Covid-19 Update 06-23-20
The recording of last night's session, COVID-19: Practical Guidance for Summer 2020, with doctors Elizabeth Talbot, Antonia Altomare, Kenton Powell, and Margaret Caudill-Slosberg, is avalable here:Video Recording
Access Password: 9V$S!&&5Audio Onlyhttps://us02web.zoom.us/rec/play/7pAkdrqvqD83SdCRsASDAf5_W9S0e_mshHBPqaYJyRqwWnkDMAHzZ7IaMeQW6AOJP1oag5sLxnCPnEIiAccess Password: 9V$S!&&5
Covid-19 Update 06-02-20,
As June begins I wanted to share some recent reviews and guidance from resources I believe capture what we currently ‘know’ about the SARS-CoV-2 pandemic. It is an evolving situation.
Here are some things we think we know about coronavirus:
- We’ll have to live with this for a long time.
- You should be wearing a mask.
- American public health infrastructure needs an update.
- Responding to the virus is extraordinarily expensive.
- We have a long way to go to fix virus testing.
- We can’t count on herd immunity to keep us healthy.
- The virus produces more symptoms than expected.
- We can worry a bit less about infection from surfaces.
- We can also worry less about a mutating virus.
- We can’t count on warm weather to defeat the virus.
NH “opening up” You can find the timelines and Guidance for various activities opened to date and in the future: Note that restrictions and modifications in “business as usual” apply across the board.
1) Governors declaration 5/1/20 Stay at Home 2.0 extended until 6/15/20.
May 4 Hospitals could resume elective and non-emergent procedures
May 11 Golf courses, Retail establishments, barbers and hair salons, drive-in theaters and dental
May 18 Attractions, restaurants, equestrian facilities
May 22 Amateur and youth sports; Childcare
May 29 Places of worship, driver’s education
June 1 Health and Fitness clubs, massage, tattoo parlors, beaches, acupuncture will be open.
June 5 Hotels, motels, B&B (non-NH residents will be asked to sign a waiver saying they have quarantined for 2 weeks before arrival)
June 22 Day camps
June 28 Overnight camps
And if you are still wondering about the benefits of wearing a mask a recent study showing the ejection of droplets during loud talking https://www.nejm.org/doi/full/10.1056/NEJMc2007800?query=featured_home have added additional support to those from coughing and sneezing. Talking, especially loud talking, can be associated with suspension of small droplets for up to 8 minutes, more than enough time if virus is present in those droplets to be a source of infection. A damp facecloth reduced this aerosol to nothing. There’s still a shortage of N95 masks but we know that surgical masks and cloth masks reduce the release of expired droplets in talking, sneezing and coughing forming a protective barrier that reduces the spread of viruses to those around you.
Anyone can request a COVID-19 test in NH, even individuals without symptoms.
There is drive-thru COVID-testing site set up in Claremont at the Middle School with the capacity to test 125 people daily with support from local partners and the NH National Guard. The site is one of seven and is by appointment only, and is open 7 days a week from 11:00am-7:00pm. Anyone who would like to be tested can call the state’s new coordination office at 603-271-5980 or register online here: https://prd.blogs.nh.gov/dos/hsem/?page_id=8479
Testing guidance for NH residents can be found at https://www.nh.gov/covid19/resources-guidance/testing-guidance.htm
Be well and stay safe. Margaret Caudill-Slosberg, EMD
Covid-19 Update 05-21-20
A major question on the minds of many in the community is “how can I be safer in this time of uncertainty as NH reopens for business?” The best advice I’ve read to date is from Atul Gawande, physician and author who published this article in the New Yorker on May 13th https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry.
What he recommends is to do what health care professionals have learned in the midst of functioning in their “hot zones” quite successfully given their intense exposure to SARS CoV-2 in the hospital.
The elements are all familiar to you: Hygiene, distancing, masks and screening. “Each has flaws. Skip one, and the prescription won’t work. But, when taken together, and taken seriously, they shut down the virus.” You did it successfully already plus “stayed at home”. It will take a bit of rebalancing if you decide not to stay at home now but it can be done if you remember these basics and strictly adhere to them.
Hygiene means washing (or sanitizing) your hands before and after you enter a public or group space and at least every couple of hours while in it. Disinfect high touch surfaces at least once a day in your home. (And don’t touch your face, nose or eyes until you have washed your hands thoroughly)
But exposure is also about not being too close to others because of the airborne spread of the virus causing COVID-19. This makes the 6 feet of physical distancing still important. Remember that loud talking, sneezing and coughing can spread the virus from an asymptomatic or symptomatic person with COVID-19 so a new strategy has been introduced and many of you have already adopted this new spring fashion statement: Masks
Wearing a mask or face covering is about keeping others safe and is a sign of respect for the life and health of others. It will also give you some element of protection so it's a win-win for you and those around you.
The COVID-19 infection is not going away but it has currently been reduced and we want to remain as safe as we can while re-engaging in more activities this summer so the idea of screening, the fourth element is presented in two ways, self-screening and testing.
Self-screening means being aware of how you are feeling particularly if you develop any new symptoms such as cough, shortness of breath, fever >100 degrees F, chills, muscle pain, new loss of taste or smell, or sore throat (CDC, May 13, 2020). If you are “off” or just not feeling well, stay home until the symptoms have improved and 2) get tested for COVID-19 if there is any question of a possible exposure causing your symptoms.
Currently you can be tested by calling your medical provider; or by registering at https://bit.ly/2WDwaoy or calling 603-271-5980 for testing at fixed sites across New Hampshire (the closest sites are in Claremont and Concord); or by calling ConvenientMD at 833-263-0131 (the closest sites are Littleton and Concord); or by callng ClearChoiceMD Lebanon 603-276-3261; or by obtaining a test kit at home through https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test . By being tested for COVID-19 you can determine if you need to isolate and can have your contacts identified so that the infection can be halted from spreading further.
