Weekly Updates

Androscoggin Valley COVID Dashboard


AV COVID-19 Dashboard will be updated weekly (Fridays) in order to provide timely information to the community.

COVID vaccine is currently available to anyone 5 years and older. Boosters and third doses available to those 12+ years.

1/20/22 - covidactnow.org

1/20/2022: COVID exposure + symptoms = COVID

Our work today is dedicated to the National Guard members who are making a big difference in many healthcare settings.

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Cases are ticking up across the North Country. The Omicron variant is contributing to positive cases that are more than twice the previous surges. The federal prison’s numbers contribute to the county’s high rates but the high positivity rate also means that the hospitals will see a portion of the general population that needs acute care. Elderly residents are still most at most risk for severe COVID and may be most affected around day 10 - 14 post infection. Check on your neighbors, family, and friends. COVID exposure plus symptoms equals COVID, especially in the same family and household.

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NH announced 2,461 new cases on January 20, 2022. There were an average of 2,663 cases per day for the most recent 7-day period (January 14 to January 20). This is a 14% DECREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

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Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040


Anyone 12+ years may be eligible for their booster or additional COVID-19 vaccine:

Informational FAQ from North Country Healthcare

NCH videos: #StepUpNH and #MaskUpNH

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Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: At the testing site on Wednesday 52 COVID tests were administered, including 23 rapid tests with 11 positive, a 48% positivity rate. Family spread is contributing to the positivity rate. In an increase from last week, there are currently 5 people being treated for COVID-19 as inpatients on the Med Surg unit. Many patients are seeking medical care after initial infection around day 10 - 14 when they are struggling with the ongoing impacts of the virus. In coordination with CCFHS, supply of monoclonal antibodies treatment specific for the Omicron variant became available and was given to qualifying patients. Past patients have been unvaccinated, as well as partially vaccinated. The ER and ICU are busy but not with COVID patients. AVH is stable and managing day by day with staffing affected by COVID. Currently there are 4 staff and one provider out. The flu is circulating regionally and elsewhere in the state.

  • Update from Coos County Family Health Services: Dr. Beals is busy with pediatric testing clinics including 26 kids on Wednesday and Thursday with seven positive cases, an increase from last week. Testing clinic on Thursday had 37 people and 4 were positive. Thursday's testing clinic was not full, a first after several weeks of full clinics. The first dose of Paxlovid, an oral antiviral COVID treatment, was given to a qualifying patient this week. Staffing is stressed with many absences due to COVID or childcare closures including 6 nurses, 2 providers, 3 IT, and 2 receptionists. Vaccine appointments are available Monday and Wednesday 8:30 - 11:30 am and testing Tuesday and Thursday 8:30 - 11 am. Call CCFHS at 603-752-2040 for appointments.

“What more can we do but provide a calm and consistent approach for our community. We’re going to continue to do that even when it can be exhausting. So proud of everyone now approaching two years of this work together.”

Education

  • Update from Berlin Public Schools: A slight decrease from last week, there are 32 students and 9 staff positive with COVID across the district, with others out on quarantine and pending test results. Each day is a different staffing challenge to provide coverage at schools. School nurses have noted that not everyone is ready to return to school on day 6. Some are still testing positive or have considerable symptoms. Negative test to return is now required and a testing resupply is scheduled for next week. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: An average of 10% of students are positive across SAU 20 schools with a constant rotation of students isolating and returning after testing. Fewer staff (approx. 4) are out across the SAU. Approximately 60 rapid tests are administered each day and supply is going quickly. Schools are maintaining in person learning while managing COVID by following guidelines when infections occur. In person learning provides the most optimal and equitable learning environment for students and families and mitigation efforts are working to keep that in place. Visit the SAU 20 office website for updates.

  • White Mountains Community College: This is the first week of spring semester. WMCC is able to continue in person programs as the best method of instruction. Closing in on two years of the pandemic, students are showing signs of mask fatigue. Students, faculty, and staff who have to isolate or quarantine for COVID are following guidelines to return. Remote options are encouraged for those who continue to be symptomatic past day 5 until they are well enough to return.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: As of Thursday there are 10 employees out of work due to COVID, including three direct care employees recently testing positive. All residents will have PCR tests. There are no residents with COVID-19 at this time. CCNH continues all previously reported COVID infection prevention and control measures. (As printed in Berlin Sun 1/20/22)

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: Three more staff are out with COVID cases originating from close household contacts. Agency remains closed to the public and staff are required to wear masks at all times. Services continue to be offered to the community.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: There are two positive firefighter cases, possibly three. Cases are not affecting emergency services response.

  • Gorham EMS: There are four firefighter and EMS personnel out, but it is not affecting emergency services response.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: There is a large outbreak of COVID cases at the prison with 167 inmates and 29 staff testing positive. This is an increase from 59 positive inmate cases last week. There is a total population of 760 inmates at FCI and approximately 70% are vaccinated. Cases are mostly mild and staff are testing to return to work. (As shared on the call, further updates available in Berlin Sun article 1/20/22)

Municipal and Local Business

Community and Legislative

  • Public Health Network: Like other organizations with temporary staffing shortages, the PHN is experiencing a decrease of available volunteer staff for vaccination clinics. The PHN is following and working with state level partners to weigh in on proposed legislation intended to support NH’s public health infrastructure.

  • Congressional Delegation: No additional updates on this call.


“It’s ticking up again and a portion of the population is going to need acute care."

1/13/2022: Get up to date and get prepared

Our work today is dedicated to those sharing Covid-19 information with the local community to keep them informed.

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Covid-19 Omicron variant is now responsible for 90% of the current Covid cases in NH. NH is seeing the highest cases we’ve seen in the past two years. Local community transmission is lower than the state average, however that will likely change as the surge moves northward. Local stores are curtailing hours due to Covid staffing shortages. People are encouraged to get prepared to follow the NH DHHS new guidance if positive with Covid or with a household contact:

Everyone, regardless of vaccination status or symptoms, should isolate for at least 5 days if they test positive for COVID-19 (or have symptoms of COVID-19 while awaiting testing), and then wear a well-fitting face mask for an additional 5 days when around other people at home or in public locations.

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NH announced 3,818 new cases on January 13. There were an average of 2,754 cases per day for the most recent 7-day period (January 7 to January 13). This is a 32% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

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NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040. On-Site Medical Services is now leading a fixed vaccination site at The Chalet in Berlin. It is open Monday through Friday, 10 am - 7 pm and Saturday, 10 am - 2 pm. No appointment is needed.

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  • Get up to date! Being fully vaccinated means receiving as many vaccination doses you are eligible for.

  • Don’t wait to get a booster shot! Booster shots can help build immune response right away so now is the time if you haven’t received one and protect against the Omicron surge.

Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: There is a slight uptick with three inpatients being treated for Covid-19. At the testing site over the past week 160 Covid tests were administered, including 85 rapid tests with 36 positive - a 42% positivity rate. Many people are taking home tests instead of a testing site. Across NH the Omicron variant is 90% of the positive cases. AVH is stable but staffing is affected with 7 to 9 staff out and some returning soon. Elective procedures have not been delayed, but may need to be considered if more staff are out. Monoclonal antibodies treatment given for the Omicron variant is different from Delta and is currently in short supply. AVH / NCH hospitals have established a system to allocate the potentially scarce resource to those who need it most. Patients are receiving the treatment locally and more supply is hoped for next week. NCH continues to thank all of its healthcare employees for their hard work.

  • Update from Coos County Family Health Services: Testing clinics are full each testing day including Thursday with 2 positive rapid tests. Dr. Beal’s is busy with pediatric testing clinics including 17 kids on Wednesday / Thursday with two positive cases. Testing appointments are booking out. Providers are advising that if there is a confirmed Covid case in the household any other symptomatic family members are assumed to be Covid positive and should act accordingly. CCFHS is providing an informational checklist to all patients to encourage preparation if quarantining is needed. Vaccine appointments are available Monday and Wednesday 8:30 - 11:30 am and testing Tuesday and Thursday 8:30 - 11 am. Call CCFHS at 603-752-2040 for appointments.

  • Vaccine / Covid Updates in Androscoggin Valley and NH: NH hospitals are meeting 7 days / week to coordinate and meet the demand for patient beds. There are 561 inpatients across the state, almost 2 times the winter surge of last year. While the severity of illness is not as high, the volume of patients is crushing the system combined with staff out due to Covid. Example, Elliot Hospital this week was 5 patients away from treating patients in non-medical conference rooms. Hospitals are transporting patients to each other as needed to meet the demand for beds. AVH will support the northeast region of the state to assist with the volume in southern regions. AVH is successfully having Covid positive staff return with improving symptoms on day 6 after isolation, followed by 5 more days of complete masking. Crisis standards of care may come into play if staffing is greatly affected.


Education

  • Update from Berlin Public Schools: Across the district there are 44 students and 13 staff positive with Covid with others also out on quarantine and pending test results. Staffing is taxed but managing. The district will move to require a negative test to return to school on day 6 in order to reduce the number of symptomatic students returning to school too early. Nursing staff are rising to the occasion and there is an opening in the district. Please share widely to avoid short-staffing of school nurses at this critical time. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: Schools are seeing a spike in cases since the return to school after vacation. Policy for returning to school on day 6 with a negative test and masking is working well to move through this time. Visit the SAU 20 office website for updates.

  • White Mountains Community College: No update on this call.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: As of mid-day Thursday 1/13 there are 13 positive Covid cases among staff and contract tracing is occurring. No residents are positive at this time and all resident testing is pending from 1/11/21. Additional support with non-clinical duties provided by several National Guard members could not be better timed and is allowing staff to continue meeting resident and family needs.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: One staff member is out due to Covid. Home testing kits are more difficult to find since they are currently in short supply.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: Department is stable, however Covid continues to affect staffing with quarantines due to close contacts.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: There are currently 59 positive Covid cases among inmates and several positive staff members.


Municipal and Local Business


Community and Legislative

  • Public Health Network: Staff continue to host vaccine clinics including school-based and booster blitzes around the region. The PHN supports the region’s continued effort to get more people up to date with Covid vaccination.

  • Congressional Delegation: Staff are informing the Congressional representatives of the updates shared on this call. No additional updates.

“ Get up to date and don’t wait to get boosted!”

1/6/2022: Staffing Challenge

CODE RED MESSAGE 1/7/22:

Prepare for what is expected to be a surge in Covid infections in our region. Area residents should prepare for the possibility of illness in their families and the need to quarantine or isolate for 5 - 10 days. Businesses and services may be affected due to temporary absence of staff. Read more from the City of Berlin, Town of Gorham, Androscoggin Valley Hospital and Coos County Family Health Services.

Our work today is dedicated to all the parents who are trying to navigate lots of information and often difficult situations impacting their kids and families.

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Positive cases are increasing again in the community. Staffing is likely going to be a major challenge over the next few weeks as Covid disrupts the essential organizations that we all count on - especially healthcare, schools, and childcare. The number of reported Covid cases have greatly increased over the past week in NH and this is likely an undercount due to many people taking rapid tests at home. NH DHHS will update quarantine and isolation guidance based on the CDC’s new recommendations.

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NH announced 2,184 new cases on January 6. There were an average of 1,776 cases per day for the most recent 7-day period (December 31 to January 6). This is a 55% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

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Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare

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  • Booster Blitz on Saturday Jan. 8th 9 am - 4 pm at White Mountains Community College

  • On-Site Medical Services is now leading a fixed vaccination site at The Chalet in Berlin. It is open Monday through Friday, 10 am - 7 pm and Saturday, 10 am - 2 pm. No appointment is needed.

Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: One inpatient is being treated for Covid at AVH. While acute illness is down, there is a lot of patient volume and staffing affected by Covid. 56 were tested at the drive through on Jan. 5th. Of the antigen tests (22) 50% were positive (11). A 50% positivity rate is consistent across other NCH facility testing at this time. Four AVH staff, including providers, are out due to Covid. AVH remains stable but very busy. Staffing shortages due to Covid is consistent across NH and it is likely to be a tough few weeks ahead.

  • Update from Coos County Family Health Services: There was a busy testing clinic on Thursday Jan. 6th with 40 tested and 1 positive adult antigen result. Pediatric testing had 1 positive and three additional positives from CCFHS trailer visits. CCFHS is seeing a lot of sick people, likely with flu / colds if testing negative for Covid . CCFHS vaccine clinic is now Monday and Wednesday 8:30 - 11:30 am and testing Tuesday and Thursday 8:30 - 11 am. Call CCFHS at 603-752-2040 for a vaccine appointment.

  • Vaccine / Covid Updates in Androscoggin Valley and NH: A statewide sample of Covid tests indicates that Delta variant is still dominant and circulating. It appears that Omicron has or will soon arrive as many people in the community are reporting positive Covid cases that have less acute illness but are highly transmissible. To address circulating information, there is emerging information that antigen test kits may be more accurate with samples from the nose and throat. In the US, antigen test manufacturer directions for nose-only samples have not changed and remain the standard.

Education

  • Update from Berlin Public Schools: Schools are seeing more positive cases including a cluster at the special education pre-K program at the elementary school. Administrators are working on contingency plans for how to support the schools through the next few weeks, if need emerges. Schools are awaiting NH DHHS updates on quarantine and isolation guidance on the CDC's new guidelines of return after 5 day quarantine with improving symptoms and additional days of required masking. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: SAU 20 is also starting to see an increase in positive cases and is working on contingency plans. The two school systems continue to communicate with each other in crafting their contingency plans to address this surge. Visit the SAU 20 office website for updates.

  • White Mountains Community College: Staff are returning to campus this week and students start classes on Jan. 18th. Among higher education institutions, WMCC has prioritized maintaining in person learning, especially since hands-on labs are essential in many programs. Programs are run in cohorts and that has aided in successful face to face instruction. WMCC is working on contingency plans for instruction including lining up adjunct faculty if instructors need to be out due to Covid. WMCC is hosting Booster Blitz on Sat. Jan. 8th 9 am - 4 pm, spread the word!


