus Welby, M.D., the TV show that highlighted the general practitioner who made house calls. I have vivid early childhood memories of my own family’s doctor, Dr. Gerry, coming to the house to tend to a sick family member. Years later I learned to make house calls, first as a medical student and then in my family medicine residency training. I can recall important moments visiting patients in their homes when I practiced in Lawrence, Massachusetts. My husband, also a family physician, recently mentioned a house call he made; this got me wondering why the thought of house calls provokes such strong and fond memories. I believe it is that they highlight the trust I had — first with my family doc, and then the trust I engendered with my patients.

Amid the flurry of misleading claims and disinformation about the Covid vaccine, we’re hearing recommendations to speak to one’s primary care provider for information we can trust about the Covid vaccine. A survey by the Larry A. Green Center revealed that people who were previously vaccine hesitant who then got vaccinated reported that receiving advice from their own doctor is what changed their mind. It makes sense that receiving advice tailored to one’s own health profile in one-on-one conversations provides a supportive and caring space to address questions and concerns in a way that results in increased confidence.

A robust primary care system is important for having better health as a country overall, and the essential elements of primary care are that it be comprehensive, continuous, accessible and coordinated. In other words, they’re always there for me when I need them, no matter what the complaint or concern, they can address most of my needs directly, and when additional help is needed they can connect me with who I need to see while keeping track of the various providers and recommendations to address my needs — all while supporting my ability to understand and take care of myself. These essential elements together contribute to building authentic relationship, and relationship is foundational to trust.

When people are talking about complex things like the Covid-19 virus and the pandemic we’re in, it’s important to have a trusting relationship with a health care provider with true expertise in medical science — whether an individual person or a practice — to help us sort through the noise presented to us by social media and politics. While house calls are less common today, trust is still at the center of the doctor-patient relationship. Your primary care provider stands ready to give it to you straight about the Covid-19 vaccine and is prepared to answer any questions you might have with your best interests at heart.

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