While these 4 elements are not difficult to do physically, they can be challenging to practice when we are distracted by seeing friends and family, eating, shopping, and engaging in all the activities that used to be done so effortlessly. Do only what you are comfortable with doing and think you can manage. Take baby steps like you might have done already in grocery shopping or walking with friends. If you are at a higher risk because of age or chronic illness consider avoiding exposure to places where the numbers of people will be higher or occurring in a smaller space or where masks are not being worn.
As we move into this next phase of our new normal and make an effort to enjoy the summer ahead these simple acts performed together will make it safer to re-engage with family, friends and the public offerings available. And when the number of cases start going back up, be prepared to resume your more restrictive routine - we might be on this roller coaster for a while.
Margaret Caudill-Slosberg, EMD
Lyme Emergency Operations Center
Covid-19 Update 05-06-20From the latest "meeting" of the LCRT came this list of resources for families from both NH and VT. Compiled by Kathy Barth, School Nurse at Crossroads Academy:
Some other additional resources for families (in case you haven't seen these)
Covid-19 Update 05-01-20
Concord, NH – Today, Governor Chris Sununuannounced he is implementing a new, modified Stay-at-Home Order. Stay at Home 2.0 is in effect until May 31st. The state is taking steps to reopen the economy in a smart, phased approach that is supported by facts, science and data.
Each of the decisions and guidance documents below have been reviewed by State Epidemiologist Dr. Benjamin Chan and his team at the New Hampshire’s Public Health Department.
“The people of New Hampshire have taken this epidemic incredibly seriously,” said Governor Chris Sununu. “We have all played a small part in flattening the curve and slowing the spread of COVID19. We all know you are healthier at home, and that continues to be true, but we are also taking steps to reopen our economy in a smart, step-by-step approach that is supported by facts, science and data.”
Universal Guidance is being issued for any business that is currently open, or will soon be opening, under these next steps. This universal guidance will serve as the bare minimum standards which businesses must meet to maintain or begin operations. For specific industries with specific operational procedures, industry specific guidance for certain sectors can be found below.
All applicable industries are able to start opening up in incremental phases as determined by Public Health.
Universal Guidance can be found here.
Industries that can continue to operate with new, modified guidance:
Industries that can begin to phase-in services on May 4, 2020:
Industries that begin to phase-in, or expand services on May 11, 2020:
Industries that can begin to phase-in, or expand services on May 18, 2020:
NOTE: A copy of the Governor's presentation can be found here.
Covid-19 Update 04-26-20
Good Evening, Here’s an update from the Lyme Emergency Operations Center (EOC)
As the EOC marks the 8th week of being activated I wanted to reflect on some of the changes I’ve observed. We have come a long way in both our learning and response to the pandemic. There have been great acts of kindness; beautiful heartfelt writing and song; laments of loss and rediscovered joy found in the simplest of pleasures. And yes, there have been the moments of loneliness and agitation, symptoms of our prolonged isolation because we’re just "trying to do the right thing!”. So when I read about these same observations all around me and across the globe there is a confirmation that it is so very human not to like the current state of affairs and that gives me courage to persevere.
Because what choice do we really have? We know that the virus causing COVID-19 can spread quickly through the air even in the innocent gesture of speaking; that you don’t have to be symptomatic to infect others and that it is circulating in every county in the state, constantly infecting newly exposed individuals. We also know that the tiresome chants of “keep your distance”, “wear your mask”, “wash your hands” and “don’t touch your face” work to limit the spread of infection. You have been able to do that as a collective effort so give your self some well-deserved kudos!
What’s the immediate future look like at the state-level?
On Friday April 24, 2020 Governor Sununu extended his State of Emergency Order 2020-04 for 21 more days that should put us at May 15th, 2020. This order extends, among other things, the orders to:
(i) require public K-12 schools to transition to remote instruction and support, (ii) prohibit scheduled gatherings of 10 or more and require restaurants and bars to transition to take-out and delivery only, (iii) temporarily prohibit disconnection or discontinuance of certain services, including public utilities, in the event of non-payment, (iv) temporarily prohibit evictions and foreclosures, (v) dramatically expand access to State unemployment benefits for individuals impacted by COVID-19, (vi) close non-essential businesses and mandate that Granite Staters stay home with limited exceptions, (vii) expand access to Telehealth Services to protect the public and healthcare providers, and (viii) restrict hotels and other lodging providers to provision of lodging for vulnerable populations and essential workers.
The extension was necessary to allow time for the task force for opening NH businesses as well as the above mentioned services and protections to remain in place after the prior May 4th deadline. I expect we will hear more about the results of these efforts and the 'when and how’ NH might re-emerge in early to mid May.
There were some interesting observations reported in the news this past week:
1) House cats (in addition to tigers) and minks have now been shown to be susceptible to the SARS-CoV-2 coronavirus (the virus that causes COVID-19).
“Until we know more, the CDC is recommending the following:
- Do not let pets interact with people or other animals outside the household.
- Keep cats indoors when possible to prevent them from interacting with other animals or people.
- Walk dogs on a leash, maintaining at least 6 feet from other people and animals.
- Avoid dog parks or public places where a large number of people and dogs gather.
If you are sick with COVID-19 (either suspected or confirmed by a test), restrict contact with your pets and other animals, just like you would around other people.
- When possible, have another member of your household care for your pets while you are sick.
- Avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food or bedding.
- If you must care for your pet or be around animals while you are sick, wear a cloth face covering and wash your hands before and after you interact with them.”