“How do we live in this new normal? That’s what we’ve been figuring out in the past 6 months. The end point is not coming soon. How do we continue doing the things we’re supposed to be doing in this world with this new reality?”

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: One new Covid positive staff case was reported on Jan. 6th. Contact tracing, follow up testing, and safeguards to reduce opportunity for potential spread are all taking place.

  • Coos County Nursing Home: (Updated Friday 1/7/22) There are a total of 6 positive Covid cases among staff and contact tracing is in process. There are no residents with Covid-19 at this time. The facility is taking an all hands on deck approach to care for residents, however as more staff are affected contingency staffing may come into play. The facility met with DHHS and National Guard to secure up to five National Guard members to support the facility with non-clinic work through mid-March. Guard members will be screened and oriented to assist with answering phones, transporting residents, greeting visitors, screening, data entry, etc. to discuss options for assistance with non-clinical duties at the Home. The facility is not taking any admissions until more Registered Nurses, Licensed Practical Nurses, and LNAs are recruited.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: There have been recent positive Covid cases among staff. All are back from quarantine and overall staffing is not affected.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: The department is experiencing a small number of positive / potential Covid cases but overall staffing is not affected.

  • Gorham EMS: Similarly, Gorham’s department is experiencing a small number of positive / potential Covid cases but overall staffing is not affected.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: (Updated Friday 1/7/22) FCI is responding to a total of 48 resident positive Covid cases (25 on Jan. 6 and 23 on Jan. 7). Follow up testing, quarantining, and screening of the institution will continue until the outbreak has passed.

Municipal and Local Business

Community and Legislative

  • Public Health Network: “Booster Blitz” will be held Saturday Jan. 8th 9 am - 4 pm at White Mountains Community College in Berlin. Booster ​COVID-19 vaccines will be available, including all 3 vaccine presentations. The clinic is open to the public and more information including advanced registration is available.

  • Congressional Delegation: No additional update.

“Staffing - that’s the major challenge right now, especially in the hospitals. In the North Country and NH staff are rapidly being affected so it’s going to be a tough couple of weeks.”

12/30/21: Keeping Up the Fight

Our work today is dedicated to the extraordinary leaders in this group who have dedicated their time, energy, and passion to the cause.

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With an unprecedented surge of infections forecasted for early in the year, community members are encouraged to make preparations in order to avoid potential disruptions.

NH announced 1,580 new cases on December 30. There were an average of 1,076 cases per day for the most recent 7-day period (December 24 to December 30). This is a 6% DECREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

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NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

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Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: AVH is experiencing some challenges with staff shortages, however, there are currently 0 COVID-19 patients in the hospital. Operations are running normally. There have been 8 patients who have received monoclonal antibodies this week, which is a slight uptick. The main variant in New Hampshire still appears to be Delta, though experts are estimating that 18% of cases are due to the Omicron variant. The state is currently working on establishing procedures for oral antiviral treatments. Overall, the number of inpatient COVID-19 patients seems to have decreased, as many patients have shifted to recovery. AVH is currently stable and is preparing for the forecasted surge in infections that may take place early in the coming year.

  • Update from Coos County Family Health Services: As far as COVID-19 testing, clinics have filled back up again. However, there have only been 4 positive test results for this week. There have not been a lot of flu cases either, though there may be a respiratory virus circulating. CCFHS is still administering booster vaccinations. Volume for immunizations has decreased significantly, almost cut in half. CCFHS is continuing preparations, in light of the anticipated incoming wave of infections, in order to avoid disruptions. Community members are encouraged to make preparations as well, if possible, including securing groceries and supplies; making a plan to stay in contact with family and neighbors; reducing gatherings; and ensuring masks are worn as much as possible. Call CCFHS at 603-752-2040 for a vaccine or testing appointment.


Education

  • Update from Berlin Public Schools: There are currently very few positive cases in the student and staff populations, except for a handful of positive tests from one of the sports teams. Berlin Public Schools was successful in securing tests for these students and the program has shut down in the meantime. Schools will return from break on Monday, January 3. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: SAU 20 is experiencing a similar situation to Berlin Public Schools in terms of the COVID-19 landscape. Visit the SAU 20 office website for updates.

  • White Mountains Community College: WMCC is preparing for a Booster Blitz event that will take place on January 8 at the Community College.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: No update on this call.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: PHN is gearing up for the Booster Blitz 2.0 event on January 8.

  • Congressional Delegation: No update on this call.


“We are all in this together. No matter what, we will keep up the fight.”



12/23/21: Be Careful, Be Safe, and Happy Holidays

Our work today is dedicated to front-line healthcare workers.

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While the spread of COVID-19 seems to have generally calmed down in the North Country, healthcare facilities are preparing to face the Omicron variant.


NH announced 1,088 new cases on December 23. There were an average of 1,042 cases per day for the most recent 7-day period (December 17 to December 23). This is a 14% DECREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

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NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: AVH currently has 1 COVID-19 patient on the Med-Surg floor. They have 16 patients overall, which is more than normal. Volume and turnover of patients has been high at the hospital lately. There have also been a fair amount of monoclonal antibody treatments administered.

  • Update from Coos County Family Health Services: In terms of testing clinics, Tuesday’s clinic had 28 tests administered and 4 positive results, while today’s clinic had 40 tests and 1 positive result. Testing demand is picking up, though the positivity rate remains relatively low. At-home tests are available for distribution at the facility. In January, the vaccination clinics at CCFHS will change from a Tuesday/Thursday schedule to a Monday/Wednesday schedule from 8:30 am - 11:30 am. The demand for vaccination is currently slowing down. On the medical front, emergency use authorization was issued for an oral medication for the treatment of COVID-19, if administered within 3 days of the onset of symptoms. AVH Pharmacy expects to receive a shipment, though it appears the supply will be limited. CCFHS remains concerned about the repercussions of the emerging Omicron variant and is continuing preparations to minimize disruption. Call CCFHS at 603-752-2040 for a testing or vaccine appointment.

Education

  • Update from Berlin Public Schools: No update on this call. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: No update on this call. Visit the SAU 20 office website for updates.

  • White Mountains Community College: WMCC closes out today with 0 cases of COVID-19 internally. In January, students, faculty, and staff will return (with a mask mandate in effect). In-person events will be limited during the first week of January to prepare for any after-effects of holiday travel. Small orientations will take place during the second week of January. WMCC has been exploring grants aimed at strengthening workforce opportunities and rural and economic development.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: Two new changes have been issued from the state level, including a requirement of eyeshields on ambulance crews, as well as a policy related to EMS transfers.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: January 8, 2022 has been confirmed as the date for Booster Blitz 2.0. They are currently exploring possible locations. PHN has been working with the Senior Center in Haverhill to ensure that residents can sign up for booster vaccinations. They are planning to call residents to help schedule their boosters, rather than using the online format that may be challenging. PHN is planning to prioritize this age group for the Booster Blitz 2.0 event. A few booster clinics have been hosted recently and there is a second-dose clinic occurring on December 30 for the children who received their primary dose at the White Mountain Regional High School clinic previously.

  • Congressional Delegation: The Senate has recessed for the year and offices will be closed until January.



“There are 3 ways in which the Omicron variant may be different than previous waves:

  1. It is likely to be more national in scope than regional.

  2. It is possible that it will occur more quickly (since it appears to be 2-3 times more infectious) and will be shorter in duration than previous waves.

  3. Community members without 3 doses (2 doses and a booster dose) are very vulnerable to this variant.

It is incredibly important for community members to receive a booster shot!”



12/16/2021: A Fragile State

Our work today is dedicated to the communications professionals, who play a significant role in COVID-19 response and public health efforts (including James Patry, Sarah Gibson, Alli Fam, and many others).

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Community transmission appears to have stabilized in the North Country, though forthcoming challenges, including the Omicron variant and rising cases in other parts of the state, indicate that it is not yet time to ease efforts.

NH announced 1,126 new cases on December 16. There were an average of 1,105 cases per day for the most recent 7-day period (December 10 to December 16). This is a 19% DECREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***

  • One year ago today, on December 17, 2020, the first COVID-19 vaccine was administered in the North Country.

  • The CDC has issued a “What you Need to Know” memo on the emerging Omicron variant.



Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: AVH currently has 2 patients who are COVID-19 positive, though both are currently stable. There was an increase in demand for monoclonal antibody treatment this week, almost twice as high as normal, which is a good indication. In terms of rapid testing, the positivity rate is approximately 20% and increased slightly yesterday. The PCR tests from Monday all had negative test results. Staffing remains tight at the hospital. Looking at the state overall, the south continues to have high community transmission rates, while the North Country seems to have stabilized for the time being. AVH is currently working on communication efforts to spread awareness about the COVID-19 situation in hospitals across the state.

  • Update from Coos County Family Health Services: This weekend, there were 9 positive test results which was highly unusual for a weekend clinic and caused a bit of a scare. However, there have only been a handful of positive test results throughout the week. Overall, the situation appears to be stable. There is a decreased demand for testing. In terms of vaccination efforts, 66 COVID-19 vaccinations were administered this week - 63 were booster shots and 3 were primary doses. CCFHS is working on a project to expand capacity for adult respiratory visits and they are hoping to be able to offer that service early in the new year. Significant concerns are emerging about the potential impact of the Omicron variant. Planning has begun to minimize potential disruption. Call CCFHS at 603-752-2040 for a testing or vaccine appointment.


Education

  • Update from Berlin Public Schools: There was a small uptick in the number of positive cases this week and the number of individuals in quarantine. At Berlin Elementary School, there are 4 students in isolation, 10 students in quarantine, and 1 staff member in isolation. At Berlin Middle High School, there are 3 students in isolation, 5 students in quarantine, 1 staff member in isolation, and 1 staff member in quarantine. It appears that these numbers are higher than normal because of community transmission numbers and household contacts. Vacation will begin next week and they are hoping that staffing remains stable. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: Echoing Berlin Public Schools, there has been a slight increase in COVID-19 cases. There are currently a handful of student cases, including 3 in the Middle School and 4 in the High School. There are no staff cases currently. They will continue to stay in the “red” risk level and will revisit in January. Visit the SAU 20 office website for updates.

  • White Mountains Community College: Final examinations are finishing up, with the last exams occurring on Thursday. There are very few cases currently at WMCC. All COVID-19 precautions will continue in the spring semester, including the mask mandate.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: No update on this call.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: PHN has been consumed with preparations for the Booster Blitz effort that occurred on December 11. Their team administered 182 vaccinations at the Haverhill location. A significant number of additional registrants, unfortunately, did not attend and it appears that the weather could have been a factor. Overall, the clinic went smoothly and the next Booster Blitz clinic is planned for January 8, 2022. PHN has been able to partner with community health workers on new efforts due to recent additional funding. The community health workers are already working with vaccine recipients to scan for social determinants of health needs. They will also prepare a marketing campaign to share their capacity and the services that they can offer. With a new grant from the UNH Cooperative Extension Service, PHN is undertaking a new exciting project to identify and film vaccination ambassadors for the North Country. Print and video versions will be available by the beginning of the new year.

  • Healthy 603 Coalition: The Healthy 603 Coalition is a new organization consisting of different stakeholders, including the hospital association, the nurses association, medical societies, non-profit organizations, and businesses, who are working together to advocate for responsible vaccination legislation at the state level. In addition to legislative efforts, they will lead social media campaigns.

  • Congressional Delegation: No update on this call.


“The challenges will be plentiful, but I’m more confident than ever before that whatever hardships come to the North Country, we will work together to overcome them.”



12/09/2021: Rapidly Approaching a Crisis

Our work today is dedicated to the IT professionals who have supported the efforts of organizations that make essential services available. Their vital work has enabled telehealth capabilities and has often included the implementation of brand new systems to adapt to the rapidly changing environment.

***

The state of New Hampshire is rapidly approaching a crisis as new records of cases are reported daily and state healthcare facilities are increasingly strained.

NH announced 1,408 new cases on December 9. There were an average of 1,245 cases per day for the most recent 7-day period (December 3 to December 9). This is an 18% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.


According to the New York Times, there has been a 20% increase in reported COVID-19 cases by day in Coos County.


***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***

  • Healthcare professionals are continuing to encourage those who have developed COVID-19 symptoms to seek care as soon as possible. In addition, community members who have tested positive for COVID-19 (including those who have used a home-based testing kit) should contact their primary care provider.

  • On-Site Medical Services is leading a fixed vaccination site at The Chalet in Berlin. It is open Monday through Friday, 10 am - 7 pm and Saturday, 10 am - 2 pm. No appointment is needed.



Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: There are record numbers almost every day in terms of COVID-19 cases and hospitalizations, though Coos County numbers have not been as high as those in the southern part of the state. AVH is meeting daily with the New Hampshire Hospital Association and the New Hampshire Department of Health and Human Services. At the hospital, there are currently 3 COVID-19 patients, with 2 in Med/Surg and 1 in the ICU. None of the patients are on ventilators. Testing volume continues to be low. There was a 25% positivity rate from the rapid tests yesterday (though it was a small sample of only 12 tests). The volume in the Emergency Department has been increasingly high and there are very few options for patient transfers. Hospitals in the state are over-capacity and there is an increased sense of urgency.

  • Update from Coos County Family Health Services: CCFHS is concerned about the rising number of cases in the region, as well as the possibility of re-infection in long-term care facilities. They are strongly encouraging community members to receive their booster shots. At CCFHS testing clinics, there were 12 positive results this week between both PCR and rapid tests. However, there are low levels of testing overall. Vaccination clinics continue to be incredibly busy with booster shots. There has been a significant uptick in flu transmission and CCFHS is seeing daily cases. Call CCFHS at 603-752-2040 for a vaccine appointment.

