Gov. Chris Sununu announced plans Friday afternoon to lift some restrictions on the state's hospitals and businesses meant to slow the spread of COVID-19, citing what he characterized as an improving outlook for the disease in New Hampshire. More details on that announcement arehere.
Ahead of the governor's press conference, NHPR's Morning Edition Host Rick Ganley spoke with Lori Shibinette, commissioner for the Department of Health and Human Services about the state's response to the crisis and what's next.
(Editor's note: this transcript has been edited lightly for clarity.)
Rick Ganley: New Hampshire is still lagging behind surrounding states like Massachusetts and Vermont with the rate of people being tested. How are state officials planning to catch up?
Lori Shibinette: Yes. So we've spent the last week or so doing a pretty comprehensive strategy on really expanding testing. And, you know, ultimately what we want to do is make sure that the supply meets the demand, right? So standing up five, six centers, clinics around the state, really areas where there were gaps in services and really looking hard at that. So standing those five up. And then in addition, you know, Convenient MD has been great partners with us, really focusing on the long term care facilities, our mobile team at the state focusing on the long term care facilities. We know that's who's hardest hit in this pandemic. So really putting a ton of resources there.
And then really working with our hospital partners to get clinics up and going. Our partners at Manchester and Nashua Public Health, they've done mobile testing there with a goal of being around 1,500 tests a day on average. But ultimately that number needs to look like who's having any symptoms at all and how can we get them tested.
Rick Ganley: So you're trying to focus on the long term care facilities in particular, because that's where the biggest impact has been. I know, you're trying to ramp up testing in general as well. What's the general timeline for being able to complete the testing on those long term care facilities, to get everyone, employees and and residents tested?
Lori Shibinette: So, you know, it just depends on the geographic region and what the need is, right? So, you know, we've talked a lot about the fact that Rockingham and Hillsborough, we're hoping to test about 6,000 with over 6,000 staff. What we're not going to do, and we don't want to do this is to send a team of people into a long term care facility that has no [COVID-19 cases] at all and potentially expose those people. So if you're a facility that has not had a positive case of [COVID-19], we would not send a team in to test all of your residents, because it's just another point of exposure, right?
So, you know, the way we've been working with our mobile testing and our Convenient MD is as soon as you have one positive case, either staff or residents, we send our team in to test all the residents on that unit. We'll send Convenient MD or our mobile team over to test all the staff in that area. And what that does is it allows long term care to do what they know how to do, which is cohort their patients, cohort their staff, so that they can prevent the spread.
But you know, what we're seeing with COVID-19 right now is that, you know, there's still many asymptomatic patients and staff that it's really, really, really difficult to contain that spread within a facility. So, as I've said before, the fight for this virus is at the door, and we need to try to support our long term care facilities any way we can to prevent it from getting in to begin with.
Rick Ganley: But if that's the case, if you've got a lot of people who are asymptomatic, and you've only tested maybe once, you get a snapshot of it. Shouldn't the focus be on providing rapid testing multiple times to make sure that you do know who could be carrying this?
Lori Shibinette: Yep. And we are doing some of that. There are facilities that have had outbreaks in the state that we've done multiple sets of testing on. So we've had two or three facilities that have had, you know, pretty significant outbreaks. And our mobile team has been there, you know, two, three, four times in some cases. And at some point our regular testing has basically a 24 hour turnaround right now from the time that the lab gets it. And even, you know, the staff testing that Convenient MD has been doing has about a 24 hour turnaround. We've now gained the ability to send out our CST team, our civil support team, which is a mobile lab on wheels. And we've deployed them to long term care facilities to do that rapid 15 minute testing. So we are doing that right now.
I mean, we are still being able to do statewide, at all 70 of our nursing homes, rapid testing. There's just not the the equipment or the supplies available to do that. And nor is there a need, you know, to send lab or a team up to, let's say, Coos County or Carroll County, where the numbers have been very low and there's no evidence in some facilities that [COVID-19] exists. You don't want to bring a team into that facility and potentially bring an exposure in. So we want to keep them closed in and keep the staff healthy, keep the residents healthy, keep the visitors out, and keep anybody out that doesn't need to be there.