2) Testing for COVID-19 infection and the antibody against the SARS-2 Coronavirus
The widespread capacity for testing for the presence of COVID-19 infection is still limited in the state of NH as it is in most states. Though the testing criterion for inclusion has increased among those at higher risk of exposure (e.g. health care professionals) and for those at increased risk if exposed (e.g. nursing home residents and those with chronic illness) it is not at a level necessary for widespread monitoring of any community spread as yet.
The antibody test for prior COVID-19 infection has generated considerable interest because of recent observations of a low-grade infection rate among those communities that have been tested in NY and CA. These tests will be useful ~3 weeks after a COVID-19 infection. Multiple antibody tests have been developed but their accuracy and consistency has been poor. In a recent study, whose pre-print appeared Friday, only 3 out of 14 tests were thought to be worthy of further evaluation? There is also another level of consideration for those who do have antibodies. Are they sufficient to infer immunity from re-infection and how long will that immunity last? Questions yet to be answered.
3) Some interesting (to me at least) devices noted in this weeks readings. (Early adopters, take note)
Kinsa QuickCare Smart Thermometer- this thermometer company has been tracking influenza outbreaks using an app that accompanies use of its “smart” thermometer for a couple of years. You can check it out at https://www.kinsahealth.co Though it hasn’t been applied to tracking COVID-19 infections there’s an intriguing possibility.
Pulse-oximeters- an opinion piece in the NYT’s earlier in the week discussed an observation that among patients with COVID-19 respiratory infections, low oxygen levels were not always accompanied by an expected shortness of breath. Using a pulse oximeter, a small device that can measure oxygen levels at the fingertip could potentially be used as an early warning device for patients. https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html
The COVID-19 tracking app being tested by the Massachusetts General Hospital, Stanford University School of Medicine and King’s College London that I mentioned a week or so ago is still looking for 267 more Grafton County residents to sign up. The daily tracking is very simple to do and takes less than 30 seconds. You can download the app by going to https://covid.joinzoe.com Once enough people register it has the potential for identifying infection spread through self-reporting to the app. One person reported back to me that the wrong county was entered after they registered it correctly but that was the only problem I have heard of locally to date.
Be safe, be kind and be good to yourself!
Emergency Management Director
Lyme Emergency Management
Covid-19 Update 04-15-20
According to the models, NH should have seen the peak of COVID-19 cases this week but thanks to your ongoing efforts to stay home, reduce your trips into the public and wearing masks when you do, we have not overwhelmed the hospital system to date. We know this isn’t easy and you have all made sacrifices.
As we move forward in response to this life changing pandemic it will be critical that these same behaviors continue until we can test more and keep those at greatest risk safe.
Rationale for covering your mouth and nose
Some of you may have read about some interesting studies that have observed how the COVID-19 virus could be spread through coughs, sneezes, breathing and speaking. Some coughs can eject virus-laden droplets and aerosol up to 16 feet away and sneezes up to 26 feet away from the person who has not covered their mouth and nose. Today’s New York Times 3-D simulation portrays this quite visually and helps to understand why masks can help reduce the spread and why covering ALL coughs and sneezes is critical.
New testing criteria
Yesterday in the health alert network (HAN) bulletin to health care providers the NH health department expanded their criteria for testing for the coronavirus that causes COVID-1 (inbold):
People in the following groups should be tested for COVID-19 if symptomatic (new additions in bold):
o Healthcare workers and first responders
o Family members of healthcare workers and first responders (because it impacts the ability for these individuals to return to work)
o Any person residing in, or who has worked or visited, a long-term care facility (LTCF) or healthcare setting
o Patients hospitalized with fever, respiratory illness, or flu-like symptoms
o Patients who may have had close contact with a large number of people
o Residents or employees of jails or prisons
o Essential workers who deliver, or directly support, home, community, or institutional care services
o Patients 65 years of age and older
o Patients with underlying chronic health conditions which puts them at increased risk of complications from COVID-19
This is so important! Expanding the testing so that we can quickly identify and contain the spread of this virus and Covid-19 is critical to understanding the effectiveness of the mitigation strategies. To date many people may have been infected with the SARS-2 coronavirus but unless they met the strict criteria were not tested. Now the determination of prior exposure and illness will depend on the development of antibody testing. Antibodies are made in response to an infection and the COVID-19 antibody tests are still being developed and tested. If we hear anything about antibody testing availability we’ll let you know.
Masks and face coverings
The surgical masks that were distributed this week by CCL and their neighborhood captains
are meant to assist you with covering your mouth and nose when out in public. If worn under a cloth face covering they can be kept clean and help as an additional filtration layer. When taking the mask off - lift the band up and away from your scalp; then down in front of your face, removing the mask in one movement. Avoid touching the inside or outside of the mask body. Place in paper bag to dry out. Wash your hands after removing masks and/or face coverings. Wash face coverings regularly.
Margaret Caudill-Slosberg, EMD
Covid-19 Update 04-10-20
We can assume that the virus that causes COVID-19 has been in the community and we are now beginning to see cases identified in Lyme. This was expected as no community has absolute protection from the spread.
In the next few days every Lyme household will be receiving an important mailing from the Town of Lyme’s Emergency Management and the Lyme COVID-19 Response Team. Please read and heed the “Getting to Well with COVID-19” page and use as a reference to guide your preparations in the weeks to come.
Our intention is to:
1) Reinforce steps you have been following to “flatten the curve”
2) Provide written guidance for wearing face coverings and
3) Provide steps to plan and prepare now for a COVID-19 illness in your household
New Hampshire and this community in particular have done an amazing job of slowing the infection and your sacrifice is acknowledged and appreciated. We will be making continued efforts through our community organizations to support those sacrifices and keep you safe as we go forward.
