Rising cases, masks, & ‘long haulers:’ 7 takeaways from NH state epidemiologists

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Dr. Benjamin Chan and Dr. Elizabeth Talbot during an appearance on NHPR’s The Exchange on March 5, 2020 – before emergency declarations on COVID-19, and before recommended mask use. Dan Tuohy/NHPR

Story Produced for NHPR’s the Exchange, a Member of


State epidemiologist Dr. Benjamin Chan and Dr. Elizabeth Talbot, infectious disease specialist at Dartmouth Hitchcock Medical Center, joined The Exchange on Oct. 28 to answer listener questions about COVID-19 in New Hampshire ahead of the holiday season. 

Here are some highlights from that conversation. You can also listen to the full show on-demand, and read a transcript of the discussion. 

The following is edited lightly for length and clarity. 


Rise in cases partly due to more clusters

Dr. Chan: It’s not just due to testing.

Testing is readily available, and people can access testing all throughout the state, and we’ve set a low bar for testing in our colleges, universities, and our kids in K-12 schools.

But what we are seeing is the number of hospitalizations beginning to rise. We’re seeing the number of people dying from COVID-19 beginning to rise again after a lull during the summer.

Part of this is because we’re seeing more clusters, and COVID-19 being reintroduced back into long-term care facilities and vulnerable populations.

On top of that, our contact investigations are identifying more and more people coming into close contact with someone with COVID-19. 

There are multiple reasons, multiple data points that community spread is increasing. It’s not just increased testing.

The ‘high yield’ time to get tested after possible exposure.

Dr. Talbot: The typical incubation period – that is, the time from exposure to the time you might become contagious or symptomatic, is five to seven days following exposure – that is the most high yield time to be tested.

Should college students travel home at Thanksgiving? Take precautions.

Dr. Chan: We’re simply recommending that people take the appropriate precautions and that the person coming home from out-of-New England is recommended to quarantine, meaning not go out in public places…

We want to stress that those social gatherings are situations that are high risk, so we continue to recommend that those social gatherings be a limited number of people, preferentially outdoors, though that may be difficult. And if people are indoors, practice social distancing and good hand hygiene and wearing face coverings when possible.

There’s little in-school transmission

Dr. Chan: There’s very little in-school transmission. I think we have a total of about five small clusters that have occurred within K through 12 schools over the last two to three months.

There’s optimism for a forthcoming vaccine

Dr. Talbot: There are four late-stage (phase three) vaccines that there’s much optimism for, and even a fifth that is about to enter into late-stage trials, and will need to show a safe and effective vaccine.

I want to convey that we are working hard to put together an equitable, appropriate distribution plan with the assumption that we will get that safe and effective vaccine in the coming weeks and months. We’ll prioritize the high risk, those who suffer the most from illness and death for this vaccine. And also, our frontline health care workers deserve our protection first with this vaccine.

Masks work. Period.

Dr. Talbot: There is no controversial data, there is no evidence against masks. In fact, all the evidence that is coming to us from every setting is that proper masking works. So we have an effective tool that studies show us is not just intuitive…

We’re seeing arguments and fights and the conflict over masks that is not productive, but I continue to hope and believe that evidence will show people that this is effective, there is no question any longer as to if this is effective.

What about ‘long haulers?’ There’s evidence health challenges stick around for some people

Dr. Chan: This is not just people that are older, or people with chronic medical conditions. There is evidence that even in young, healthy people, COVID-19 can cause long-term health complications and health problems…

It’s not just issues of chronic fatigue, or sometimes what people call “brain fog,” difficulty concentrating. We’re hearing reports of chronic lung problems, chronic cough and difficulty breathing and damage to the lungs, even heart injury, where there’s heart muscle inflammation that can lead to long term cardiac problems…

This is one of the reasons we continue to stress that people take this pandemic, this virus, very seriously. A lot of what we’ve noticed in the last couple of months are people relaxing restrictions because people may not think it poses a significant health threat to themselves or their children or their teenagers.

But we want to put the message out there: it’s not just about community spread. It’s not just the fact that somebody can get COVID-19 and spread it to other people in the community, potentially more vulnerable individuals. 


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