Education

  • Update from Berlin Public Schools: The case count has remained low, with approximately 6 cases between both Berlin Elementary School and Berlin Middle High School. There are no current cases amongst staff members. There are a few students currently quarantining, as well as a couple of staff members who are symptomatic and awaiting results. In terms of mental health, it has been a difficult time for the students, with ongoing stressors of the pandemic adding to the situation. This is emotionally tiring work for staff. The upcoming school break starts on December 23 and will run through January 2. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: Cases are currently low, though SAU 20 is monitoring the situation in the region. Although they continue to see a low number of cases, it is not reaching zero. Echoing the concerns of Berlin Public Schools, mental health has been a focus and remains a critical aspect of adapting to the “new normal.” Visit the SAU 20 office website for updates.

  • White Mountains Community College: No update on this call.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: Gorham EMS is seeing an increase in COVID-19 patients.

  • Northern NH Correctional Facility: The Facility is doing well, with low rates of COVID-19 and zero current cases.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: The PHN team is working diligently to prepare for the Booster Blitz, taking place on December 11, from 10 am - 2 pm in Haverhill.

  • Congressional Delegation: Senator Hassan recently published an article explaining how vaccinations can save lives while supporting the economy. The delegation would like to thank all of the education and healthcare professionals for their continued hard work and dedication.



“We are rapidly approaching a point where none of us wanted to be. If things do not change significantly and quickly, we will be in a crisis.”



12/2/2021: Cause for Concern

Our work today is dedicated to the maintenance crew of the Berlin Public Schools. Bryan Lamirande and his group have been part of the many groups of unsung heroes. Without all of the behind-the-scenes folks, including maintenance workers and those who are helping to run the vaccination clinics, we would not have accomplished what we have so far.

***

Despite marginally improved rates of community transmission in the region, the state healthcare system is under incredible stress due to an increase in COVID-19 cases in the southern part of the state.

NH announced 1,134 new cases on December 2. There were an average of 975 cases per day for the most recent 7-day period (November 26 to December 2). This is a 5% DECREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***

Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: Over the last week, the hospital has been very busy in the ICU and in Med-Surg. The number of community members interested in testing has increased, with 47 people tested. 19 rapid tests were administered and 5 had positive results (approximately 26%). AVH is very concerned about the rise in cases in the southern part of the state. There have been 1,250 new COVID-19 cases in the last 24 hours. Tertiary facilities are currently completely full, which is a major concern. There are 4 patients currently with COVID-19 in the hospital and 2 post-COVID patients. In terms of communications, the AVH/NCH website will be undergoing updates and revisions within the next week.

  • Update from Coos County Family Health Services: Similar to the experience of AVH, community interest in testing seems to have increased at the CCFHS sites. Testing clinics were conducted throughout this week, with a handful of positive results. At today’s clinic, there were 40 individuals tested, with 4 positive results (a higher than normal rate). Regarding vaccinations, 103 individuals attended the Brown School vaccination clinic hosted today. Almost all of the attendees received their booster shot. CCFHS continues to offer vaccinations on Pleasant Street on Tuesdays and Thursdays from 1 pm - 4 pm. They are currently booking about a month out, due to the increase in demand stemming from the fact that all adults, 18+, are now eligible for a booster. Noting that there are currently many questions regarding the new Omicron variant, a CDC health advisory was issued this week with new guidance. CCFHS is also continuing their ongoing efforts to promote vaccinations. Call CCFHS at 603-752-2040 for a vaccine appointment.

“There is no need to panic. We have a number of tools to address what the Omicron variant throws at us, including antivirals that are on the cusp of being approved. Patience is the watchword here.”


  • Vaccine Update in Androscoggin Valley: The rates of community transmission are far lower in the Berlin/Gorham area than a couple of weeks ago. However, there are higher rates of transmission in Lancaster, Conway, and Littleton, as well as significant rates in the lower part of the state. There is incredible stress on the state healthcare system. It has not been greater at any point over the last 22 months. It is incredibly important to preserve capacity at the hospitals. It appears to be a fairly dire situation even though community transmission rates seem to have marginally improved.

Education

  • Update from Berlin Public Schools: The Berlin Public Schools remain stable with low numbers of COVID-19. One staff member is currently in isolation at Berlin Elementary School and no staff members are in isolation at the Berlin Middle High School. A few students at each school are currently in isolation. The schools are preparing to host upcoming gatherings as responsibly as possible, including Parent-Teacher conferences and holiday concerts, which will require masks and physical distancing. The schools will remain in “red,” noting the responsibility to the community amid the current strain on medical facilities. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: SAU 20 started on Monday with zero cases of COVID-19 among staff and students, however, there have been a handful of cases throughout the week. They will likely continue in “red” through the holidays due to the current strain on hospitals. Visit the SAU 20 office website for updates.

  • White Mountains Community College: No update on this call.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: No update on this call.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: Tri-County CAP would like to emphasize that there is not a vaccination requirement to obtain services through their organization. In terms of programming, there is currently an increase in applicants for fuel and rental assistance. As of right now, it does not matter if a community member has been affected by COVID-19 directly in order to receive services. All regular programs are running, operating on an income-basis. They are starting a new program to provide assistance to pay for water bills. All information on this new program, as well as the application, is on their website. As a note, if a community member qualifies for fuel assistance, they will be automatically approved for water assistance.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: In the past week, Gorham EMS has seen some higher acuity patients. They are preparing for their community Santa workshop tomorrow evening, where masks will be required.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: Boosters continue to be administered to staff and there will be an extension issued regarding disciplinary action if staff members have not yet been vaccinated.


Municipal and Local Business


Community and Legislative

  • Public Health Network: PHN has been very busy helping to plan the “Booster Blitz” initiative that was announced before Thanksgiving. There will be 3 different locations in the North Country, leveraging existing sites and current mobile capacity. Haverhill has been chosen as one of the sites, bolstered by the presence of On-site Medical Services in Berlin. At the 3 different locations on December 11, booster shots will be available for adults over the age of 18, from 9 am - 3 pm. PHN will also be hosting their second-dose community clinic this Saturday, December 4 at White Mountains Regional High School from 10 am to 2 pm. Primary series and booster ​COVID-19 vaccines will be available, including all 3 vaccine presentations. Flu vaccines​ will also be available for children. The clinic is open to the public and no advance registration is required. The statewide initiative for home-based testing also began this week, which was a partnership between the Institute of Health and Amazon. 1 million tests were secured, though 850,000 were claimed in the first 24 hours of the announcement. There is an effort underway to secure more tests to distribute. The intent of the program is to provide free, easily accessible testing methods to community members who may be symptomatic.


“We are seeing an incredible amount of activity right now in our clinics, but it is all booster activity. The same people who were hungry for vaccines in the beginning of the year are still interested. The people who have been resistant all along still seem to be resistant. There are only so many ways to share the same message.”

  • Congressional Delegation: No update on this call.

“There is incredible stress on the state healthcare system. It has not been greater at any point over the last 22 months. It is incredibly important to preserve capacity at the hospitals. It appears to be a fairly dire situation even though community transmission rates seem to have marginally improved.”

11/23/21: The Next Wave

Our work today is dedicated to those in Coos County who have lost their lives as a result of COVID-19 (69 Coos County residents and 1,672 statewide residents). We are keeping those folks, as well as their family and friends, in our hearts.

***

Partners are preparing for a surge in COVID-19 cases, amid the steady rise of infections in the southern part of the state and the upcoming holiday.


NH announced 561 new cases on November 23. There were an average of 955 cases per day for the most recent 7-day period (November 17 to November 23). This is a 9% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: It is currently busy, but stable, at AVH. The state is experiencing a new record for hospitalizations (367 individuals) and the emergency departments in the southern part of the state are definitely overwhelmed. AVH is worried and concerned about the surge that is likely coming. In terms of COVID testing, 40 individuals were tested yesterday and 20% of the results came back positive. Berlin recently extended their mask mandate last night, while Gorham has ended their mask mandate (while encouraging the community to continue wearing them). AVH staff issued a strong letter in local media platforms to emphasize the importance of vaccination and of continuing protective measures to halt community spread. In a recent development, the Governor will be issuing executive orders focused on alleviating testing demand, increasing vaccination opportunities, and providing flexibility to hospitals to prepare for the upcoming surge in cases.

  • Update from Coos County Family Health Services: In terms of testing, CCFHS provided 14 tests over the weekend, with 4 positive results. There were 11 tests provided today and no positive results. In anticipation of the next wave of cases, CCFHS is preparing to provide additional respiratory visits for adults. In partnership with AVH, they are also hoping to provide monoclonal antibodies to patients directly at their site, in order to keep patients out of the hospital. CCFHS continues to invite the community to brainstorm methods of creative outreach in order to strengthen vaccination efforts: “We’re going to have to do something a little different to move the needle here...this is about engaging people in conversation, listening to concerns, and trying to reach out to that subset of people who are on the fence - to answer questions and to see what we can do to help them make a decision.” Call CCFHS at 603-752-2040 for a vaccine appointment.

  • Update from On-Site Medical: Planning is on-schedule to open the vaccination clinic next week in Berlin on November 29. Vaccinations will be available Monday through Friday (10 am - 7 pm), and Saturday (9 am - 2 pm). On-Site Medical has continued preparations to offer mobile vaccinations as well. They are continuing to look into the possibility of adding testing capabilities to their sites, as well as the opportunity to provide flu vaccinations.

Education

  • Update from Berlin Public Schools: The Berlin Public Schools will be closing for the rest of the week for the holiday. Both staffing levels and COVID cases are currently stable. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: Sports are starting soon for SAU 20. The number of current COVID cases is stable. Visit the SAU 20 office website for updates.

  • White Mountains Community College: No major update on this call. The Community College will be closed on Thursday and Friday for the holiday.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: CCNH does not have any active resident cases of COVID-19. There is a second non-direct care worker who has tested positive for COVID-19, though they are asymptomatic. This makes two (2) active cases of non-direct care employees who are positive with COVID-19. Public Health is aware and contact tracing has been completed.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: No update on this call.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: The mask mandate ended last night in Gorham, although it has been recommended that community members continue wearing them. No other updates on this call.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: PHN recently attended a meeting with the state and found out that the Governor has decided to set up several vaccination sites. One will be hosted in Haverhill near PHN. They are recommending sites in the Haverhill/Woodsville area due to anticipated need. More information will be coming in the future.

  • Congressional Delegation: No update on this call.



“We are anticipating the next wave coming...it is not a matter of if, but when.”



11/18/2021: Status Quo

Our work today is dedicated to Dr. Brian Beals, who was recognized this week as the 2021 New Hampshire Community Star from the National Association of State Offices of Rural Health.

***

Overall, cases seem to have generally stabilized in the region over the past few weeks. However, amid concerns of a surge in nearby areas, there is work to be done and a need to consider methods of additional action.

NH announced 986 new cases on November 18. There were an average of 880 cases per day for the most recent 7-day period (November 12 to November 18). This is an 18% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: Over the past few days, there has not been a lot of COVID activity in the Emergency Room at AVH. There are currently 2 COVID patients in the ER, 1 active patient in Med/Surg, and no patients in the ICU. In terms of testing, only 25% of the rapid tests yesterday came back positive. While there have been beds available at AVH over the past few weeks in the Med/Surg and ICU units, in certain areas, such as Littleton, there appears to be a shortage. COVID cases across the state appear to be very high as of yesterday (the highest since January). There are concerns that as the southern section of the state experiences a surge in cases, the North Country will not be far behind.

  • Update from Coos County Family Health Services: In terms of testing, there were 28 tests performed yesterday and 31 performed today and none of the tests had positive results. Overall, the testing clinics are not filling up, which continues to be a trend. Testing will likely continue weekly despite the decreased demand to ensure access for the public. At the vaccine clinic this week, 77 people received vaccinations, though there was capacity for 400. CCFHS is hoping that demand will increase once it is decided that all adults (18+) are eligible for a booster shot. Currently, the majority of people coming to the clinics are receiving booster shots and there are only a handful of people receiving their first dose. CCFHS would also like to brainstorm creative ways to conduct outreach to the section of the public that may be hesitant to receive a vaccine. Call CCFHS at 603-752-2040 for a vaccine appointment.

  • Update from On-Site Medical: The fixed vaccination site in Berlin is starting on November 29 and will have capabilities for mobile access. It will be open Monday through Friday from 10 am - 7 pm, as well as on Saturday from 9 am - 2 pm. There is no charge for vaccines offered through this program. Sites in Plymouth, Claremont, and Rochester will likely follow.

Education

  • Update from Berlin Public Schools: The number of cases has dropped in the schools. There is currently 1 staff member and 2 students in isolation from Berlin Elementary School and 1 staff member and 6 students out in isolation and/or quarantine from the Berlin Middle High School. It is a relief to have stable levels of staffing once again. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: There is currently only 1 active case in the schools and a couple of individuals in quarantine. However, there are concerns about surges in nearby areas and SAU 20 will stay in the “red” zone for the time being. The schools are focused on educating the students and trying to enjoy the school year in the “new normal.” Visit the SAU 20 office website for updates.

  • White Mountains Community College: No update on this call.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: There is currently 1 active case from a non-direct care employee and contact tracing has been completed. Testing of unvaccinated staff for COVID-19 continues twice weekly, due to the high transmission rate of COVID-19 in Coos County. On November 5, 2021, the Centers for Medicare and Medicaid (CMS) announced they will now require mandatory COVID-19 vaccines for certain healthcare settings. The Coos County Nursing Home is covered by this regulation and must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021. Visitation is now allowed for all residents at all times, subject to the Core Principles of COVID-19 Infection Prevention.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: There is currently only 1 active case. Tri-County CAP is glad to hear of the new developments with the vaccination site in Berlin and they are hoping to provide free transportation to upcoming vaccination clinics.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: This week, there was a decrease in call volume. There were no COVID patients in their cases this week.