Margaret Caudill-Slosberg, Emergency Management Director
Town of Lyme
Covid-19 Update 3-27-20
From Margaret Caudill-Slosberg,
Emergency Management Director
Tonight we are going to start our Stay at Home/Save Lives in NH until May4th. I am very much relieved and this is why:
Looking at the models from the infectiousness of COVID-19 we could easily exceed 600,000 by the beginning of May a number that would overwhelm the entire health care system in NH if NO CONTROLS WERE IN PLACE.
Your participation in restricting contact, practicing physical distancing has slowed the spread a little, but more has to be done. The continued lack of sufficient protective garb for health care workers and first responders; the limited number of ventilators; limited testing and no specific treatment for the infection makes us very close to a crisis if we don’t continue the restrictions and possibly strengthen them.
Please understand that the most restrictive orders have not been given yet and if they were the number of cases could stay below the tipping point and not overwhelm the health care system health care. However the incremental restrictions have been rolled out because of the recognized burden borne by NH citizens. With no playbook to direct the perfect balance, the next order to stay at home EXCEPT for essential travel, plus continuing all the things you have been doing is what is necessary to slow the spread in the community and the state.
Let me also address the multiple inquiries I have been getting regarding the understandable fear that the coronavirus that causes COVID-19 is lurking everywhere, for example: should I let people pet my dog when I’m outside walking, should I sterilize my newspaper, should I wash my grocery packaging, can I safely eat the take-out food.
The answer is not perfect or absolute. The research that has identified the COVID-19 coronavirus on surfaces has been under laboratory conditions, controlling humidity and other conditions, and not in the “real world.” The virus has a sensitive fatty coat that makes it susceptible to drying, heating, freezing and disinfectants. Some surfaces like metal or plastic, non porous in nature, can have virus detected for 9 days, but are they infectious? are they alive? -we don’t know yet.
COVID-19 is now believed to be spread less by airborne transmission (suspended virus like dust particles in the air) and more by droplet transmission meaning when a person with infection breathes, coughs or sneezes those micro-virus-laden droplets are released into the air but drop within 6 feet of where that person was standing and on to surfaces around them.
So when a doctor or nurse or ambulance person has to put a tube down a patient’s airway with COVID who has stopped breathing that is a dangerous time for exposure. Kissing someone who is infected is a dangerous time of exposure. If you are out and about and touch a door handle or light switch that has been touched by someone with COVID infection who didn’t sanitize their hands and then touch your face, mouth, eyes or nose you could become infected if you don’t wash or sanitize your hands first.
So in general consider that with all contact of surfaces outside the home, wash hands regularly or use hand sanitizer. Disinfect shopping carts and don’t touch your face. Stay 6 ft away from others while in public. When you arrive home, clean your hands, disinfect knobs or handles and light switches you’ve touched before you washed hands.
If you feel better doing it, put groceries away then wash your hands; read the mail then wash your hands; read the paper then wash your hands and don’t touch other peoples dogs unless they give you permission (that’s probably for lots of reason). You have to draw the line somewhere and if you make your living space clean, limit your outside contacts to picking up the essentials you will do okay. If anything changes in terms of recommendations I will let you know ASAP.
Covid-19 Update 3-26-20
Concord, NH — Today, Governor Chris Sununu released Emergency Order #17, mandating the closure of all non-essential businesses and requiring Granite Staters to stay at home.
A copy of Emergency Order #17 can be found here.
A copy of designated “Essential Services” can be found here. Additional services may be designated as Essential and added to EXHIBIT A with written approval of the Commissioner of Business and Economic Affairs and the Governor.
Covid-19 Update 3-26-26
COVID-19 Update 3-21-20 Community Update #6
COVID-19 behaviors; transmission; take-out food safety; grocery packaging or packaging in general; disinfection of surfaces - in response to the many questions received on these topics.
The behavior of COVID-19 is being watched carefully in the US. The lack of adequate testing has frustrated best efforts but the case descriptions are being reported and reviewed. From this we see that the disease can affect people across the age range; less so in the very young and more significantly in the very old.
Symptoms requiring hospitalization have to do with the development of severe pneumonia so the symptoms of cough, fever and shortness of breath should be taken very seriously. The development of mild disease is by far the experience of the majority of COVID cases. But as we have seen elsewhere even the presence of a number of people with mild disease can quickly overwhelm the medical system and allow spread to the more vulnerable population. We will need to flatten that curve for many months to come.
Symptoms seem to be more variable than described in Wuhan, China so strict case descriptions have been challenging. Having a thermometer is very helpful and unfortunately in short supply but that will hopefully change quickly as well; keep looking if you don’t have one.
The disease can mimic many of the viral illnesses common at this time of year. So much so that some have taken to suggesting we assume any illness developed recently as a possible COVID infection. Until there is more testing available the practice of self-quarantine and self-isolation for mild COVID symptoms is warranted (See Bulletin#5). When there is a system in place to use private labs we will make you aware of the options. If you go too soon for testing or while you have no symptoms the test will not be accurate.
If you have been infected and recover, the current test for infection will not be accurate. That would require a different way of looking for antibodies your body made against the virus and is currently being developed, but not available now.
The major mode of virus spread is now thought to be respiratory droplets in the air up to 6 feet from of an infected person’s breathing, coughing, sneezing. That's why we stress the 6 to 8 feet physical distancing from others.