Rick Ganley: Commissioner, I understand what you're saying, but I can also hear in my head listeners who have relatives in these long term care facilities saying, you know, evidence pointed really early on to some long term care facilities being really vulnerable here. We're two months in plus here. We've got two thirds of the state's deaths have happened in these facilities. You know what went wrong?
Lori Shibinette: Oh, I don't think anything went wrong from a testing strategy point of view or from the long term care facilities point of view. I think that they've done everything that they can to really try to suppress the virus. I think the virus is just something that we're not accustomed to dealing with a virus that we can't see that is not symptomatic and that spreads so rapidly. I think that you're seeing the same results throughout the country that this is a struggle for, not just long term care facilities, but all congregate living settings.
It's a struggle to really try to get in and to contain that virus once it's in the door. So I think, you know, the long term care facilities have done everything that they know how to do, right? I've said several times that, you know, they've worked through influenza. And we've taken those, all of those practices that we've known for the last, you know, 50 to 100 years. And we've tried to apply those to [COVID-19] and [COVID-19], you know, is just more infectious than what what our practices are used to.
So we've adjusted as we've gone. You know, initially we said we would test in this not isn't just in New Hampshire, but across the country,we would test anybody that was showing symptoms. And very early on after our first outbreak, we said, no, we can't test just people with symptoms. We've got to go in and test everybody. And we've been doing that across the board as soon as there's a symptom. So it really isn't. What went wrong? It's really how can we evolve our techniques to fight this better? And we've been doing it in the state very rapidly. Decisions being made hour by hour at the department and in those long term care facilities to say, how can we do this better?
Rick Ganley: Commissioner, numbers from your department show that the virus continues to disproportionately affect communities of color here in the state. Why is that? And what's the state's thinking about that? Have these numbers changed the way that the department thinks about engaging with with communities of color, especially those with limited English proficiency?
Lori Shibinette: Yes. So part of our testing strategy was to bring in our Office of Health Equity, which absolutely has that lens on everything we do. So, you know, our communities of color and our minorities, you know, tend to live in our population centers in New Hampshire. So really focusing our testing and making sure that access to testing and and treatment and all of those things are happening in our population centers. So, you know, I just had a conversation with the director of public health in Manchester who's standing up mobile teams next week, specifically targeting those areas and those populations to make sure that they have the same access to testing or even more access to testing than the rest of the population.
Rick Ganley: Are you able to communicate with these communities. Are able to get, information to them in their languages?
Lori Shibinette: Yes. So our Office of Health Equity has made sure that we've had, you know, interpretation and translation services. We have those at our six sites throughout the state right now so that that communication is not a barrier to receiving testing.
Rick Ganley: Later today, I know the governor is expected to announce some relaxation of the social and economic restrictions that he's imposed to slow the spread of the virus. What advice have you given him on that?
Lori Shibinette: You know, it really is about going slow. And we'll see this when it when I talk about health care too this afternoon is that, you know, our want and our need in a lot of cases to just flex a little bit and ease off the restrictions, to do that we need to go slow. We need to take time in between steps to see what the impact is that of those decisions are. So, you know, that's the intent. It's small steps, baby steps at a time and really, really watching the data to see what difference that makes.
Rick Ganley: Are you comfortable with beginning that process?
Lori Shibinette: Yes. Yes, definitely comfortable with taking those small steps to see where this goes. You know, from the health care point of view, it's really important because what we've seen is for the last two months, we've, you know, delayed elective procedures. And some of those time-sensitive procedures then started grey between time sensitive and urgent. So being able to get to move people back into accessing health care safely is really important. And people need to be able to see their providers and get the diagnostic tests to manage chronic conditions. So just, you know, increase in capacity overall. You know, in the state just by a little bit so that we can get people to the to the services that they need to receive is really, really important.
