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Cases of Covid-19 are rising in states across the country, and in New Hampshire, there is evidence of increasing community transmission.
The state’s two largest cities, Manchester and Nashua, are both experiencing this community transmission. Spokeswoman for the New Hampshire Department of Health and Human Services (NH DHHS) Laura Montenegro stated via email Friday that the densest population of residents in the state reside in Nashua and Manchester, so increased cases in those two cities would be expected.
She explained how officials are seeing that places where many people congregate together are high-risk settings, more so if they are inside. These sorts of settings can include weddings, sports teams, birthday parties, churches or any variety of gatherings.
“That risk increases if those individuals aren’t wearing masks and if they are singing or yelling or sharing cups,” Montenegro stated.
According to data last updated Friday on the NH DHHS website, the number of COVID-19 cases in New Hampshire stood at 8,970 with 450 deaths. The state’s total current cases of Covid-19 stood at 585.
Additionally, more than half of the states across the country are reporting a rise in new positive cases this week as well.
“We believe that there is also evidence of increasing community transmission, especially in the southern communities and southern parts of our state, in particular Hillsborough, Rockingham and Strafford counties,” State Epidemiologist Dr. Benjamin Chan said during a press conference held Thursday. “As we identify people with Covid-19, we continue to conduct public health contact investigations on each and every person to identify close contacts who are then tested to identify additional infection.”
The state learned of an outbreak of COVID-19 cases at the Gate City Church on Main Street in Nashua early this week, which has since resulted in 13 cases as of the end of the day Thursday, according to Director of the Division of Public Health and Community Services Bobbie Bagley. However, she added that this number is fluid because testing was done Thursday and Friday.
“Right now, we are trending even above that as more cases continue to be identified, and the reason why we’re seeing more cases identified is because we’ve been doing testing,” Bagley said Friday.
Since city officials learned of this outbreak on Oct. 5 the city’s public health department has been working with the state and the church to try to identify anyone who might have been in contact with an individual with a positive case.
NH DHHS addressed this outbreak in a press release issued by the Bureau of Infectious Disease Control on Wednesday about potential community exposures connected to the positive cases at the church.
“DHHS and the Nashua Division of Public Health and Community Services are investigating these illnesses further and the church has moved to hosting virtual services only,” states the press release.
During a press conference held Thursday Bagley said that officials know someone attended a service that was infectious at the church but may not have known they were carrying the virus.
A multi-day prayer service was held at the church between Sept. 18-28 and Bagley said that the church followed the rules outlined by the state with regards to social distancing, making sure families were spaced six to ten feet apart and were wearing their masks.
“At one point during their service they did take their masks off once they were in their family units to sing, to have a good time praising God.” Bagley said during the press conference. “Singing, however, in an enclosed building is one of the riskiest exposure opportunities with the virus and although there was nothing that was intended to cause any harm, this situation did allow for extensive exposure at this church.”
Now, city health officials are urging people experiencing any signs and symptoms who know they’ve been at the church during that time period to seek testing. When these officials do their contact investigation they are looking to identify individuals that may have been at the church during those days, and are asking those contacts to self-monitor for signs and symptoms.
Officials are asking people to get tested in order to identify if there is further spread, and then asking people to go into isolation and then quarantine to make sure to slow the spread of COVID-19 down.
“Now, we are aware that there were over 100 folks that attended these meetings over that time period for the ten days and so there’s a potential for widespread and that’s why we’re asking people to cooperate with us by getting tested,” Bagley said during the press conference.
On Friday, Bagley said that for at least a month now cases have been on the rise across the state. As restrictions have been gradually eased back, what is being seen is increased activity with people gathering together doing social things. Additionally, she explained that moving into the fall and entering flu season people may have mild symptoms that they may not think are related to COVID-19, and so they continue engaging in social activities, some without wearing masks in some situations.
“Our masks are our first barrier to reducing the virus from making its way into our respiratory system and so, without having a mask on and with the singing there’s an opportunity for viral particles to be floating around in the air and then to be inhaled,” Bagley said Friday.
Clinics have been set up in Nashua this week to test individuals for COVID-19 as well, and as more people are checked out, case numbers have since risen. More positive cases are expected as more individuals from the church are tested.
“People come from Manchester, Merrimack, Amherst, folks that attend the church can come from any one of our surrounding towns and so our contract tracing will be extensive because of the number of people that attended,” Bagley said Friday.
Pastor Paul Berube of Gate City Church also issued a press release Thursday addressing the situation at the church stating:
“Please understand that we have diligently endeavored to follow State of New Hampshire and CDC Protocols. We implemented strict social distancing, physically removing more than half the seats in our facility. We screened our attendees for fever, provided hand sanitizer, required masks when proceeding to or from seats, and posted advisory signs. Each and every seat, handrail, and door knob in our facility was sprayed with disinfectant before and after each meeting. If these infections did occur in our facility, they did so notwithstanding the careful work of our staff, whose efforts likely mitigated even further spread of the infection.”
This recent outbreak comes soon after a similar situation occurred within Nashua City Hall where six positive cases were identified, including Mayor Jim Donchess. Bagley also said on Friday that the case involving the city hall outbreak was closed last week. She explained that city hall ended up closing for 14 days which gave an opportunity for people to be distanced, and so there was no further spread of cases in that scenario. Bagley said all six cases involved individuals who experienced mild cases and that there were no hospitalizations as a result of the city hall outbreak as well.
Moreover, Manchester Public Health Director Anna Thomas said that community transmission is occurring in Manchester and statewide. Moving forward, as case numbers increase, the city will be doing community testing, case investigation, contact tracing, cluster investigation, community outreach and education.
“From September 25 – October 2, we have experienced a relatively steady trajectory without major increases or decreases in documented cases with consistent testing rates in Manchester,” Thomas stated via email.
She added that the next 14-day period will close on Oct. 16. In any event, things being done locally include mobile community testing, ongoing contact tracing and surveillance and data analytics to name a few. Additionally, Thomas cited that the city activated their Emergency Operations Center and Stood up an alternative care site based on surge needs.
According to a weekly data update from the city’s health department, “New daily case counts for Manchester are calculated as three‐day averages to reduce reporting extremes (lows and highs) that may inaccurately bias the data. In the month of August, new daily case counts averaged four cases per day, and for the month of September, new daily case counts averaged 6 cases per day. To date, in the month of October, new daily case counts have averaged eight cases per day.”
Thomas believes it would have been helpful to have included the technical expertise of both Manchester and Nashua’s health departments in the creation of statewide reopening guidelines and metrics. She added that there is also a lack of understanding as to what entities are legally responsible for enforcing the reopening guidelines.
In terms of whether there has been any outbreaks in Manchester similar to what is happening at Gate City Church in Nashua, Thomas stated, “Not yet – but we will not be surprised if this happens in the future.”
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