These droplets carry the virus to hard surfaces where they can last for several hours to days but are very sensitive to disinfectants and environmental changes such as dryness. Disinfecting doorknobs, light switches, cellphones, computers once a day at home is important. When you are outside the home, even if briefly, use disinfectant wipes and or hand sanitizer on grocery carts or gas pump handles etc. and don’t touch your face. Use a barrier like a sleeve or Kleenex if you must scratch an itch until you can wash your hands. Nitryl or non-latex gloves may help protect you but you have to take them off correctly and wash your hands after you do. Don’t touch your face with gloves on.
At this time, since food preparation businesses should be following their usual universal precautions for infection control during normal food preparation while preparing take-out food, just like they would when life and business was normal, - the food they prepare is safe.
The transmission of the COVID virus from touching grocery store packaging or any packaging not from your home is not thought to be a source of any significant COVID virus exposure. There also comes a point when you must draw the line to excessive precautions because the evidence just doesn’t support it. Wash your hands when you come home from shopping, wash your hands before eating, don’t touch your face and put some de-stressing activities into your daily life! We have a long way to go and we plan to help you get there.
Finally, there are several ways of accomplishing adequate disinfection:
Most common EPA-registered household disinfectants will work. Use disinfectants appropriate for the surface.
Diluting your household bleach.
To make a bleach solution, mix:
- 5 tablespoons (1/3rd cup) bleach per gallon of water
- 4 teaspoons bleach per quart of water
Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
· Ensure solution has at least 70% alcohol.
Other common EPA-registered household disinfectants.
Products with EPA-approved emerging viral pathogens pdf icon[7pages]external icon claims are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
COVID-19 Update 3-21-20 Community Update #5
COVID-19 Definitions: Self-Quarentine, Self-Isolation, Higher Risk Individuals
There continues to be confusion around terminology and the implications of being in self-quarantine versus self-isolation and under what circumstances each is requested. These actions for removing yourself from contact with the general public are in addition to the steps you have been counseled in and are doing - strict hand hygiene, disinfection, physical distancing for self-protection. So we would like to clarify further:
The term being used for people who are not symptomatic (i.e. not ill) who have come into contact with a person who has tested positive for COVID-19 or had contact with a person with COVID-19 infection symptoms but no test because of mild symptoms.
Please Note: This replaces recommendation for self-observation guidance since mild COVID cases are no longer being confirmed by test as of 3/18/20 and this situation is the same as if you had contact with someone who might possibly have a COVID-19 infection, but you are not showing any signs of being ill:
1. Stay home and out of the public for 14 days after your last contact with the COVID-19 infected or presumed COVID-19 infected person.
2. Contact health care provider to let them know of your status.
3. If you proceed to develop symptoms – e.g. fever, dry cough, and feeling sick and/or runny nose, head congestion and/or loss of appetite, nausea, diarrhea self-isolate and notify your health care provider.
The term being used for the action taken by people who have or think they have a COVID-19 infection. Symptoms can be fever, dry cough, and feeling sick and/or runny nose, head congestion and/or loss of appetite, nausea, diarrhea. Symptoms can spread out over 12 days. Please Note: If symptoms worsen: increasing fever, cough and shortness of breath and are no longer mild call your health care provider immediately or 911 if severe.
Take these actions:
1) Stay at home
2) Let your health care provider know you are ill and self -isolating
3) Keep away from other people in house as much as possible at least 6-8’
4) Use a separate bathroom if possible and if not possible disinfect surfaces touched: doorknobs, light switch, toilet handle; let your health care provider know you are ill and self -isolating
5) If possible, stay in separate room from others. Have food trays placed at doorway by others to decrease contact.
6) You are still expected to cover coughs or sneezes, wash hands frequently,
For How Long?
Any person with COVID-19 compatible symptoms who is not tested and can be managed at home (i.e. does not require hospitalization) should self-isolate until:
1) At least 7 days have passed since symptoms first appeared, AND
2) At least 72 hours (3 days) have passed since recovery – which is defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms.
HIGHER RISK INDIVIDUALS
These include those who are older (age 60 and above) and/or have heart disease, high blood pressure, chronic respiratory diseases, diabetes or in cancer treatment.
Because these health conditions may affect your ability to fight infections it is recommended that in addition to all the personal hygiene recommendations and periodic disinfection of surfaces that you avoid contact with others outside your residence except for essential trips to obtain food, medications, or medical care.
COVID-19 Update 3/19/20
Covid-19 infections, testing, and self-quarantine
We know that there have been increasing concerns with the almost daily changes in restrictions, new declarations, and shortages. The increase in the number of COVID-19 infection cases in the United States as well as New Hampshire continues. We knew this was going to happen in this pandemic, but all of this can easily create increased anxiety, fear and confusion.
Therefore, we want to address the issue of testing for COVID-19 and the latest recommendations that were received by your health care providers late yesterday afternoon. We want to give you the rationale for why the changes in testing have occurred so that you can understand how these decisions were made.
We are now seeing community-based transmission which means people are becoming ill with no known risk factors, and this will lead to an increase in community infections. This prompted a change in recommendations for testing people with mild COVID-19 symptoms. Why? Because most people with mild symptoms from the COVID-19 infection can be managed at home without testing, much like managing flu symptoms, and confirming the infection for every person does not change how most people’s illness is managed. The only available treatment at this time is strictly for symptoms a person may be experiencing, for example, acetaminophen or ibuprofen for fever, aches and pains; rest; light meals; and plenty of fluids.
As a result of this community transmission, health care providers are advised not to test everyone with mild fever or respiratory symptoms because of the following:
· Coming in for a COVID-19 test exposes the public, healthcare workers, and vulnerable persons to COVID-19
· We must preserve our limited personal protective equipment (PPE) and COVID-19 test supplies for our healthcare system to be able to care for those who develop more severe COVID-19 illness.
