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'We Need People To Continue To Come Out And Be Vaccinated:' N.H. Doctor Looks Over Pandemic Horizon

Dan Barrick / NHPR
A sign in a story in Littleton, May 15, 2021.

COVID-19 cases are at their lowest level in months in New Hampshire, and more than half of the state's adult population has now received at least a first dose of vaccination. While the pandemic is certainly not over, the signs are good. So where are we now in the pandemic, and what do things look like as we head into summer?

Dr. Michael Calderwood, infectious disease physician and chief quality officer at Dartmouth-Hitchcock Medical Center spoke with Morning Edition’s Rick Ganley.

Rick Ganley: When Gov. Chris Sununu lifted the state's mask mandate last month, there were many concerns among public health officials about a possible rise in transmission several weeks later. Daily COVID case counts in New Hampshire have continued to fall. What reasons do you see for that for that drop in cases?

Dr. Michael Calderwood: So I think that it really is worth highlighting where we are. We're seeing a lot of very positive trends, as you mentioned. And the first thing I'll say is that we've now had three days in a row with less than 100 cases of COVID-19 across the state. And we really are back to where we were in October of 2020. We are averaging less than 100 cases per day over a seven day period. We have under 50 people hospitalized across the entire state and that continues to go down. Our positivity in terms of testing is the lowest it's been, again, since October. And there are a lot of reasons for this.

I think that part of it is that we have done very well with vaccination. In the state of New Hampshire, we have 58 percent of the overall population that have had at least one dose and approaching 50 percent that are fully vaccinated. And we have to understand that includes some members of the population that have only recently been approved for vaccine. And so we see with each week that number goes up. I think probably the thing that really heartens me the most is that we really are seeing a flattening in terms of the number of people on a daily or weekly basis that are dying from this illness. It's estimated that it's probably about 2,800 to date that have died from COVID-19 in the state of New Hampshire. We know that it will be higher than what's actually reported. So that is a real big number. But we think that that number will not continue to rise significantly in the months ahead.

Ganley: The overall cases and deaths have remained low compared to earlier this year. People are still catching COVID and some are still dying from it, as you said. What do we know about those fatalities, and are they largely among unvaccinated people?

Calderwood: We are definitely seeing a shift towards those that are younger and those who have chosen not to be vaccinated. And so what we have seen in the state of New Hampshire is very similar to what has been seen across the country: The vaccines work. And so when people are vaccinated, they are protected, they are not falling ill, they're not transmitting to others. They're not being hospitalized and they're not dying.

Ganley: How does the vaccination rate here in New Hampshire compare to your expectations? Are we where you thought we would be right now?

Calderwood: You know, I think there's a lot of discussion about really wanting to be at that 70 percent. When we look at the variants that are circulating right now across the United States, the vaccines are about 90 percent effective. If you were to calculate out how many people would need to be vaccinated in order to prevent spread with the current variants, that 70 percent number is around where we need to be. And, again, we're at only about 50 percent that are fully vaccinated. So we need another 20 percent to get to that number.

I do worry a little bit if that vaccine effectiveness were to drift down into the 70 percent range, and there are some variants that are out there where that may be true, we actually would need to vaccinate over 80 percent. So we need people to continue to come out and be vaccinated.

And you will see that the numbers, like they did last summer, will look better. We know that it is safer to do activities outside. We know that the mask recommendations, particularly in indoor environments, where you don't know if those around you are vaccinated, have absolutely played a role in reducing things. And we know that with each week as we vaccinate more people, this is going to reduce our overall infections. I worry as we hit the other side of the summer that if we really haven't gotten up to that 70 or 80 percent, that we may be at risk in the fall. And that's what we're trying to prevent.

Ganley: What about schools, as we look towards September? Where do you think we'll be?

Calderwood: When we think about where we're seeing the highest risk, it really has been in middle school and high school children. We are not seeing as much severe illness in those of elementary school age. And in fact, through the year, we've had many schools that have operated in person. And most of the transmission is occurring outside of the school. I will say, as we go to next fall, it is my hope that actually we will not need to have masks in the school. But that will really be determined by our total level of vaccination and community spread. If that gets low, if we can get enough of those who are eligible vaccinated, we will be without masks in the schools next fall.

Ganley: Well, what about that vaccine hesitancy? We're starting to see vaccine distribution now in local pharmacies and doctor’s offices. Is that helpful in getting some people over the fence that may be hesitant?

Calderwood: Yes, and I think there are different reasons, and not everyone is hesitant. Some of this is access. We do recognize that when we've had these state fixed sites, even though they've done an incredible job to really get large numbers through and to have a very inclusive ours, we know that some people have difficulties with the technology and being able to sign up, that some people feel more comfortable doing this through their primary care office with people they've known for years, and to have those conversations. And so as you can begin to make vaccine more widely available out in the community, those conversations can occur, and we can remove some of those access issues. And we hope that that will really drive up the numbers in terms of those who will be vaccinated.

For many radio listeners throughout New Hampshire, Rick Ganley is the first voice they hear each weekday morning, bringing them up to speed on news developments overnight and starting their day off with the latest information.
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