Two Manchester hospitals at the center of New Hampshire’s COVID-19 response have identified new outbreaks among patients and staff not directly connected to their coronavirus treatment units.
In a joint statement Friday afternoon, Elliot Hospital and Catholic Medical Center said they are in the process of testing, contact tracing and otherwise assessing the scale of the outbreaks at their facilities after discovering initial infections earlier this week.
At Catholic Medical Center, at least seven patients and seven staff within a general surgical unit tested positive this week. At least one of those staff members was symptomatic at the time they were tested, according to CEO Dr. Joseph Pepe, but that person was already home from work and not on the job while symptomatic.
All of the patients were asymptomatic at the time they were tested, Pepe said, and the initial cases were detected through routine screening to evaluate patients for possible transfer to long-term care facilities.
“It just shows us COVID-19 is really still out there in the community, and you don’t always know who has it and who can transmit it,” Pepe said in a phone interview Friday afternoon.
As a precaution, CMC is now testing more than 600 employees and putting some time-sensitive surgeries on hold until at least next week. In the event that CMC needs to take extra time to control its outbreak, Pepe said it will work with patients to arrange the procedures they need at other facilities.
At Elliot Hospital, five patients in the geriatric psychiatry unit also tested positive for COVID-19 this week.
Elliot Hospital President Dr. Greg Baxter said the first case was identified at the start of the week in a patient who was displaying symptoms of COVID-19, including a fever and cough. Two more positive cases emerged in the following days, Baxter said, and by Thursday night the hospital was working on testing the entire unit.
“We’d already cohorted the patients who had tested positive and were symptomatic,” Baxter said. “And then [the plan] was to test all patients on that unit and then test all staff who had been in contact with any of those patients.”
Test results are still pending for many of Elliot’s tests, Baxter said, so it’s not clear how many patients or staff are infected. While managing a COVID-19 outbreak is difficult in any healthcare environment, Baxter said doing so in a geriatric psychiatry unit is especially precarious.
“Many of these patients, not all, but many of them have cognitive dysfunction, various types of dementia,” Baxter said. “And getting them to comply with hand hygiene and mask wearing and not touching can be really challenging.”
Manchester, home to both CMC and Elliot, has been hit harder by COVID-19 than any other community in New Hampshire. As of Friday morning, it was the site of at least 442 active cases, more than four times the number recorded anywhere else.
On any given day, Pepe said, CMC has been treating around 30 coronavirus patients, while Elliot has been averaging around 21. At most other New Hampshire hospitals, those numbers are in the single digits.
Both CEOs said their institutions are better equipped than a month ago in terms of having the kind of protective gear needed to manage the outbreak, but it’s far from business as usual. Pepe said CMC staff are reusing N95 masks in certain low-risk procedures — which is in line with current CDC guidance but would have been unheard of in a pre-COVID world.
“In normal times, we would only use an N95 once and throw it away,” Pepe said. “Now every hospital around is doing this, but these are not normal times.”
Beyond a strained supply chain for protective gear, Pepe said the even more acute shortage is in staffing, which has been under added strain after the hospital furloughed hundreds of employees due to COVID-related financial pressures.
“Sometimes we don't have enough staff to treat the patients,” he said, “so we have to keep trying to pull them from other areas.”