This means that any person with COVID-19 compatible symptoms (fever, dry cough, fatigue) who is not tested and can be managed at home (that is, those not requiring hospitalization) will be instructed to self-isolate* until:
a) at least 7 days have passed since symptoms first appeared AND
b) at least 72 hours (3 days) have passed since recovery – defined as resolution of fever without the use of fever-reducing medication and improvement of respiratory symptoms.
1. People who don’t have symptoms (asymptomatic) should not be tested for COVID-19 regardless of exposure because it depletes PPE and the limited testing resources and in addition will not change the need for the exposed individual to self-quarantine**
2. All asymptomatic close contacts of a person with COVID-19 symptoms, with or without a positive test for COVID-19, should stay home (self-quarantine**) for 14 days from the last day of contact or exposure to the infected or presumed infected individual.
3. Finally, although international travel is no longer the only risk factor for COVID-19, persons who have traveled from countries with widespread sustained transmission must also stay in self–quarantine** for 14 days from the last day of travel.
Both self–isolation and self-quarantine require a person to avoid contact with the public.
*Self-isolation is a safety measure for those infected or thought to be infected by the coronavirus to prevent transmission of the virus to others.
** Self-quarantine is a precautionary measure for people who may have been exposed to the coronavirus and lasts two weeks, the length of time during which symptoms emerge in 99% of cases.
What you can do:
· Practice all the prevention strategies: hand washing, avoid touching your face, disinfecting surfaces, social distancing, cover coughs or sneezes, and stay at home except for necessary errands.
· Regular sleep and exercise routine, connect with friends by email, phone calls, letter writing, whatever works for you.
· Call 211 if you have questions about COVID-19 or for other resources.
Flattening the curve and slowing the spread is still possible and we ask all of you to do your part.
Margaret Caudill-Slosberg, Emergency Management Director
Bill Waste, Public Information Officer
COVID-19 Update 3/17/20
Fact Sheet regarding COVID-19 frequently asked questions
New FAQ available Here
COVID-19 Update 3/17/20 Governor’s Emergency Order #2 relative to gatherings of 50 or more people and restaurant/pub restrictions. Emergency Order #2 Pursuant to Executive Order 2020-04 Temporary prohibition on scheduled gatherings of 50 or more attendees and onsite food and beverage consum ption Pursuant to section 18 of Executive order 2020-04, it is hereby ordered, effective immediately, that:
- In accordance with CDC guidelines, the following activities are hereby prohibited within the State of New Hampshire:
- Food and beverage sales are restricted to carry-out, delivery, curbside pick up, and drive through only, to the extent permitted by current law. No onsite consumption is permitted, and all onsite consumption areas in restaurants, diners, bars, saloons, private clubs, or any other establishment that offers food and beverages for sale shall be closed to customers.
- Section 2 of this order shall not apply to food and beverage service in (a) healthcare facilities, (b) airports, or (c) cafeterias located within a private business which are primarily intended to serve the employees of that business.
- The Division of Public Health shall enforce this Order and if necessary may do so with the assistance of State or local police.
- This Order shall remain in effect until Monday, April 6, 2020 .
Many developments have occurred in the past 36 hrs. and we wanted to share with you the latest developments and concerns:
This week will be extremely important as our community, now impacted by school closure and the closure of multiple venues in NH, face the growing awareness that safety and endurance may require a different way of living.
Closing schools will only help to control the spread of this virus if we all take appropriate measures to comply with the recommendations of our public health officials. At least during the period of this initial school closure, we should be limiting the potential for disease transmission by avoiding unnecessary contact with other people.
This means that gatherings such as play dates, parties, and other unnecessary social contact should be avoided. Older children should be advised to practice “social distancing,” which means staying at least six feet from one another, and avoiding gathering in large groups. For this next phase of our community response, we should all stay home as much as possible in order to minimize the opportunity for the virus to spread.
This afternoon Governor Sununu issued the following order that “Effective at close of business tonight, all restaurants and bars in NH will be required to serve patrons by takeout, delivery, and drive-through methods only. Scheduled public gatherings over 50 people will be prohibited. This order will remain in effect until April 7.”
As we proceed to follow daily developments for you if you have questions about the ongoing COVID-19 outbreak or other state or local services please call 211 or visit their website at http://www.211nh.org/.
Remember to take care of yourself and others by following the guidance provided by the CDC, which we’ve linked below.
This is a situation that is changing daily and we are attempting to follow developments and keep you informed.
Margaret Caudill-Slosberg, Emergency Management Director
William Waste, Public Information Officer
Emergency Operations Center
COVID-19 Update 3/14/20 We are sharing a press release from the New Hampshire Department of Health and Human Services regarding the 7th presumptive case of COVID-19 in New Hampshire. Personal concern should only be a factor if you went to the Department of Motor Vehicles office in Manchester during the dates and hours listed (see below). Locally, little has changed in the past week. The initial cases associated with DHMC and the church in West Lebanon are coming to the end of their two-week isolation period and (thankfully) no new cases have appeared as yet. All the precautions published about personal hygiene and social distancing still apply. National and New Hampshire States of Emergency have been declared and there are some restrictions (at least in Vermont) on large gatherings. This is already having a negative effect on local events from performances to ski areas. It is still left to local organizations, municipalities and schools to make their own decisions about closing or postponing events and still left up to individuals to decide whether to attend such gatherings or not. Please exercise due caution depending on your personal level of risk, and call ahead before heading off to an event or meeting to confirm it is still being held. Bill Waste Public Information Officer Lyme COVID-19 Response Team
The person is an adult female from Rockingham County who notified their healthcare provider after developing symptoms. There is an ongoing investigation to identify people with close contact before this individual self-isolated. Any person who has been identified as a close contact will be notified directly by DHHS. DHHS has determined that the person was at the Manchester branch of the NH Division of Motor Vehicles, at 377 South Willow Street in Manchester on the following days:
- Monday, March 2, from 8:00 am to 4:30 pm
- Tuesday, March 3, from 8:00 am to 4:30 pm
- Wednesday, March 4, from 8:00 am to 4:30 pm
- Thursday, March 5, from 8:00 am to 4:30 pm
- Tuesday, March 10, from 8:00 am to 4:30 pm
The Manchester DMV will be closed on Saturday, March 14, for enhanced cleaning and to allow DHHS to conduct the contact investigation. Any individuals who entered the Manchester DMV during those days and times may have been potentially exposed to the novel coronavirus that causes COVID-19 and should monitor their health for fever or respiratory illness. Any persons who were in the Manchester DMV on those days and have developed symptoms should stay home, limit their contact with others, and immediately contact their healthcare provider. Any individual who is symptomatic but does not have a healthcare provider should contact DHHS at (603) 271-4496.
