LITTLETON — Nearly two years into the COVID-19 pandemic, high active case numbers persist in Littleton and some surrounding communities as health care officials work to keep North Country residents healthy and safe.
Contributing factors include the vast majority of positive cases occurring in unvaccinated people, those who remain resistant to the vaccine, COVID fatigue by some who have become lax in masking, hand-washing, social distancing and avoiding large groups with unvaccinated people, and the more contagious Delta variants that makeup nearly all North Country and New Hampshire cases, Koren Superchi, vice-president of patient care services at Littleton Regional Healthcare, said Friday.
Locally, LRH is seeing high numbers across the board.
“I would say it is a little surprising and a little disappointing when we’re this far in,” said Superchi. “Our testing demand is higher than it’s ever been. Our hospitalizations are higher than they’ve ever been.”
And the acuity of those patients who are hospitalized is also high.
“We’ve had far more patients in the ICU than we have since this started,” she said.
Superchi spoke of treatment for COVID-positive patients at LRH, the booster shots for adults and new pediatric shots for children ages 5 to 11 that are available, and upcoming vaccine clinics at local schools.
“Right now, we have set up a dedicated space [at the hospital] to be able to do monoclonal antibody infusions,” she said. “We are having providers reach out to us via our COVID hotline if they have patients who test positive. We also are dealing with patients that we see through our own emergency department who fit the criteria for infusion.”
While patients needing infusions shouldn’t wait for days, the procedure does not need to be done immediately and can be within 24 to 48 hours, though sooner is better before patients develop symptoms, she said.
The infusion itself is about 90 minutes, with an observation period before and after, making for a process of about three hours.
“We’re doing about four and nine a day,” said Superchi. “We are very committed to providing this service to the community because if you’re positive and you receive monoclonal antibodies, it significantly decreases the likelihood of you needing hospitalization. The focus right now is to relieve some of the pressure that hospitals are feeling from patients with COVID and just all of the other stuff that patients come to a hospital for. We’re seeing a higher census now than at any point in the pandemic of both COVID patients as well as non-COVID patients. We’ve been tight on beds a lot lately.”
In addition to reducing the chances of severe symptoms in patients, the infusions help ease that burden on hospitals.
“Today, we have two COVID patients,” she said. “In the last week, we had no less than two and we’ve been as high as four. We definitely have been at the three and four more often than two. Four is the most that we had at any one time since the pandemic started.”
Currently, about 80 percent of LRH-hospitalized COVID patients are unvaccinated.
“We have good vaccination rates up here, but obviously we’re not where we need to be,” said Superchi. “Not being vaccinated and then the Delta variant being much more contagious has led to more cases.”
In the early days of the pandemic, hospitalizations across the nation involved a large swath of older people.
Now, in Littleton, it has been the younger group.
“The hospitalized patients we’ve had are generally younger, in their 20s, 30s, 40s, and 50s,” she said. “We’ve had some older patients being admitted, but overwhelmingly it is in the 20-to-50 age group.”
As older people have higher vaccination rates than younger people, she said there appears to be a direct correlation between the current number of active cases and LRH hospitalizations and the younger age bracket.
LRH patients are tested at the hospital’s urgent care clinic or drive-up testing site.
“Of the testing that we do, we track our positive rate each week, and our positive rate for this week is 14. 7 percent, and the average age of the positive person is 29,” said Superchi. “We had 74 positives this week and 27 of them are under 18. Then 25 of those were in the 19-to-39 age group.”
Youth Vaccines And Adult Boosters
While the monoclonal infusion is one weapon in the fight, the youth vaccines from Pfizer that LRH received on Thursday is another.
“We have been planning now for about a month or more with six local schools in our area,” said Superchi. “We will be going to the schools next Friday, Nov. 12. We’ve worked closely with the school nurses to set up clinics and will be going there to vaccinate kids 5 to 11.”
Any student 12 to 18 who wasn’t previously vaccinated can also get the shot, and adult staff members will be able to get the booster shot during the school visits.
The schools are Littleton School District (Littleton High School, Daisy Bronson Middle School and Lakeway Elementary School), Bethlehem Elementary School, Profile School, Lafayette Regional School, Lisbon Regional School, and the Monroe Consolidated School.
LRH is anticipating vaccinating a total of 150 to 200 students in the 5 to 11 age group, just in time for peak holiday travel season.
“We are excited to get in the schools,” said Superchi. “We did the same thing in the spring for the kiddos who were 12 to 18 and it was very well received. It makes it easier for parents. They don’t have to make an appointment, they don’t have to get out of work, and they don’t have to do all of the logistics planning. For us, because of the positives we’re seeing in that age group, we want to get them vaccinated. This will get kids their first dose before Thanksgiving so they’ll have some protection for the Thanksgiving holiday. And then we’ll go back to the schools on Dec. 3 to do second doses, so kiddos will be two weeks post their second dose the week before Christmas and kids will be fully immunized for Christmas.”
Superchi said if there are other schools outside of the immediate area that are interested in vaccine clinics they can reach out to her directly to get it set up.
Parents who might be uncomfortable about having their children vaccinated at school can make an appointment at LRH’s urgent care clinic.
“We are trying to consolidate clinics on Tuesdays and Fridays, but we are able to do doses seven days a week and we are also setting up a couple of evening clinics,” she said. “One is confirmed with staff and is set up is for Nov. 17 from 3 to 6 p.m.. There will be more information coming out about how to contact us to get scheduled for that. We are going to start scheduling patients next week for that clinic.”
Adult boosters shots for anyone over 18 are also available.
While the guidance initially stated boosters are for anyone with a medical condition that puts them at high risk, that guidance has changed to state that anyone over 18 who feels like they are at high risk from occupational exposure or have family members who are immuno-compromised is eligible to receive a booster, said Superchi.
The state has been very clear, she said — if someone needs a booster and they are at least half a year out from their second shot, they can get one.
“They’re not eligible until they are six months past their second dose and they have to bring their card with them to verify that they are in fact six months out from that second dose,” said Superchi.
Unlike the first two shots, patients can now pick which booster they want and can mix and match between Pfizer and Moderna.
The recommendation is that those who had the one-shot Johnson and Johnson get a Pfizer or Moderna booster for better protection.
Flu Shots And Winter Concerns
“There is concern for the winter months because of the increase in cases that we’ve seen and we haven’t even hit winter, when things typically get worse,” said Superchi. “We’re definitely expecting a much higher rate of flu for the winter. Last year, flu was pretty much nonexistent. Everybody was masking and nobody was going anywhere. That helped. But throughout the state, we’re worried about flu and we’re also worried about what the COVID numbers will look like heading into the dead of winter … We are strongly encouraging people to get vaccinated against the flu and COVID, and it is safe to receive the two vaccines at the same time.”
Health care officials say both vaccines will help ease the burden on hospitals.
“Hospitals are struggling right now with capacity throughout the state and the nation,” she said. “I think it’s super-important for people to get vaccinated. If they are not going to get vaccinated, then hand wash and practice good physical distance to try to decrease the numbers that we see.”
In Littleton, the number of confirmed active cases on Friday was 29.
Lancaster sat at 25, Colebrook at 26, Whitefield at 14, Haverhill at 14, Jefferson at nine, Stewartstown at nine, Franconia at six, and Lisbon at six.
In Littleton, school-related cases appear to be driving numbers there, with 13 active student cases and five adult staff cases at Lakeway Elementary School and four student cases and one adult staff case at LHS and the middle school.
On Monday, the Littleton School Board will convene an emergency meeting to revisit the district’s masking policy.
Masks are currently optional.