COVID-19 Update by DJ Bettencourt

The following is an explanation of the uptick in COVID-19 case numbers, written by DJ Bettencourt, and shared on some of the Salem social media groups. DJ is a Salem resident, who is the Policy Director for Governor Sununu. This is reposted here with DJ’s permission.

Recently, it has been noted that New Hampshire’s COVID-19 numbers have been “going up.” To be exact, the number of new cases per day is increasing. Given this fact, I wanted to share an update on the situation and what the road ahead may bring.

In the first instance, case numbers are rising this month across the country and is not a surprise. Governor Sununu has been warning since mid-June that the science, data and history of pandemics foretold that the fall months would bring rising cases. This is now being borne out but the state is prepared to manage it.

There are a few important things to remember:

1.) Increased testing:

During the summer months, the state was averaging 2,000-3,000 tests per day. Since September, and the return of schools, the state is averaging 8,000-9,000 tests per day with some days reaching as many as 10,000 tests. At the expense of stating the obvious, the more tests you conduct the more cases you find. It also explains the recent demographic shift of individuals testing positive from older individuals to younger people who are carrying the virus asymptotically. Regardless, the state has greatly increased its testing capacity which has produced more positive cases.

Beyond this, the state has begun counting positive results produced by Antigen tests as part of our overall daily number. The most notable Antigen test is the “rapid test.” Previously, the CDC advised states against counting positives from Antigen tests because those tests were not as accurate as PCR (deep nasal) tests. However, advancements in Antigen testing have now made them 85%-90% accurate. Therefore, the federal government is now recommending that those results be considered confirmed cases. So while Antigen tests have been widely in use for some time, they are only recently being captured in our cases per day.

2.) Key Metrics:

When looking at the management of this pandemic there are three key metrics. The first is percentage positive. This is what equalizes the increases in testing. In that regard, the state still has a percentage positive rate of under 1%. This stands in contrast to the beginning of the pandemic when we had positivity rates of 30%-40%. Keeping our percentage under 1% remains a very good thing.

Second is hospitalizations. Everyone recalls at the beginning of the pandemic the term “flattening the curve.” The principle behind that was to ensure that the state’s health care infrastructure was not overwhelmed with individuals needing COVID-19 related hospitalization. In New Hampshire, our hospitalization rate remains very stable with between 10-20 people in the hospital for COVID-19 on any given day. To put that in perspective, our open hospital capacity is between 2,000-2,500 beds. As such, we have plenty of capacity to manage the current uptick.

Finally, we obviously look at deaths. September was a very good month. In that month, we had two instances where we went over a week with no COVID related deaths. October has started off poorly. It remains the case that 95% of COVID-19 related deaths involve individuals in Long-Term Care (LTC) facilities or older individuals with underlying health conditions. The state will be taking action soon to tighten up procedures around LTCs to protect those most vulnerable to the most serious consequences of the virus.

3.) What’s driving the numbers?

In addition to the recent inclusion of the Antigen positive tests in our daily count, our contact tracers have told us there are some additional dynamics driving the increased numbers. Most prominent are social gatherings, informal events, and get togethers. People have become more comfortable living with the virus and re-engaging with society and with their social circles. In many ways, this is a good thing. However, individuals lowering their guard is producing more informal events that turn into clusters and outbreaks.

So what’s the solution? It’s easy. People just need to take personal responsibility for themselves and maintain vigilance. Practice physical distancing, proper hygiene, mask wearing when appropriate and utilizing other common sense measures. There is no government solution to this one. It’s entirely on us as individuals.

4.) What about schools?

We are now well over a month into the school year and both K-12 schools and universities/colleges are going incredibly well. There were some early incidents at UNH that served as a lesson and since then there have only been sporadic cases. With K-12 schools, there have been additional cases that have certainly pushed the daily case count higher but there have been no large clusters or outbreaks.

This is a testament to the guidance the state issued, the perseverance of school administrators and teachers and the hard work of parents and students. There is no reason schools should not remain open at this time.5.) Should the increased numbers worry us? The increased numbers should concern us but do not justify panic. I’m going to be honest and straightforward, the numbers are going to continue to climb over the next couple months. However, we are ready to manage it.

We are miles ahead of where we were in March when the pandemic began. We have a much better understanding of the virus, we have adequate PPE, we have sufficient testing capacity and our healthcare infrastructure remains well able to handle this increase.

Additionally, this also explains why Governor Sununu isn’t considering any further widespread guidance changes. There could be tweaks to certain things based on what the data identifies as hotspots or problem areas, but because we have all the tools necessary to manage the recent increase, there is no need for dramatic changes at this time.

This was obviously a long post but I hope it helps to put the current situation in perspective.

~ D.J. Bettencourt

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