Any person who develops fever or respiratory symptoms (e.g., cough, shortness of breath) should stay home away from others and seek health advice by phone from a healthcare provider to discuss symptoms and any risk factors for COVID-19.
Given the increasing numbers of infections globally and around the United States to protect themselves and help prevent further community spread, all persons should:
- Stay home and avoid public places when sick (i.e. social distancing)
- Cover mouth and nose when coughing and sneezing
- Wash hands frequently
- Avoid being within 6 feet (close contact) of a person who is sick
- Avoid sharing drinks, smoking/vaping devices, or other utensils or objects that may transmit saliva
- Disinfect frequently touched surfaces
COVID-19 Update 3/12/20
To date there are 6 positive cases of COVID-19 in New Hampshire, 2 confirmed 4 presumptive.
All cases have been either travel related to Italy or the most recent (6th case) was to multiple European countries; or from direct contact with infected individuals such as the 3rd case, exposed when they sat next to the second case in church on 3/1/20 in West Lebanon.
So we have the three original cases in our immediate vicinity; no new cases here at the moment. The good news is that the first wave of local contacts in quarantine will be finished this weekend and no new cases have developed to date.
The work of Public Health is to quickly identify potential exposures of contacts or advise symptomatic or individuals at risk i.e. those with the travel histories to global hotspots or known contact exposures to isolate or quarantine depending on presence of symptoms and risk. Both procedures are meant to remove those individuals for the 14 days from last exposure from the general population.
There has been some confusion and circulating rumors in the state after some individuals reported that they “had a coronavirus infection” and thought they were infected with COVID-19. These individuals had been tested presumably for cold symptoms in doctor’s offices. Some of the common colds are caused by coronaviruses, however not the novel coronavirus, COVID-19 virus. Those individuals do not have the pandemic infection of current concern.
The test for COVID-19 is not available in the doctor’s office. To collect the samples, usually throat swabs, health care workers wear personal protective equipment (PPE) in controlled environments to reduce their exposure. Current testing is under the direction of public health. More testing availability will occur soon but this is the situation at this time.
Cancellation of large gatherings defined as greater than 50, 100 or 1000 depending on the organization, has been all over the news. How “big” is the trigger size for these cancellations? Well a lot has to do with density of the population to be gathered; travel distances of participants, physical size of venue e.g. larger implies less contact; population characteristics of participants- older adults or younger adults? mixed ages? and many other factors. The goal is reduction of exposure risk to flatten the curve.
**211NH is New Hampshire's statewide, comprehensive, information and referral service operated by Granite United Way and will replace the current Department of Public Health Hotline (603-271-4496) for COVID-19 related questions. Call 211 for questions, concerns and information.
Nothing has changed in terms of what you can do to limit your exposure: Hand hygiene, regular disinfection of office and home surfaces frequently touched, (don’t forget your computer and cellphones), social distancing 6’ when out and about but particularly from coughing or sneezing individuals; and stay home if you are ill. Take care of yourself; stress management is definitely effective and called for in this situation. The Lyme COVID 19 Response Team met today and there is a gathering storm of assistance and support going forward. You are not alone. Be kind to each other. Margaret
Margaret Caudill-Slosberg, EMD, Town of Lyme
03/11/20 Update to add link to Library Covid 19 resource Page.
03/08/20 Update on COVID-19
The Town of Lyme is committed to communicating any new information it receives from DHHS relating to COVID-19 as quickly as we can. Here is what we know:
On Sunday, March 8, 2020, Town of Lyme officials were alerted by DHHS that another presumptive case of COVID-19 has been identified in Grafton County. An individual who attended a worship service at Hope Bible Fellowship in West Lebanon has tested positive for COVID-19.
Recommendations from DHHS regarding this new development are as follows:
“Anyone who attended a coffee social at 9 AM or the worship services at 10 AM on Sunday March 1st at Hope Bible Fellowship at 114 Seminary Hill in West Lebanon, NH are asked to stay home and avoid contact with others for 14 days (through March 15th) and monitor for symptoms of COVID-19. Anyone who attended the March 1 social or service and has developed symptoms of fever or respiratory illness should immediately stay home and distance themselves from household members and contact the Bureau of Infectious Disease Control at 603-271-4496 (after-hours: 603-271-5300).” The church cancelled all activities for today March 8th.
DHHS has stated there were approximately 60 people in attendance at the March 1st service.
In addition to this incident, the DHHS has released the following stats for total NH contacts to date 3/7/20:
- 150 people are currently being monitored by DHHS
- 2 cases have now been confirmed by the CDC, they were the first patients reported last week in Grafton
- 2 additional cases are presumptive COVID-19 positive awaiting CDC confirmation (The third case from church exposure above and a 4th case who traveled to Italy from Rockingham County.)