  • Northern NH Correctional Facility: In terms of COVID cases, the facility is doing well. They hosted a vaccination clinic for staff members on Monday, offering booster shots and the flu shot, with a positive turnout. Booster shots are also currently being offered to inmates.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: It was recently discovered that there might be a disconnect at the state level regarding the vaccine capability in the North Country due to the current methods for publicizing vaccination availability online. PHN is continuing to connect local groups with information about vaccination, including homeless shelters and housing facilities. They are starting to receive more requests for community-based clinics. PHN is thinking thoughtfully about how to conduct outreach and message effectively in ways that are specific to the North Country, recognizing that there is hesitation in the region regarding vaccination. The North Country Health Consortium 2021 Annual Meeting will be hosted tomorrow morning and all stakeholders are invited to participate.

  • Congressional Delegation: As today is National Rural Health Day, the delegation would like to recognize the work of this community group: “This group exemplifies what energized rural health truly means.”



“We want to make sure that the resources made available in the North Country are being made available in ways that make good sense for the North Country.”



11/11/2021: Grateful for Partnership

Our work today is dedicated to our elected officials who are trying to support their communities and to create public policy to serve the state well, all while addressing the concerns of multiple constituents.

***

Partners throughout the region continue to work together to promote vaccination opportunities to the public. This week, the N.H. Executive Council voted to accept significant funding to improve vaccination rates in the state (final approval is still needed from the Fiscal Committee).

NH announced 736 new cases on November 10. There were an average of 675 cases per day for the most recent 7-day period (November 4 to November 10). This is a 27 % INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: AVH had two COVID inpatients today, which is a lower number than they have seen in a while. Unfortunately, one patient passed away earlier in the week. In terms of testing, their center had 25 swabs, 11 rapid tests, and only 3 positive results. They are happy to share that they have noticed an improvement in coordination between primary care providers and monoclonal treatment. The last 2 patients received monoclonal antibodies within 48 hours, which is a marked improvement from when patients might not receive this treatment until 5-10 days into care. AVH is also focusing on flu vaccine administration in the hospital. Generally, it seems that COVID numbers have decreased compared to the numbers from the last couple of weeks, though Littleton seems to be experiencing a high COVID positivity rate. Although the situation can change rapidly, overall, it seems that the numbers are headed in the right direction. As an additional note, AVH would like to thank the Berlin Fire Department and to recognize the 3 firefighters who helped to administer emergency CPR during a recent situation in the Emergency Room. They are grateful to the Fire Department for their partnership.

  • Update from Coos County Family Health Services: Overall, the testing volume is down. They have received a few positive results, but the numbers are much lower than a few weeks ago. The Brown School clinic hosted approximately 170 people, mostly who were receiving a booster shot (though at least 2 individuals received their first dose). Although they do not have the final headcount, it generally seems to have been lower than expected. The clinic had capacity to administer 400 vaccines. CCFHS continues to consider ways to improve messaging to ensure the community is aware of their booster eligibility. The state is setting up a vaccination clinic in Berlin and Plymouth and CCFHS has reached out to ensure efforts are coordinated. In the news, the N.H. Executive Council voted to accept $22 million for vaccination efforts (though approval is still needed from the Fiscal Committee). Call CCHFS at 603-752-2040 for a vaccine appointment.

Education

  • Update from Berlin Public Schools: No update on this call. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: No update on this call. Visit the SAU 20 office website for updates.

  • White Mountains Community College: The event yesterday went well and they would like to thank the Congressional Delegation (particularly Chuck and Madison) for their work in organizing it. The remarks were appreciated for their recognition of what was going on in the region and the highlights shared from the work of this group.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: No update on this call.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: The Public Health Network is excited to learn of the recent news that the Executive Council intends to move forward with some of the available federal funding for vaccination support. In particular, they would like to recognize the importance of the infrastructure opportunities that will become available if this funding proceeds. For example, this funding will be used for several temporary positions allocated to improving and integrating the state’s immunization information system, resulting in long-lasting positive effects for the New Hampshire Immunization Program, which delivers all types of vaccines administered in the state. They are also gearing up for their community-based clinic on November 13 at White Mountains Regional High School from 10 am to 2 pm. COVID-19 vaccines will be available for kids aged 5-11. They will also provide all 3 COVID vaccines for adults looking to receive their primary COVID-19 vaccination series and booster shots, as well as the flu vaccine ​for children aged 4-19. The clinic is open to the public. No advance registration is required, but registration forms are available at https://bit.ly/WMRHSclinic for folks who would like to fill them out in advance. Second doses will be offered three weeks later, on Saturday, December 4. They are hoping to administer at least 100 vaccines, with capacity for up to 300. PHN has provided a graphic to use for the promotion of tomorrow’s vaccination clinic.

  • Congressional Delegation: The Congressional Delegation is grateful to the members of the group for their partnership and their continued work in communities. At a recent community event, the efforts of the partners in the group were highlighted and the Congressional Delegation was able to share how they are working to ensure that funding and support continues to be provided.


“We are encouraging the public to step up...every dose that is administered is important to this whole process.”



11/04/2021: Lots of little ones being vaccinated!

Our work today is dedicated to: all of CCFHS for working to get a youth clinic set up so fast, as well as the partners at the state (and UPS!).

***

This week brings uplifting news, with the FDA authorization of the Pfizer- BioNTech COVID-19 pediatric vaccine in children 5-11 years of age, but it is clear that there is still work to be done as numbers of new cases in the North Country remain quite high.


NH announced 635 new cases on November 4. There were an average of 585 cases per day for the most recent 7-day period (October 29 to November 4). This is a 38% increase compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

***

NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


The Vaccine is available to anyone 5+ years old by calling Coos County Family Health Services at 603-752-2040

***

  • Pediatric Vaccine Authorization: On October 29th, 2021, the U.S. Food and Drug Administration (FDA) authorized use of the Pfizer- BioNTech COVID-19 pediatric vaccine in children 5-11 years of age.

  • Early COVID-19 Intervention Encouraged: North Country Healthcare (NCH) is strongly encouraging all patients who begin to experience symptoms consistent with COVID-19 (difficulty breathing, nasal congestion, nausea, vomiting, etc.) to not delay seeking care. Rather, it is encouraged to speak with your healthcare provider, and promptly explain the changes in your health. Prompt action, including COVID-19 testing, is critical to appropriate treatment of this disease.


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: Yesterday, the Emergency Department had 21 patients, a slight uptick from the day prior. Of the 6 in-house patients, 4 are unvaccinated. 24 individuals were tested yesterday, with 16 positive rapid test results. AVH is conducting flu clinics for employees today and a Moderna booster clinic tomorrow, with 17 people already signed up. In terms of communications, there is a letter in the paper stressing urgency of care today, with another planned from senior staff tomorrow. A survey also was sent to staff today asking if people were interested in having their children get vaccinated.

  • Update from Coos County Family Health Services: Of the pediatric testing carried out today, there were no positive results. Generally, the positive results have occurred at smaller percentages compared to a couple of weeks ago. However, new cases in North Country remain quite high overall and rapid testing supplies are starting to become tight again. In terms of communication efforts, CCFHS started the “My Why” campaign, which was highlighted in the local paper today and appears to resonate well with the community. A sample of the “My Why” campaign is available here. CCFHS plans to move back to a more normal posture starting on Monday, November 8, pivoting from a primary focus on telehealth to a more face-to-face format.

  • Vaccine Update in Androscoggin Valley: A lot of vaccines are currently being administered, with boosters and third doses available at Brown today. Close to 400 vaccines will be administered by staff from CCFHS, AVH, and volunteers. Dr. Beals has started a pediatric vaccination clinic today. Confirmation is still needed on the numbers, but CCFHS received 500 doses from the State yesterday. Clinics will occur this evening and tomorrow afternoon at Pleasant Street Clinic. CCFHS continues to offer testing and vaccines through clinics on Tuesdays and Thursdays with individual appointments available. CCFHS also shared a fact sheet detailing important information for parents to know regarding the vaccine. Call CCHFS at 603-752-2040 for a vaccine appointment.


Education

  • Update from Berlin Public Schools: There are lots of little ones being vaccinated and Berlin Public Schools would like to thank everyone for their efforts in this accomplishment. Dr. Beals reached out to the schools to notify families regarding the clinics being offered today and tomorrow afternoon. It was reported that, as of this morning, 75 had signed up for the clinic today and 50 more for tomorrow. There are over 100 people signed up for the staff booster clinic tomorrow, which will offer all 3 vaccines. Only 1 new positive case was reported today. Overall, things have been trending well. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: There continues to be a decline in active cases and there is currently only 1 active case per building. Mitigation efforts seem to be working well. If the trends continue, SAU 20 is hoping to move toward allowing students to eat together again in the cafeteria to allow for a sense of normalcy. Booster clinics have already occurred for employees at the Middle/High schools and nearly all staff have attended. A clinic for the Elementary school staff is currently being planned. Visit the SAU 20 office website for updates.

  • White Mountains Community College: There has been minimal transmission at the Community College, with only a case here and there. White Mountains Community College is trying to allow flexibility for parents as children become eligible for the vaccine.The community has unfortunately recently experienced loss due to COVID-19, so there are some additional folks stepping up to get their vaccines as a result of that.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: They have been advised that the second employee who was presumed positive for Covid-19 is negative, with all of the resident activities, social visits, and communal dining in the related section of the Nursing Home resuming, and another round of testing being initiated for the other section of the facility. All of the same infection prevention and control measures as previously reported are being continued.

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: No update on this call.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: No update on this call.

  • Gorham EMS: There have not been many changes. There has been a drop-off in requests for testing. Many staff members are getting their third doses of the vaccine. Gorham EMS also shared an official NH DHHS Health Alert regarding the recent FDA vaccine authorization for children 5-11 years old.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: There have not been any major changes. They are continuing the efforts regarding booster shots.


Municipal and Local Business


Community and Legislative

  • Public Health Network: With a rapid turnaround, the Public Health Network received contracts to extend their vaccination efforts tied to ARPA funding. The funding will allow the Network to continue vaccination efforts for the newly eligible 5-11 year old age group, as well as to continue primary series, boosters, and third doses that they have been working hard to get to communities. They also received an additional piece of funding to fund a community health worker position, which will allow for an increased focus on alleviating the primary drivers of inequity in communities. The community worker will conduct active outreach and connect individuals to testing and vaccines, particularly focusing on more vulnerable populations, such as homebound elderly, lower socioeconomic groups, and homeless individuals. They are also working on an employer request for a booster clinic and took a count of employees that are interested in receiving one (75 have responded so far). 2 clinics have been requested to provide boosters to first responders. The North Country PHN will conduct a vaccine clinic on November 13 at White Mountains Regional High School from 10 am to 2 pm. COVID-19 vaccines will be available for kids aged 5-11. They will also provide all 3 COVID vaccines for adults looking to receive their primary COVID-19 vaccination series and booster shots, as well as the flu vaccine ​for children aged 4-19. The clinic is open to the public and no advance registration is required. Second doses will be offered three weeks later, on Saturday, December 4.

  • Congressional Delegation: The Offices of Senator Shaheen and Senator Hassan both sent letters to Secretary Becerra regarding the shortage of COVID tests in New Hampshire and the increased wait times for testing results. In a Committee meeting this morning, Senator Hassan received confirmation that New Hampshire will receive 60,000 additional rapid tests (10,000 tests per week).



“This is an emotional moment for many people...there is a real sense of relief stemming from the fact that their kids can get protection.”



Additional Information:

NH's COVID-19 statewide summary reports: https://www.nh.gov/covid19/

10/28/21: Counting on you #StepUpNH

Our work today is dedicated to all those involved in reinstating mask mandates passed in Berlin and Gorham this week to protect community members.

(Read more about local mask ordinances in Berlin Sun article 10/28/21)

***

Counting on you:

As the team at Coos County Family Health Services gears up for a second pandemic winter, we urge our community members to get vaccinated, wear your masks, practice good hygiene and do all you can to protect yourself and those around you. (Read more at Berlin Sun’s 10/28/21 editorial letter)


“The surge in Covid-19 cases appears to have eased in Androscoggin Valley but health care officials are wary that the recent numbers are a temporary lull. The state Monday reported 59 active cases in Berlin, 12 in Gorham, 7 in Milan, and under 4 in Randolph, and Dummer. A week ago, the Berlin-Gorham area had about 174 active cases. Coos County now has 131 active cases compared to 217 active cases a week ago. There is guarded optimism among AV Covid-19 Community Group members”: (Read more at Berlin Sun’s 10/28/21 coverage)


Due to an issue with the system healthcare providers use to inform NH DHHS of new cases of Covid-19, new case data is unavailable as of 10/28/21. The state dashboard will be updated soon. Visit https://www.covid19.nh.gov/ for more information. Visit www.covidactnow.org for additional NH and Coos County information.


NCH videos: #StepUpNH and #MaskUpNH


Who needs an additional Covid-19 vaccine or booster?

Informational FAQ from North Country Healthcare


Vaccine is available to anyone 12+ years old by calling Coos County Family Health Services at 603-752-2040

***

Sadly, another Androscoggin Valley community member has passed away from Covid-19 related illness: Pastor Rob leaves legacy of caring. (Berlin Sun, 10/26/21) Our deepest condolences to Pastor Rob’s family, friends, and the community.


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: On Wednesday 10/27, AVH saw 18 patients in the ER, four (4) of the 18 were positive for Covid. Thursday 10/28, on MedSurge (non-ICU) unit, there are currently 11 inpatients, three (3) of whom are Covid positive. On ICU, there are three (3) patients, two (2) of which are Covid positive. Three patients received monoclonal antibodies. On Wednesday 10/27, 45 Covid tests were administered, of them 27 were rapid and 4 were positive. Numbers are improving however, systems and services remain impacted to focus on Covid response. Maternity ward is busy over the next week.

  • Update from Coos County Family Health Services: Testing volume this week is down compared to past few weeks and there have only been a few positive cases. Telehealth will continue next week.

