'COVID-recovering' patients and potential post-holiday surge add further stress to N.H.'s hospitals
State data suggests the latest surge in COVID-19 patients at New Hampshire hospitals has started abating in recent weeks. But at some of the state’s busiest facilities, health care workers say they’re still under intense strain as they prepare to enter a third year battling the pandemic.
At the end of December, 353 people were reportedly hospitalized in New Hampshire with active COVID-19 cases, down from a peak of more than 450 two weeks earlier.
But the New Hampshire Hospital Association says hospitals were also treating an additional 144 patients who were no longer deemed to have active COVID-19 cases but still required hospitalization as they recovered.
This figure — what the hospitals refer to as “COVID-recovering” patients — isn’t reported as part of New Hampshire’s official coronavirus metrics. But the New Hampshire Hospital Association has started sharing it as part of its own daily pandemic updates in recent weeks, as they put it, “to better reflect the COVID-19 burden on hospitals.”
A spokesperson for the state health department says they have no plans to reproduce the Hospital Association’s data on their dashboard.
Patty Labrie, a nurse and unit director who’s worked at Catholic Medical Center for more than 33 years, said caring for recovering COVID-19 patients can still be intense. As of Monday morning, she said her team was taking care of 16 COVID patients plus four who were recovering.
“The recovered COVID patients are still on oxygen and they still require a higher level of care,” she said.
Dr. Kevin Desrosiers, chief medical officer at Elliot Hospital in Manchester, said the range of care required by these patients can vary.
“Some of the patients will be exceptionally ill and may still succumb to their illness and die from COVID while others may be toward the end of their recovery period,” he said.
Right now, there are seven recovering COVID patients at Elliot.
At Concord Hospital on Monday, the number of recovering patients was even more significant. There were 44 patients “officially” hospitalized who have COVID-19. There were an additional 22, still recovering from the virus.
Unvaccinated individuals continue to make up the majority of COVID-19 patients filling New Hampshire’s inpatient and ICU beds. According to the New Hampshire Hospital Association, more than 60% of those hospitalized as of Dec. 31 were unvaccinated. About 26% were fully vaccinated, and vaccination status was unknown for nearly 13% of the remaining patients.
Dr. Matthew Gibb, chief clinical officer at Concord Hospital, said the breakdown of vaccinated and unvaccinated patients is the sharpest at the most intensive levels of care. Overall, he said, the hospital is seeing more breakthrough COVID-19 patients than it was a few months ago, but “the ICU patients are maintaining a 90 percent or higher unvaccinated status.”
Healthcare workers reported mixed feelings about what’s on the horizon heading into the new year.
At Catholic Medical Center, ICU Director Diane Kobrenski recalled the COVID patients that flooded her unit after Thanksgiving — and how many of those people ended up dying.
"Are we going to see the same thing? And there were two holidays, is it going to be twice as bad?” Kobrenski said during a Monday morning roundtable with hospital colleagues hosted by Sen. Maggie Hassan. “There's a lot of anxiety. It's almost like today, everybody's just like waiting and, you know, what is going to happen? When is it going to happen? Because we know it is.”
On the other hand, Dr. Kevin Desrosiers, at Elliot Hospital said this year, widespread access to vaccines means fewer people who contract the virus will have a severe case.
Desrosiers also said, compared to last year, the holidays may not have as much of a clear impact on case rates and hospitalizations because people are already gathering so frequently.
“The reality is people are probably gathering more regularly and continuously, whether it's at a high school basketball game or other things that last year they wouldn't go to,” he said.
The other big unknown, he said, is the severity of an omicron surge in New Hampshire.
New Hampshire hospitals awaiting more details around CDC quarantine guidance for health care workers
At the end of December, the CDC released new emergency guidance for health care facilities to prepare for a potential omicron surge.
The guidance shortens the COVID-19 quarantine period for health care workers who contract the virus but remain asymptomatic to seven days with a negative test. It also gives healthcare employers discretion to cut that period down further if needed.
Desrosiers said Elliot Hospital has not yet implemented the new guidance, but they are looking at how it could be put into practice. New Hampshire hospitals are also awaiting further state guidance, he said.
At Concord Hospital, Gibb said rates of staff out quarantining with the virus have been rising dramatically.
“We're worried that's going to have as much of an impact on our capacity to manage inpatient beds as the active COVID patients,” he said.
Reducing unnecessary quarantine time and bringing workers back will be good for the healthcare system, Gibb said. He is in favor of measures “that can accomplish that and that are based in good science.”
Federal Monoclonal Antibody teams coming to New Hampshire are delayed
Meanwhile, three New Hampshire hospitals were expected to receive federal staffers Monday to help administer monoclonal antibodies, an often labor-intensive COVID-19 treatment that can keep patients with the virus out of the hospitals.
The state has received word the teams are delayed, due to overwhelming demand across the country.
Elliot Hospital was one of those slated to receive a team. While the hospital is continuing to administer the treatment to their own patients, Desrosiers said the federal team will allow Elliot to reach patients outside their own health system.
The federal teams may arrive next week.
NHPR Reporter Josh Rogers contributed to this story.