We are currently awaiting test results from other persons who may have been exposed. It takes approximately 24 hours from the time of testing for results to be received.
During this time of uncertainty, we ask that our community continue to follow CDC guidance regarding practicing responsible social distancing and personal prevention measures as well as the following recommendations for People at Serious Risk for COVID-19:
If you are at higher risk of getting very sick from COVID-19, you should:
- Stock up on supplies
- Take everyday precautions to keep space between yourself and others
- When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
- Avoid crowds as much as possible
During a COVID-19 outbreak in your community, stay home as much as possible
The Town of Lyme will continue to post updates on our Town website page as well as List serve as we receive them.
EMD, Town of Lyme
COVID-19 - TOWN OF LYME PLANNED RESPONSE
Posted on: March 5, 2020 – 4pm
What Is Being Done?
The Town of Lyme is actively engaged with the New Hampshire Department of Health and Human Services (DHHS) and our local and regional partners with regards to the State and local response to the COVID-19 virus through the Public Health Emergency Management structure.
DHHS has a very active website that contains the most updated information on COVID-19 that can be accessed here: dhhs.nh.gov/dphs/cdcs/2019-ncov.htm.
DHHS is in close contact with the Center for Disease Control (CDC) and maintains links on its website to the CDC’s most recent information on the virus that can also be found here: cdc.gov/coronavirus/2019-ncov/index.html.
The Lyme COVID-19 Emergency Response Team will continue to serve as a resource conduit for reliable and timely communication between the Emergency Operations Center staff and the community in this rapidly changing situation.
While the Town is closely monitoring the progression of the virus and is planning for the potential spread in the Upper Valley region, we are asking everyone to concentrate their efforts on PREVENTION. There is currently no vaccine to prevent COVID-19.
Prevention measures that are accessible to almost everyone and should be practiced regularly include:
- Proper Hand Washing (If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol)
- Covering Your Cough
- Avoiding Touching your Eyes, Nose, and Mouth
- Avoiding Close Contact with Anyone Who is Sick (Maintaining a minimum distance of 6 feet)
- Staying Home When You Are Sick
- Regularly Cleaning and Disinfecting Frequently Touched Objects and Surfaces
- Following the *CDC’s Guidance for Travel. In addition, please monitor CDC sites that identify locations with COVID-19 for both foreign and domestic travel to determine appropriate travel times.
- Wipe down contact surfaces, door knobs, telephones and key pads with any of the recommended products identified in this document: Interim Environmental Cleaning and Disinfection
*DHHS has put together a Self-Observation Guide for anyone returning to the United States from a country other than China with a travel advisory and strongly recommends you protect yourself and others by following the steps outlined in the Observation Guide.
Symptoms of COVID-19
Symptoms of COVID-19 may appear 2-14 days after exposure and include
- Shortness of Breath
If you develop symptoms AND have been in close contact with a person known to have COVID-19 or if you have recently traveled from an area with widespread or ongoing community spread of COVID-19 contact your healthcare professional to see if you should be tested.
Frequently Asked Questions
Outbreaks involving COVID-19 continue to evolve quickly. It is important that you stay informed of new information as it becomes available.
Safety Response Plan
Should an outbreak occur that requires a large public safety response, the Emergency Operations Center is open and information will be provided on what is being requested of the public.
Emergency Operations Center
COVID-19 Community Update
Posted March 1, 2020
To the Lyme Community:
We are writing to provide you with an update about the coronavirus COVID-19 that has been spreading across the globe since December 2019 and our plan for a Lyme COVID-19 Emergency Management Response Team to support our regional and state public health response. Our immediate goal will be to provide a reliable resource for the most accurate and timely information available on developments as they unfold. Updates will be posted regularly on the town’s website https://www.lymenh.gov/, the Lyme Listserv and disseminated through multiple community organizations.
We are also dedicated to encouraging community members to incorporate good habits into their overall health practices as everyday measures to prevent illness and spread of diseases in the flu and cold season such as:
- Covering mouth and nose when coughing and sneezing. If you use a tissue, discard it immediately and wash hands.
- Staying home and avoiding public places when sick, i.e. social distancing
- Washing hands with soap and water, frequently, for 20 seconds (or two rounds of “happy birthday to you”) OR using an alcohol-gel sanitizer
- Avoiding close contact by staying at least 6’ from a person who is sick
- Not sharing anything that transmits saliva: drinks, smoking/vaping devices, utensils
- Disinfecting frequently touched surfaces - consider using spray disinfectant with cloth rather than wipes (which do not break down in landfills)
Finally, we encourage you to begin preparation of your household as if we were about to have a huge snowstorm that required being self-sufficient for an extended period of weeks. Consider the special needs of children, older adults, and pets (food, medication, phone numbers, activities, etc.).
By beginning our preparation now we can fine-tune it as the situation unfolds. Working together we will be stronger.
The Lyme COVID-19 Emergency Response Team
Margaret A. Caudill-Slosberg, EMD
Michael Hinsley, Deputy EMD
Kevin Sahr, Select Board and Deputy EMD
Michael Mundy, Fire Chief
Shaun O’Keefe, Police Chief
Lisa Rayes, Fast Squad
Jeff Hannisian- Town Health Officer
William Waste, Public Information Officer and Lyme Congregational Church
Patty Jenks, Community Care of Lyme
Jeff Valence, School Principal
Judy Russell, Librarian
Lyme Parish Nurses
Jeff Snelling, Lyme Baptist Church
Dina Cutting, Town Administrator
A resource for questions about the COVID-19 (C-19) virus in New Hampshire:
The following number is the 24/7 number for the public’s questions to the NH Dept of Public Health 603-650-1818.