  • Vaccine Update in Androscoggin Valley: The Brown School vaccine clinic administered over 100+ Moderna third dose / boosters on Thursday 10/28. Next week vaccine clinic continues on Thursday with an anticipated 400 appointments. Informational FAQ from North Country Healthcare on Covid-19 third doses or boosters. Call CCHFS at 603-752-2040 for a vaccine appointment.

  • Other health updates: Healthcare providers are fielding calls from parents asking questions about the pediatric vaccine anticipated to be approved for 5 - 11 year olds. Dosage is dependent on age and immune system development rather than size. More information to come from North Country pediatric healthcare providers.


Education

Have a safe and Covid-free Halloween!

  • Update from Berlin Public Schools: Berlin Schools continue to see Covid numbers drop. There are currently two (2) staff and nine (9) students out with positive cases. The schools are working with CCFHS to set up staff vaccine booster clinics for next week. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: Numbers of positive cases continue to drop in SAU20 schools as well. Currently 1 student and 1 staff out at GMHS, down from a high of 13 several weeks ago. There is a low absence rate and optimistic to return to yellow status, however the schools are currently supporting required masking to end this surge. Staff are signing up for booster shots. Visit the SAU 20 office website for updates.

  • White Mountains Community College: No update on this call.


“Many staff members are eager and anxious to get their third dose booster shots - that’s good news.”


“We will respond to this new normal with ups and downs and through it all we’ll provide the best education we can for our students.”

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home: Public Health advised CCNH to test all residents potentially exposed to a positive staff member over the past 14 days, which is a change from the previous 48-hour exposure window policy. All rapid tests were negative and a second round of PCR lab-based testing will occur early next week (Nov. 1 or 2). Visits will continue following policies based on residence floor. Call CCNH for more information. All infection prevention measures will continue and Covid vaccines and boosters are offered in-house to all residents and staff in coordination with AVH. (Update from Berlin Sun 10/28/21 editorial letter)

  • Northern Human Services: No update on this call.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: Two (2) staff are out with positive Covid cases causing some staff shortage in programs. The organization is looking forward to hosting students this week from NH health careers programs to share the role social services play in supporting social determinants of health.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: Attended, no additional update today.

  • Gorham EMS: The department is assisting businesses and the public with understanding Gorham’s updated mask ordinance. Call Town Hall for posters available to area businesses.

  • Northern NH Correctional Facility: No update on this call.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: The network received revised orders to supply vaccine boosters in the region. A vaccine clinic was held 10/28/21 with SAU58 for flu and Pfizer Covid-19 booster vaccines available to those eligible. Public health officials are responding to school requests to begin planning for vaccine clinics available to students 5-11 years old with their parent(s)/guardian. NH is anticipating delivery of pediatric doses as early as next week once officially approved. There are 100,000 5-11 year olds in NH and public health officials are encouraged that the enough vaccine doses will be made available to avoid any immediate shortages for pediatric doses. Area health partners are supporting workforce development with hosting public health AHEC scholars this week to learn more about practicing healthcare in NH’s rural communities

  • Congressional Delegation: Federal delegation offices are involved in the new legislative reconciliation package currently being considered. Sen. Maggie Hassan joined the call to express her thanks to everyone working in public health and Covid-19 response in the Androscoggin Valley community. The senator expressed her condolences for the community members recently lost to Covid-19. Members of the call expressed thanks to Sen. Hassan and the delegation for working to get federal funding available to NH to support vaccine and other public health efforts, including funds recently passed up by NH’s Executive Council. The senator recognized the hard work in Androscoggin Valley and the North Country in light of the recent Covid surge, including the effects on schools and workforce.


“It’s a hard time and a time that we will get through. It’s a time to partner with each other as this group does. We hope to see the Covid positive numbers continue to go down and see an uptick in vaccination and boosters. The entire delegation is working to find ways to get you the funds needed to respond to this public health crisis.”

10/21/21: It’s hurting right now

“Unfortunately for some in the community, it doesn’t become real until it really hurts. It’s hurting right now. The front page of the paper this week tells the simple story of how dangerous Covid is.”

Sadly, we have lost community members to Covid this week:

COVID claims life of dedicated Berlin community volunteer, Guy Lopez. (Berlin Sun, 10/21/21)

Our deepest condolences to family, friends, fellow volunteers, and the community.

Amid a COVID-19 surge in the North Country, residents and officials hope behavior will change. (NHPR, 10/20/21)

***

Coos County positivity rate remains at an extreme level with 96 per 100,000 as of 10/20/21. Coos County continues to have the highest 7-day test positivity rate in NH at 13.2%. There are early indications that numbers are improving, however they are still very high compared to the rest of NH. (Sources CovidActNow.org and Covid19.nh.gov)


NH announced 609 new cases on 10/21/21. There were an average of 538 cases per day for the most recent 7-day period (10/15/21 - 10/21/21). This is a 6% decrease compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

Initial vaccine and third doses are available by calling Coos County Family Health Services at 603-752-2040

#MaskUpNH video #SleeveUp with AVH and CCFHS

***

Our work today is dedicated to our southern NH healthcare colleagues, especially at Cheshire Medical Center, Dartmouth-Hitchcock, and Concord Hospital.

Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: The hospital has seven (7) Covid inpatients in a census of 18. Sadly, patients have passed away due to Covid illness. One patient remains on a ventilator. There were a total of 67 Covid tests conducted on Wednesday 10/20/21, and of 38 rapid tests, 7 were positive. Overall the hospital is stable though some non-emergency services are curtailed to care for Covid patients. Within the North Country Healthcare system, Weeks Medical Center is very busy with some critical Covid patients and Upper Connecticut Valley Hospital in Colebrook is experiencing high volume.

“We know how sick people can get. Seven (7) Covid inpatients may not sound like a lot, but this has a BIG impact on available hospital services and staff capacity.”

  • Update from Coos County Family Health Services: On Thursday 10/21/21, 49 tests were conducted, with 11 rapid tests, and for the first time in a long time, there were 0 positives. There were nine (9) pediatric rapid tests and one positive result. CCHFS update: Currently 50% of patients are coming in for appointments, 40% are seen over the phone, and 10% have telehealth appointments.

  • Vaccine Update in Androscoggin Valley: The former Brown School vaccine clinic will soon reopen on Thursdays for third doses of Moderna. Initial clinics aim to see 200, followed by 400 a day, once a week to meet demand. More details and getting the word out soon. CCFHS Pleasant Street is open for Pfizer third doses. Call CCHFS at 603-752-2040 for a vaccine appointment - initial and third doses. Vaccine clinics for pediatrics will be developed soon, likely held at CCFHS buildings and exam rooms at times best for families - evenings and weekends.

  • Other health updates: NH state senate is working on another vaccine funding effort after the Executive Council voted down federal funds to support the effort.

“Super powers are built when you get a Covid vaccine. Getting Covid in an unvaccinated state can have a very different outcome.”

Education

  • Update from Berlin Public Schools: At each school, BMHS and Berlin Elementary, there are four staff and seven students positive. Staffing was difficult at the Elementary School on Thursday even as numbers are starting to go down. The Public Health Network has a supply of PPE to deliver to Berlin Public Schools.

  • Update from SAU 20: Covid positivity numbers are decreasing this week. Positive cases in schools are: one staff and two students at GMHS, two at Ed Fenn Elementary, and one at Milan Village School. Staff are interested in clinic information for the third dose. Visit the SAU 20 office website for updates.

  • White Mountains Community College: Present, but no additional update this call. Status quo.

“Covid has a huge impact on all of us, including our schools. There is interconnectedness through the whole community.”

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update on this call.

  • Coos County Nursing Home update: No update on this call.

  • Northern Human Services: Services continue to be available in person with preventative measures and remote / telehealth services are available. The Crossroads program with communal gathering is on hold for several weeks until Covid numbers decrease. Staff are affected but client services have not been impacted. The organization will coordinate with the Public Health Network for third dose vaccine clinics.

  • Family Resource Center: No update on this call.

  • Tri-County CAP: No update on this call.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: The department helped place over 30 Covid-prevention best practice posters around city businesses and buildings to help remind people. Chief James Watkins was on NHPR sharing Berlin’s current Covid story and hoping behavior will change.

  • Gorham EMS: The department is involved in transferring Covid patients from the hospital. EMS will provide information to the Public Health Network to reach those eligible for third vaccine doses in local housing facilities. In non-Covid news, the department transported several car accident patients to the hospital on Wednesday night.

  • Northern NH Correctional Facility: The last quarantine unit was cleared on Thursday 10/21/21 and there are no inmate cases. One staff member remains out. Covid impacts on the facility have improved and are stable.

  • Federal Corrections Institution: No update on this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: Public health staff are coordinating with southern NH colleagues to assist with third dose vaccine clinics in the North Country. The network continues its effort with northern NH schools as well.

  • Congressional Delegation: Present on the call, no additional updates.

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10/14/21: Rockstars for the kids

Our work today is dedicated to those working in public health – their important work is valued by this group.

***

Limiting community transmission is now the best tool for mitigating the current surge in Androscoggin Valley, including staying home, social distancing and mask compliance indoors, and masking outdoors when within 6 ft. Vaccination is the best defense against COVID-19. Vaccines and testing are available by appointment at CCFHS and testing at AVH.

___

NH announced 620 new cases on Thursday Oct. 14th. There were an average of 537 cases per day for the most recent 7-day period (Oct. 8 to Oct. 14). This is a 12% INCREASE compared to the previous 7-day period. More information at https://www.covid19.nh.gov/.

#MaskUpNH video #SleeveUp with AVH and CCFHS

Vaccine is available to anyone 12+ years old by calling Coos County Family Health Services at 603-752-2040

***

Coos County's fully vaccinated rate is 55.9% as of October 14th, the lowest county-wide rate in NH. A slight uptick in vaccination is occurring in response to the surge, however it is weeks away from having a real mitigation impact at the community level. Preventing transmission, including masking, is a critical strategy right now to reduce the spread.

Now is also the time to get a seasonal flu shot!


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: There are currently ten (10) Covid-19 inpatients, one on a ventilator. There were four (4) Covid patients admitted to the ER Thursday, some received monoclonal antibodies, and all are returning home. AVH is working hard to support patient needs in all circumstances. Mike Peterson, AVH President and CEO, spoke with NHPR on 10/14/21 to share more about AVH’s experience with its worst Covid surge since the pandemic’s start. All critically ill AVH Covid-19 inpatients are unvaccinated. Hospital staffing is stretched thin and steps are being taken to free up beds and make staff available. Staff of Berlin Public Schools are sending care baskets to AVH staff in appreciation of their hard work in these extreme circumstances.

  • Statewide update: Hospitals in the neighboring regions and southern NH regions are also experiencing a surge. There are 140 inpatients statewide and ICU beds are critically low across the state.

  • Update from Coos County Family Health Services: 38 rapid tests were conducted Thursday with two (2) positives. Dr. Beals tested 14 on Thursday with two (2) positive children under the age of 5. Pediatric testing is trending down compared to last week. Dr. Beals and his team are greatly appreciated by the community! Staff are stretched thin and experiencing fatigue and stress from the past couple of weeks. CCFHS will be starting telehealth visits on Monday for the next weeks and the waiting rooms remain closed.

  • Vaccine Update in Androscoggin Valley: CCHFS is seeing an uptick in demand for Covid shots as well as for eligible 3rd doses. They are looking to expand the vaccination clinics to meet demand and need. Homebound individuals can receive a home visit for 3rd dose by calling CCHFS. Call CCHFS 603-752-2040 for a vaccine appointment for anyone 12+ years. Vaccine development for ages 5-11 is being monitored, as well as consideration of Moderna third doses.

Education

  • Update from Berlin Public Schools: BMHS currently has three (3) positive staff for a total of four (4) staff positive since the beginning of this school year. There are currently 20 positive BMHS students, with a total of 66 since the beginning of the school year. Berlin Elementary School has no staff currently positive, with a total of 10 since the beginning of the school year. There are currently 24 positive BES students, for a total of 37 since the beginning of the school year. School nursing offices have been out straight with a high of 17 students sent home on one day last week at BMHS. This is showing improvement this week with one day having only 3 sent home. BMHS absence rates peaked at 27% and now down to 20%. BES absence rates peaked at 22% and now slightly down to 17%. Elementary staff experienced two very difficult weeks covering students with 20% absence last week. At the end of this week 6% staff absence shows improvement. Universal masking has helped to improve the situation. There continues to be little school transmission compared to most contract tracing to outside school and family activities. In good news, the school district received a large grant for computers and chromebooks from emergency connectivity legislation - thank you to the delegation! Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: GMHS now has six (6) active cases, down from 13 positive students and staff from two weeks ago. Mitigation and masking efforts have improved the situation. With large community events this weekend during this surge, schools are asking community members to wear masks indoors and to continue masking outdoors because distances may not be maintained at all times during these events. The school nursing offices are quickly going through available testing kits, as well as sending students out for testing. Visit the SAU 20 office website for updates.

  • Update from SAU 7: The Superintendent from NH’s northern most SAU attended the call to listen and provide an update. Pittsburg School has one (1) positive case, with six (6) cases since the beginning of this school year. Universal masking is in currently in place. Stewartstown had one recent case, which was resolved and not spread. Colebrook has 15 active cases, with 18 since the beginning of the school year. Last week was a peak. There are significant staffing issues with 40% staff out last week and student absence 15-18%, which is high for the schools. Unrelated clusters have been identified so the schools are in outbreak status with universal masking in place, which has helped mitigate transmission. This week is seeing some improvement.

  • White Mountains Community College: No update this call.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: The last rounds of Covid testing for all residents and staff were returned with no additional positive cases. The initial positive from last week has not resulted in additional cases so far and if negative status is maintained, the organization will be out of response mode by next week. The state lab identified some errors and false positives and the additional staff provided negative results when retested.

  • Coos County Nursing Home update: No update this call.

  • Northern Human Services: Masks and screening before entry for all staff and clients is required and in person visits may continue in the absence of any symptoms. Remote / telehealth services are available to those who need it.

  • Family Resource Center: Attended, but no additional update this call.

  • Tri-County CAP: No update this call.

Emergency Services and Correctional Facilities

  • Berlin Fire / EMD: Attended, but no additional update this call.

  • Gorham EMS: First responders have upgraded to wearing n95 masks on calls with Fire Department personnel upgrading as well. The department is not extra busy with Covid response, but they are working with AVH on transfer requests. Staff are drained and spread thin with several staff out or in quarantine to care for family. Staff are noting that the severity of illness from C-19 is worse than previous strains.

  • Northern NH Correctional Facility: As of Wed. 10/13/21, there are five (5) positive inmates, a reduction of two (2) positive cases since Monday, and two (2) positive staff, with other staff cleared to return by the end of the week. Two units are quarantined and will be cleared next week, pending any further positive cases. The situation is showing slight improvement over the previous week.

  • Federal Corrections Institution: No update this call.


Municipal and Local Business

  • City of Berlin and Town of Gorham: Both local municipalities issued a Code Red last week updating community members on the C-19 surge and recommended action to reduce community transmission. The Code Red information was sent out to additional Gorham businesses. Ken Gordon, CCFHS and Mike Peterson, AVH met with both Berlin City Council and Gorham Select Board this past week to discuss the surge and response.

  • Androscoggin Valley Chamber of Commerce: No update this call. The Code Red information was sent out to all Chamber members.


Community and Legislative

  • Public Health Network: Flu vaccine clinics are currently being held around the region, with Covid vaccines available. Mobile vaccine van is available to employers and for community gatherings and the state is looking to add North Country visits. PPE supplies are available to partner organizations. Get in touch with Kris van Bergen-Buteau at NCHC for supplies or mobile clinic information.

  • Congressional delegation: Offices of Sen. Shaheen and Rep. Kuster are working to assist Androscoggin Valley organizations in their response to the current surge. NH’s Executive Council voted to turn down 27M from the federal government for vaccine support and other community health center / public health efforts. The congressional delegation is looking into other opportunities to provide support to NH.


“The pediatric team of Dr. Beals and staff are rockstars. They are doing an amazing job of caring for young people in this community, especially over the recent weeks. They are greatly appreciated.”

10/11/21 Code Red - Berlin Emergency Management COVID Task Force

And shared by other Androscoggin Valley municipalities

Forwarding on behalf of the Berlin Emergency Management COVID Task Force:

With the current situation in the community, our COVID Emergency Management Task Force wanted to reach out to everyone with a few updates and reminders. Please share this message.


As you likely have heard, Berlin and Gorham are experiencing extremely high levels of community transmission, the larger problem is that this is overwhelming Androscoggin Valley Hospital, Coos County Family Health Services, and the local Emergency Medical Services.

To put this in perspective, this is the worst we have seen since the pandemic started 18 months ago.

An update on yesterday's Oct. 11th local conference call regarding the status at AVH:

  1. Eleven (11) patients currently in the hospital due to COVID.

  2. Three (3) of them are in the Intensive Care Unit.

  3. Two (2) of them are on ventilators.

  4. AVH is working to transfer any non-Covid emergency patients to other hospitals for care, but beds are scarce across the State.


The situation at AVH is being described as dire. AVH and CCFHS are experiencing staffing shortages, Covid positive employees, and systems which are being stressed to the max.

The good news is you and your networks can do something to make a difference:

  1. Stay home from work if you have any symptoms and get tested.

  2. Wear a mask indoors in public settings.

  3. Avoid large groups, especially indoors.

  4. Get vaccinated, Covid-19 and the flu shot.


We have all been down this road before, but this time the situation at AVH is dire, Please help do your part to get us through this. The consensus is that we likely have at least 2 weeks more during which it will only get worse. The pandemic won't last forever and now is the time to make a difference.

We are posting a Face Covering message that is similar to the attached message on City buildings. I know many businesses have done this. Now is a good time to set the same expectation.

Stay Safe and Healthy,

Berlin Emergency Management COVID Task Force

Jay Watkins, Fire Chief, EMD

Pete Morency, Police Chief BPD

Dan Buteau, Deputy Chief BPD

Jennifer Cloutier, Communications Manager BPD

Pamela Laflamme, Community Development Director

Jim Wheeler, City Manager

10/7/2021 We all need to pull together again

Our work today is dedicated to the Emergency Room staff at AVH.

***

Daily new cases in Coos County average 92.3/100k, which is a very high level of community transmission. The positive test rate is 7.2%. The infection rate is 1.21.

***

Health Care and Medical Services

§ Update from Androscoggin Valley Hospital: Things have been busy in the ER with Covid. They are getting about 2 admissions per day. They currently have 8 patients, as there have been a few discharges. There are 3 in the ICU who are stable but not getting better, and 5 on the floor. They had their first Covid death with an elderly patient. In speaking with other area hospitals, Lancaster currently has 4 patients, Colebrook 2, possibly 3, and the ICU in Littleton is full. Cases are becoming widespread. They did 70 tests yesterday, 42 rapid tests, and 10 were positive. They are having a difficult time transferring any patients, and will probably not be able to transfer any Covid positive patients. Although they cannot control the Covid population, they can control elective surgeries, of which some have been moved out a few weeks. They can also cut down on procedures to preserve respiratory therapists. All in all, the hospital is stable. There is a shortage of Covid testing, and they are working to get additional testing. Currently, they are considering utilizing a third space for Covid testing, monoclonals, IV therapy, and provider coverage to preserve the functions of AVH and CCFHS. Both Brown School and the Armory were suggested as possible locations. They would need to obtain a waiver, and if the plan is put in place, would like to put it up in 48-72 hours depending on what IT is able to do. WMCC advised that nurses and medical assistants would be happy to help if there is a way for them to be of assistance at the alternate location. It was noted that the surge in the South lasted about 4 weeks, and they are hoping it will only last 2-3 weeks here. They reviewed the Kentucky trend, and pointed out that NH is mirroring what happened there. They are trying to avoid what happened there with hospitalizations. Everyone is the community plays a part in taking steps to minimize the impact here.

§ Update from Coos County Family Health Services: They are struggling with supplies for BiNAX and rapid test supplies. They had an additional 20 positive cases, of which 7 were school age. Three of the school age children were from Berlin, and 4 form Gorham. They are still continuing vaccine clinics, and have had about 20 per clinic. They administered 7 third doses this week. Flu clinics are beginning to ramp up. The waiting rooms are closed. The RiverFire 5k will be held virtually again this year. A concern was shared about the FFRCA benefits, as employees are now required to use their own leave time to stay home with children or family members. This creates a hardship on parents and may jeopardize public health. They will reach out to the national delegation to try to extend this benefit.

§ Other updates: AVH advised they do have a marketing campaign in the works and more information will be available on that later.

Education

§ Update from Berlin Public Schools: This week was better than last with fewer positives, but they still have about 14 students in isolation from both schools and many more out with symptoms. At the high school, they noticed that almost all of the students that have been positive are unvaccinated. They do not have any staff at the high school on isolation. At the elementary school they currently have 6 staff on isolation that are all vaccinated, also many staff out with symptoms or with childcare issues. They will be picking up BiNAX now supplies tomorrow in Concord. It was noted that some are going early for tests and they are not reading accurately. It was suggested that the community numbers be posted so that people are aware of what is happening, as the information bar that used to be on WMUR is gone.

§ Update from SAU 20: They have slowed a little with cases. They have a total of 6 students and 3 staff out. There is only 1 case in Milan and no cases in Errol.

§ White Mountains Community College Masks are now required, they are spacing as much as possible, and they are canceling or limiting events that were planned.

Family Resources and Long-Term Care Facilities

§ St. Vincent de Paul: They had one employee test positive.

§ Coos County Nursing Home: They still have a few positives among staff.

§ Northern Human Services: No update this call.

§ Family Resource Center: They have had several staff test positive and have closed down offices until next Tuesday. Staff meeting will be held virtually only. Visits with clients will be conducted outside or by telehealth. They do have an event planned at the end of the month for Halloween, and will be discussing whether or not this will be cancelled.

§ Tri-County CAP: They officers will be closed to the public but will remain operational, as they have had several staff members test positive. Transit will still be running but they will be limiting the number of passengers on the buses. If there is a new testing site, they will work to provide transportation safely to those needing it.

Emergency Services and Correctional Facilities

§ Gorham EMS and Berlin Fire / EMD Gorham EMS advised they have been doing 1 or 2 rapid tests for first responders each day, with a couple of positives, but mostly negatives. They advised that any first responders who are having trouble getting tested should contact them and they can provide the service. Berlin Emergency Management advised that they are monitoring numbers with RiverFire coming up.

§ Northern NH Correctional Facility: They do have a cluster of cases at the prison.

§ Federal Corrections Institution: No update this call.

Municipal and Local Business

§ Androscoggin Valley Chamber of Commerce: They met with the Berlin PD today on the logistics for RiverFire. They are still moving forward with the event, but cautiously and with modifications. Everything is held outdoors and they will space out as much as possible. They will be cancelling the bouncy houses and may require masks on the hayrides.

§ City of Berlin and Town of Gorham: No update this call.

Community and Legislative

§ Public Health Network: They have been continuing with school-based clinics in communities along the Connecticut River, and find that parents are more interested in the flu vaccine than in the Covid. They are paying close attention to the hot spots in Coos County, which include the Androscoggin Valley and Lancaster. Cases in Lancaster have been linked to some private child-care providers and they find that cases are coming from transmission in the home. They have received a revised order for vaccine clinics for delivering Pfizer boosters shots in addition to third doses and have been thinking of their vaccine strategy through the fall. They are concerned about staffing and suggested that many retired providers would be more interested in short shifts. The Governor’s Municipality Initiative is moving forward and of the list of towns with the lowest vaccination rates in the state, the North Country has 12. They do have a community health worker that will be joining them part-time to help with clinics.

§ Senator Shaheen’s Office: They will be getting some answers on the question from CCFHS tomorrow.

§ Senator Hassan’s Office: No update this call.

§ Berlin Daily Sun: They asked about the number of cases in the area, which is well over 100, and the county, which is about 200. AVH advised that they are seeing some breakthrough cases in vaccinated people, but find that the unvaccinated are sicker. Those getting monoclonal antibodies are the patients that are very ill. They asked about vaccinations and testing and were advised that testing is not easy to get now, as supplies are limited. The demand is exceeding the capacity. AVH is no longer doing vaccinations for the public, as CCFHS is doing this along with pharmacies and Walmart. CCFHS advised that they can make appointments for those who cannot attend the vaccine clinics on Tuesday and Thursday.


9/30/2021 Staying Focused

Our work today is dedicated to all those who are helping children and families to stay safe and keep school in session.


***

Health Care and Medical Services


  • Update from Androscoggin Valley Hospital: The hospital has been stable. There are currently three COVID positive patients in the hospital, two vaccinated and one unvaccinated who has received monoclonals. The census is still high, with a number of discharges earlier in the week. They have done a lot of testing and have offered 4-6 doses of monoclonals in the last few days, including two nursing home residents from Bethel, ME.


  • Update from Coos County Family Health Services: This morning at the Pleasant Street location they did 17 rapid tests with three positives, two adults and one child. Dr. Beals had over 30 tests scheduled this afternoon, and Chelsey Andrea was also doing testing at the Pleasant Street office. A fair amount of students that were in direct contact tested negative, which was encouraging. There seems to be clusters that were associated with homecoming events. There is still strong evidence of community transmission. The pediatric team has been struggling to keep up with supply for the BinaxNOW kits, and they may reach out to schools if AVH does not have an additional supply. They have started offering Pfizer boosters for those who qualify. Flu clinics will continue on Monday and Wednesday next week.


  • Other updates: AVH advised in terms of communication they have been fielding inquiries from the media, including the BBC, regarding their vaccine mandate policy.

Education

  • Update from Berlin Public Schools: They had lots of negatives today, but were busy on Monday and Tuesday with positive cases and symptoms. They currently have 2 positive staff and 4 students at the elementary school, and 19 students and 1 staff at the middle/high school. The absentee rate is about 25% at both schools, which is causing a challenge with staffing. Due to the hours needed for direct contact calls, they have changed the process a little and will no longer be making personal calls when volume is high. They will use automated messaging, which can be narrowed down to select the specific families to be notified. They are following DHHS guidelines, and if there is direct contact from a non-household member they may still come to school with a mask and a test is recommended within 3-5 days. As far as SAS testing, one portal has been set up and consent forms have been sent to students and staff. They have sent in their application for CLIA so they can start BinaxNOW and get their supply in. They do have one nurse out, non-COVID related, and have put out an ad for a substitute nurse.

  • Update from SAU 20: Monday was busy but things have calmed down since then. They are trying to set up protocols with AVH and CCFHS on how to use the BinaxNOW so that it will be a positive for everybody. The middle/high school is still in red, with 5-6 students and 5 staff out. They are only 3-4 weeks into school and staff is already very tired with the constant barrage of unknowns. CCFHS agreed that fatigue is clearly setting in as it has been a tough stretch.

  • White Mountains Community College No update this call.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD Gorham EMS advised they have received 80 BinaxNOW kits and have reached out to Berlin PD, Gorham PD, and Berlin and Gorham Fire and EMS to clear those with symptoms so that they can return to work, as there is a staffing issue at the PD.

  • Northern NH Correctional Facility: No update this call.

  • Federal Corrections Institution: No update this call.


Municipal and Local Business


Community and Legislative

  • Public Health Network: They have been watching the Delta variant spread in the Lancaster area. School based clinics have started, with the first being SAU58 in Groveton. The uptake has been slow, partly due to the state being backlogged in terms of setting up appointments. They are hoping to see a good uptake in the schools they are working with this fall. They had a good conversation with state leadership teams regarding vaccinations on Tuesday, and they indicated they may be reaching out to municipalities with lower vaccination rates to figure out how to increase vaccine confidence. Two-thirds of the towns in our region have a less than 50% vaccination rate. An interesting takeaway from the conversation was that if distrust of government agendas is the reason for the low vaccination rates, then a push from Concord is not the right answer. The potential to bring up the EMS workforce with additional temporary staffing was suggested, so that those local, trusted faces that did clinics this spring would be freed up and would be good influencers in the community. There will be more to come as they figure out what is happening with the Governor and Council with the vaccine funding in Concord, and whether they will be able to accept the Federal vaccination funds from the recovery plan for vaccination efforts in the state. They are planning to host scholars that are currently in healthcare programs at the Geisel School of Medicine, Franklin Pierce College, and UNH, to see what it is like to practice in a rural area. They have expressed an interest in hearing from the workgroup on COVID response in rural areas, and would like to set up a panel discussion in the morning on Saturday, October 30. They are currently seeking a location for this. Gorham EMS inquired about third doses of Moderna, however the FDA has not approved boosters for Moderna yet. Gorham EMS is hoping to provide these when available to the homebound and they were advised that there is still funding for EMS on the books to provide this service. It was noted that many people are looking for boosters, however there are still people who need to get a first dose.

  • Senator Shaheens Office: They are working on a resolution so that the government will not shut down and are still trying to pass some version of the infrastructure bill.

  • Senator Hassans Office: They advised that the resolution to extend the limit to avoid a government shutdown has passed the House and Senate.



9/23/21 We are starting to see an increase in positive cases

Our work today is dedicated to the Information Technology (IT) people in our community who have been behind the scenes supporting the work of all essential service providers.


***


Daily new cases in NH average 43.9/100k, which is the highest level of community spread we have seen. The positive test rate is 17.4%.

61.5% of the state’s population have received at least the first vaccine dose. About 55% of the state is considered to be fully vaccinated.


***


Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: The hospital has been doing 70-100 swabs per day, a total of 91 yesterday. Out of 48 rapid tests yesterday, 17 were positive, and PCR’s are coming back with a high rate of positivity. There is widespread community transmission. There are currently two COVID in-patients at AVH. Both patients are elderly; one was partially vaccinated and the is fully vaccinated. Both patients are stable. The emergency department was busy two days ago with lots of COVID activity, but yesterday and today were not as bad. There are a couple staff members who tested positive and they are concerned about the Med-Surg unit if there are more positive cases. The hospital stressed that despite the vaccine mandate protest, they are not divided, and everyone works hard to meet needs. Every time there is a challenge, they fight harder and they are incredibly proud of the efforts. They have made a change in their visitor policy, which is one visitor per patient. They did have a family that was rotating visitors, but this will not be allowed. Exceptions to the rule will be for pediatric or end-of-life cases, or based on clinical judgement as has been practiced effectively to date.


  • Update from Coos County Family Health Services: Dr. Beals reported that he did 33 tests today and 4 were positive. One was undetermined and they will need to test again tomorrow. Today at the clinic at AVH, they tested 27 with 5 positive cases. Three of the positive cases were in children under 18. Since they have to account for every COVID vaccine, they have not been able to administer them as planned this week due to the computer issues. AVH did get some second vaccine doses done for them. The waiting rooms remain open on a limited basis, but consideration is being given to temporarily restricting access again. They have started to restore the computer system and it is going smoothly, however it will take several days before returning to normal. There is limited phone service at each site and lots of catch-up work is being done. They plan to be fully operational on Monday. To the best of their knowledge, there was no release of any confidential or health information, and they are grateful for all of their partners for the help.

Other updates:


  • Another print ad regarding credible sources ran this week and they will continue to get information out.

  • The vaccine van will be at St. Barnabas tonight with vaccines and cookies. They have all three vaccines on-board.

  • They are currently watching the news from the CDC and FDA on third shots.


Education

  • Update from Berlin Public Schools: Additional positive cases were reported including students and staff. There are currently two staff out, 1 student at the elementary level, and 5 at the middle/high school level. No in-school transmission has been identified, as no one was in direct contact in the building. However, they are getting close to the red zone. Homecoming is scheduled for this weekend, and all activities including the pep rally will be held outside. They will send out a Facebook message reminding those watching the parade to wear a mask if they cannot distance.


  • Update from SAU 20: One positive case reported today. Currently have 6 middle school students out, none in the high school, and 1 in the elementary school. They have moved to the red phase at the middle/high school and are masking all day, with the hope of returning to yellow at the end of next week. EFS, Milan, and Errol will stay in yellow. They have BinaxNOW test kits which the nurses can offer on-site. They will administer them in the parking lots with the nurses in PPE. CCFHS advised they are open to talking about a vaccine clinic held at a convenient time for students ages 12-17.



Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: No update this call.

  • Coos County Nursing Home: They have 4 positive cases among unvaccinated staff, but no cases in patients at this time. Both nursing homes are struggling with staffing and are being careful with admissions. They are concerned about the vaccine mandates.

  • Northern Human Services: No update this call.

  • Family Resource Center: No update this call.

  • Tri-County CAP: They are operating programs as normal with COVID restrictions. They do have a couple of staff who are positive and quarantining. They also have a couple staff quarantining due to travel. They are disinfecting offices and the waiting areas daily.

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD No update this call. The Director can be reached by email this week due to quarantine.

  • Northern NH Correctional Facility: No update this call.

  • Federal Corrections Institution: They have one more case among staff for a total of three. There are no cases in inmates.


Municipal and Local Business


Community and Legislative

  • Senator Hassan’s Office: No update this call.


9/16/21 Back up and Running

Our work today is dedicated to the children and families who are trying to make their way through this start to the school year, and all the decisions and challenges they are facing.


***

Health Care and Medical Services

  • Update from Androscoggin Valley Hospital: The hospital has been stable. There are currently no COVID positive patients in the hospital. The COVID testing line has been busy, with 30 testing yesterday. Of the 30, two were positive. They do not have the results from the PCR tests yet. One employee was not feeling well, and the rapid test was positive, so they are home isolating. The need for travelers and the difficulty finding housing was discussed. This is an issue that will need to be addressed as a community, as it has an impact on staffing at the nursing homes and hospital. Concerns about housing inventory and rates was noted to be a statewide problem, and the lack of policy concerning rates on rent hikes has led to those on fixed incomes becoming homeless or housing insecure. It was also noted that AirBNB has added to the problem, and that Gorham is addressing this with a 120-day cap on residential properties. James Wheeler mentioned that the City of Berlin has been trying to get property values to increase for more than two decades, and that people need to make money to maintain their properties. It was agreed that property owners need to earn income to invest in their properties, however the base rate for travelers does not change, and although they get a stipend for housing they will not come if costs are too high. This may lead to nursing homes not having available beds and emergency rooms backing up, along with other hospitals not having beds and being unable to transfer patients.

  • Update from Coos County Family Health Services: There were no positive rapid tests yesterday or today. They are wrapping up the week with 14 positives, of which 10 were in children. Eight of the positive cases were at the Christian Unity Academy, which will be closed through next week. They did 42 vaccinations last week, but do not have a number yet for this week. Only 7 of the vaccinations were third doses for immuno-suppressed, as there has been almost no demand. They will be starting flu clinics on September 20, and will be offering drive-thru clinics on Mondays from 11:30 am- 4:30 pm and Wednesdays from 8:30 am- 4:30 pm. Appointments will be required for the flu clinic, and same day appointments will be available by calling. They will also roll out boosters as soon as they are announced. Waiting rooms are still partially open and staff is still masking and socially distancing when possible.

  • Other updates: Information on monoclonal antibodies was sent by James Patry to be shared with the group. Monoclonal antibodies should be given within 10 days of the start of symptoms for high-risk patients with a positive test who have not been admitted to the hospital and are 12 years of age or older. These are now under the control of DHHS and will be allocated to the areas where it is most needed, so they will need to be conservative.

A print ad regarding credible sources will be going in the paper next week that is consistent with the one released this week by UCVH.


Education

  • Update from Berlin Public Schools: There was one positive case this afternoon at the high school. The nurses have completed contact tracing and notified those in direct contact, who will be required to wear a mask. Testing will be recommended within 3-5 days for those involved. There have been lots of students with symptoms at the high school and middle school level, however not many at the elementary level. The press conference with Dr. Chen was mentioned and Julie King advised that the general message from the commissioner is that you cannot close or move to remote, students must be on-site. The concern is how to educate two groups of students if a majority is out due to quarantine or isolation. An effort to get the 12-17-year-old students vaccinated was proposed, as there is room for growth from the numbers last spring.

  • Update from SAU 20: There are no positive cases yet, and it was noted that things are much better than last year so far. They are hoping to stay in yellow as long as they can.

  • White Mountains Community College No update this call.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD Gorham EMS reported no changes this week. They are waiting to see if they will be doing third doses for the homebound. Their first group of vaccinations are coming up on 8 months next week, and there have been some questions about third doses for them.

  • Northern NH Correctional Facility: There were no new cases.

  • Federal Corrections Institution: There were no cases for the last couple of weeks, so the outbreak reported must be an artifact from prior reporting.


Municipal and Local Business


Community and Legislative

  • Public Health Network: They continue to do mobile clinics. They are waiting to hear on the States response to President Bidens mandates announced last week. They are hesitant to go full-bore on an employer-based campaign if the State will not support their efforts. They have started setting things up for employers who have reached out to request clinics. The school-based influenza clinic roll-out is continuing as the state makes information concerning registration, protocols, and training available. Most schools that hold the flu clinics have also welcomed Covid-19 vaccinations as well. However, they are starting to see some battle fatigue among school staff who are concerned about how offering Covid vaccines in schools will be perceived by community members. They will navigate this on a district-by-district basis and try to be as supportive as they can to assist schools in offering this to community members who are interested. They have scheduled a meeting with DHHS and NH Immunization Program leadership, trying to get ahead of the plan for the State to reach out to municipalities with a less than 50% vaccination rate. More than half of the towns in the North Country region have less than 50% rates. There has been a significant amount of feedback from community members of distrust of government agendas. They are hoping to collaborate with the State before they start calling municipalities. They are hoping to set strategy at the municipal level to address the vaccination rates.



6/24/21: Celebrate the wins and more to be done

Our work today is dedicated to everyone who has lost someone or something over the past 16 months – family members, colleagues, jobs, homes, and time spent with loved ones. We give our support to the collective loss experienced during this time.

***

As summer begins, COVID-19 testing and positive cases in the Androscoggin Valley have significantly decreased. Coos County is now one of three NH counties with a green COVID designation. County level vaccination rates are on par with the rest of the state, however there is still much work to do to increase the vaccination rate and continue preventative measures to end the pandemic.

Vaccine is available to anyone 12+ years old by calling Coos County Family Health Services at 603-752-2040

NH announced 30 new cases on June 24th. New cases continue trending downward across the state. There was an average of 21 cases per day for the most recent 7-day period (June 18 – June 24). This is a 33% decrease compared to the pervious 7-day period. More information at https://www.covid19.nh.gov/.

#MaskUpNH video #SleeveUp with AVH and CCFHS

***

The AV COVID-19 Community Group will take a summer break and will resume meeting in August 2021 to explore its continuation addressing COVID-19 and other emergent and long-term public health needs of the Androscoggin Valley community.

This is the final update for the AV COVID Dashboard which documented updates to the community over the past 6+ months. Thank you to everyone participating and staying updated with local COVID information. The AV COVID Dashboard site was supported by SAU 20 on behalf of the Androscoggin Valley community.


Health Care and Medical Services

  • Vaccine Update in Androscoggin Valley: Vaccine clinic at the former Brown School in Berlin closed its doors last week after successfully serving as the hub of COVID-19 vaccination for the Androscoggin Valley. Vaccine is available to anyone 12+ years old by calling Coos County Family Health Services at 603-752-2040. A celebration of the Brown School vaccination clinic and the AVH and CCFHS teams will be planned to acknowledge the great work.

  • Update from Androscoggin Valley Hospital: COVID testing is at very low demand, in the single digits each day, mostly from pre-op testing. The hospital is maintaining its policies and procedures around COVID-19 preventative measures, including masking, limited visitors, and social distancing.

  • Update from Coos County Family Health Services: A total of 62 COVID tests were administered over the past two weeks, a 50% decrease from a month ago. There were no positive test results. Vaccine is available at CCFHS offered in a clinic setting, similar to a flu clinic, during other appointments, or with a nurse appointment. Call CCHFS at 603-752-2040 for a vaccine appointment.

  • Other vaccine updates: Vaccination rate in Coos County is close to state average and there have been great gains in controlling the pandemic. Vaccination is the best tool for ending the pandemic and there is still a significant number of people unvaccinated. As more is learned about the Delta variant, the community remains vulnerable in some ways and more work can be done. The Public Health Network (NCHC) will continue to look at vaccine pop-up clinics, including partnership with local businesses. Vaccine data is now available at a town level which will help with targeted vaccination efforts around the region.

  • Other updates: Cases continue to decrease in NH and Coos County is now one of three NH counties with a green designation. It is reported that there has not been a new COVID case in Coos County since June 18th.

Education

  • Update from Berlin Public Schools: School is out for the summer and a busy summer program is underway with close to 300 students participating. A staff nurse is available for student check ins every morning. Mask guidelines were updated and the district submitted its reopening plans with DOE this week. Visit Berlin Public School Facebook Page for more information.

  • Update from SAU 20: The schools are supporting the recreation department full day summer program. A smaller education program will run this summer as well. The district is looking forward to some to time to reflect and celebrate getting through this difficult time as a team, including the work of this group. Visit the SAU 20 office website for updates.

  • White Mountains Community College: The college is updating its mask guidance to reflect new protocols outlined by DHHS and the CDC. As of July 1st WMCC will no longer be requiring screening to enter facilities.

Family Resources and Long-Term Care Facilities

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD: Gorham Fire and EMS is stable on the COVID front, though an increase in other calls was notable this week. The department is preparing for 4th of July celebrations where lighter than normal crowds are expected with no specific COVID concerns at this point.

  • Northern NH Correctional Facility: There are 0 COVID cases in the facility and normal operations are resuming including inmate movement within the facility and weekend visits with masks in place. Vaccination is upwards of 80% among inmates and 75% among staff, rates which are supporting more normal activities and operations.

  • Federal Corrections Institution: no update this call.


Municipal and Local Business


Community and Legislative

  • Congressional delegation: A bipartisan group has reached a tentative agreement on the infrastructure plan, including several areas supporting rural health (access to broadband for telehealth, etc.)


“We need to celebrate some of the wins. Think back to a year ago and the many unknowns and questions we had. We’re now on the other side. Proud to be part of this team.”

5/27/21: We can move mountains

Our work today is dedicated to this Androscoggin Valley COVID-19 Community Working Group in acknowledgement of the remarkable journey over the past 16 months and the extraordinary work that was accomplished.


Also, in appreciation of Patty Couture and Dr. Gessner for their leadership and commitment especially over the past challenging year. You each leave a legacy. Congratulations on well-earned retirements from CCHFS and we know they will remain a resource and presence for many on this call.

***

COVID-19 testing and positive cases in the Androscoggin Valley are decreasing in line with trends across the state. However, the prevalence of COVID is higher in Coos County than elsewhere in NH and there continue to be positive cases in the community. NH is on a path back to normal and vaccination rates continue to pave the way as the best way forward. When social distancing cannot be maintained mask wearing and preventative measures should still be taken to reduce community transmission.

NH announced 105 new cases on May 27th. New cases continue trending downward across the state. There was an average of 89 cases per day for the most recent 7-day period (May 21 – May 27). This is a 33% decrease compared to the pervious 7-day period. More information at https://www.covid19.nh.gov/.

Nearly 800,000 Granite Staters (796,608) have received at least the first vaccine dose – 58.7% of the state’s population. About 47.6% of the state is considered to be fully vaccinated. Vaccine registration is currently open to all NH residents 16+ years old. The vaccine clinic at the former Brown School in Berlin has availability on Fridays. To register visit https://www.vaccines.nh.gov/, call 2-1-1, or call AVH at 603-752-2300.

#MaskUpNH video #SleeveUp with AVH and CCFHS

***

The summaries for May and June are available once a month as the AV COVID-19 Community Working Group transitions into its next steps. The community working group will continue to meet through June. The group will then explore the best avenue and focus in its continuation addressing COVID and other emergent and long term public health needs of the Androscoggin Valley community.

Health Care and Medical Services

  • Vaccine Update in Androscoggin Valley: Vaccine clinic at the former Brown School in Berlin is winding down as initial vaccination numbers are slowing. This week a small student clinic was held Wednesday and walk ins worked well. On Friday 5/28/21, 35 – 40 are scheduled. Friday clinics will continue into June but as the state transitions away from fixed sites, vaccine will be available at AVH, CCHFS, and retail pharmacies. Individuals interested in the Johnson & Johnson vaccine may call AVH to check on available supply. NH residents 16+ years are eligible and encouraged to register at vaccines.nh.gov, call 2-1-1, or call AVH at 603-752-2300.

  • Update from Androscoggin Valley Hospital: COVID testing and positive cases are decreasing steadily. This week approximately 25 tests were administered with 2 positives mid-week, the first in about a week. Positives were travel related and community transmission. Hospital is busy as people return to more normal routines and addressing health issues that may have been delayed over the past year. There is an increase in behavioral and mental health needs in the region and across the state. NCH is working with regional partners and the state to address mental health needs.

  • Update from Coos County Family Health Services: A total of 61 COVID tests were administered Monday through Thursday and one adult, four children received positive test results. Demand for testing is decreasing, however there still are several positive cases in the community. Regular health visits are increasing. CCFHS is waiting on specifics for when vaccine will be available in the clinic.

  • Other vaccine updates: The Public Health Network (NCHC) continues the effort to vaccination for homebound residents. On May 14th NCHC held three concurrent school-based vaccination clinics for eligible school age students with 22% participation. Overall good numbers for day one. Students were very enthusiastic and empowered to receive a vaccine. Day two will follow with second dose. A NH / VT vaccination clinic at Lancaster Fairgrounds was held May 21st with 145 people. Vaccine recipients mentioned reasons for getting vaccine including: a loved one asked them to; someone they knew and trusted encouraged them; upcoming travel plans; and free Lancaster Fair tickets. NCHC is looking to host small pop-up vaccine clinics in the region. The State of NH is processing 180 provider agreements that will get vaccine into primary care and community health centers across the state.

  • Other updates: While cases are diminishing in NH and the county, the prevalence of COVID is higher in Coos County than elsewhere in NH with 13.1 cases / 100,000 people. This is a decrease from the past several months but important to be aware that Coos is trending higher than elsewhere in the state. The news is covering cases of mild heart inflammation for younger people after vaccination but there does not appear to be evidence of connection. Medical professionals are watching this closely, but numbers are on par with normal levels of this condition in the population. Getting COVID and other viruses can also cause the same heart response. Moderna vaccine is proven effective for 12 – 17 age group. Novavax is coming out with another vaccine that we will not likely see distributed in the US because of the current substantial supply. Vaccine rates in Coos County are 68% received at lease one dose and 44% fully vaccinated. Good number for the county. Providing more vaccine education and addressing hesitancy are next step efforts.

Education

  • Update from Berlin Public Schools: No update this call. Visit Berlin Public School Facebook Page for information.

  • Update from SAU 20: The schools are seeing some continued positive cases and the impact of quarantining reminds everyone to keep diligent with preventative procedures and encourage vaccination. The school districts are creating reentry plans to submit to the state, knowing that changes will happen. The goal is to be back to normal as possible by August. Visit the SAU 20 office website for updates.

  • White Mountains Community College: Now that the academic year and commencement have passed, the current focus is on planning for future COVID precautions on campus. WMCC is currently looking to phase out some of the screening and use of forms/apps to attest to screening questions. Additionally, the college will be updating mask policies as appropriate. If there is a local outbreak or increase in cases the college is able to shift back to additional preventative tools as needed. The goal will be to streamline procedures and encourage vaccination.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul: There are no new updates from CMS or CDC for long-term care facilities. St. Vincent’s is committed to following guidance available to support residents and families as best as possible.

  • Coos County Nursing Home update: no update this call.

  • Northern Human Services: Berlin area staff will return to the office June 7th to assist clients accessing services more easily in person. More clients will see therapists and case managers for services as the organization continues to transition back in person. There was update and discussion about changes to inpatient hospitalization for mental health crisis. NCH / AVH and Northern Human Services work in close collaboration and are considered a model that can be shared elsewhere in the state as mental and behavioral health partners navigate the current changes and challenges.

  • Family Resource Center: no update this call.

  • Tri-County CAP: no update this call.

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD no update this call.

  • Northern NH Correctional Facility: no update this call.

  • Federal Corrections Institution: no update this call.


Municipal and Local Business


Community and Legislative

  • Congressional delegation: no update this call.


“It’s natural to see this chapter of COVID come to a close. The next public health crisis is probably around the corner. This is a good group to tackle any public health crisis – both emergency and long term. We can move mountains.”

“We need to celebrate. Memory fades from what this battle really took.”

MAY 21: Vaccine Clinic in Lancaster

The North Country Public Health Network will be holding a COVID-19 Vaccination Clinic this Friday at the Lancaster Fairgrounds. The Johnson and Johnson vaccine will be used so this will be a one and done shot.

Individuals who schedule an appointment and receive their vaccine will receive a 1 day pass and ride bracelet to this year's Lancaster Fair! Do your part in our best "shot" at getting back to normal.

5/6/21: The bumpy path back to normal

Our work today is dedicated to the nurses on this call and in our community on National Nursing Day.

Also, in appreciation of Julie King who was awarded the Sylvia Evans Leadership Award of 2021 for her community contribution in education.

***

COVID-19 testing and positive cases in the Androscoggin Valley area are holding steady with slight upticks of positive cases and ED patients observed this week. Although NH is announcing a path back to normal with sunsetting statewide mandates, mask wearing, social distancing, and vaccination are very important to reduce community transmission.

NH announced 269 new cases on May 6th. New cases are trending downward across the state. There was an average of 228 cases per day for the most recent 7-day period (April 30 – May 6). This is a 15% decrease compared to the pervious 7-day period. More information at https://www.covid19.nh.gov/.

725,000 or 53% of NH’s population has received one vaccination dose and 36% are fully vaccinated. Vaccine registration is currently open to all NH residents 16+ years old. The vaccine clinic at the former Brown School in Berlin has availability on Fridays. To register visit https://www.vaccines.nh.gov/, call 2-1-1, or call AVH at 603-752-2300.

#MaskUpNH video #SleeveUp with AVH and CCFHS

***

Health Care and Medical Services

  • Vaccine Update in Androscoggin Valley: The vaccine clinic at the former Brown School in Berlin administered 130 doses on Wednesday including only 15 new first doses. This week was the last Wednesday clinic as initial vaccination numbers are slowing and there will be transition to CCFHS primary care and retail pharmacies. Friday clinics will continue, including approximately 100 vaccinations scheduled for this Friday. The state is beginning to plan for its fixed sites to wind down in the coming months and fully transition vaccine availability to primary care and retail pharmacies. Individuals interested in the Johnson & Johnson vaccine may call AVH to check on available supply. NH residents 16+ years are eligible and encouraged to register at vaccines.nh.gov, call 2-1-1, or call AVH at 603-752-2300.

  • Update from Androscoggin Valley Hospital: COVID testing is holding steady at approximately 100 tests per week, with 1 – 2 positive cases per day. There is an observed slight uptick in positive cases, including seeing several unvaccinated younger adults with COVID coming through the ED. The hospital is overall stable. Upper Connecticut Valley Hospital in Colebrook is seeing a similar uptick in positive cases with 66 tests and 5 positive cases as of Tuesday this week. A few positive COVID cases are coming through UCVH ED as well.

  • Update from Coos County Family Health Services: A total of 55 COVID tests were administered Monday through Thursday and one adult, five children received positive test results. The uptick in pediatric cases is likely originating through local community transmission. Contact tracing is being conducted and the uptick is being monitored. Strep continues to be present in the community with 9 positive strep tests this week.

  • Other vaccine updates: The Public Health Network (NCHC) is reaching out to North Country schools to arrange school-based student clinics in anticipation of Pfizer vaccine approval for 12 – 15 year olds before the end of the school year. NH and VT organizers are planning for an open vaccination clinic to be held at the Lancaster Fairgrounds. North Country Healthcare has administered a total of over 18,300 vaccine doses, the majority given to Coos County residents.

  • Other updates: The 7-day average of new COVID cases is down in NH, though there is still a substantial transmission rate in every NH county, including Coos. There are 5-10 new cases in Coos County each day and there community transmission is present. While mandated statewide NH COVID policies are sunsetting, state epidemiologists continue to encourage universal best practices of masking, social distancing, and hand hygiene to prevent community transmission. Vaccination rate is Coos County is encouraging and will hopefully reach 60% of eligible population soon. Vaccinate education and encouragement continues, including a planned community event to address COVID vaccine Q+A with local medical professionals.

Education

  • Update from Berlin Public Schools: For the first time since September no staff members are out on quarantine on this week, though there are two new positive student cases. Teachers and staff continue to be thankful to receive vaccination. School is in person 5 days a week and there was a slight drop in fully remote students, now at approximately 16%. People are happy to be closer to normal operations. Planning is underway for next year. Visit Berlin Public School Facebook Page for information.

  • Update from SAU 20: After a few weeks of quiet COVID activity there are a few staff and students out on quarantine. Vaccinated staff do not need to quarantine. Administrators are navigating staff quarantine policies going forward. Spring events and spring sports are underway. Visit the SAU 20 office website for updates.

  • White Mountains Community College is status quo and no additional updates this call.

Family Resources and Long-Term Care Facilities

  • St. Vincent de Paul reported on many changes allowing more back to normal activities and visits at the nursing home. Group activities, community dining, and socializing may resume following the state’s standard of the CDC’s universal best practices. In group settings mask wearing and social distancing will be continued. Vaccinated residents and vaccinated family members may have close unmasked visitations, including off site outings. The organization is encouraging vaccination among residents, family, and community members as a way to more safely enjoy back to normal activities.

  • Coos County Nursing Home update: The state closed the outbreak case that was being monitored at Coos County Nursing Home. No additional information or update provided.

  • Northern Human Services: no update this call.

  • Family Resource Center: no update this call.

  • Tri-County CAP: no update this call.

Emergency Services and Correctional Facilities

  • Gorham EMS and Berlin Fire / EMD no major updates this call. The departments encourage community members and businesses to continue proven preventative measures even as NH statewide mandates begin to sunset.

  • Northern NH Correctional Facility: no update this call.

  • Federal Corrections Institution: FCI outbreak status from the past several weeks has improved. There are currently 5 positive cases among staff and inmates. The institution continues to use widespread testing, quarantine units, and careful monitoring.


Municipal and Local Business


Community and Legislative

  • Congressional delegation staff shared that the legislators are preparing the congressional directed appropriations process which will provide funding to NH projects, including efforts in the North Country. Recent legislative topics include career pathways, including pipeline for skilled nursing, and the opioid workforce act to address medical response to opioid misuse. The Friendship House will be reopening soon under a new name and management and will start taking referrals to provide residential treatment to individuals with substance use disorders. Congressional summer college interns observing the call noted the high-level of communication among community stakeholders to be interesting and encouraging.


“The path back to normal is going to be a little bumpy.”

4/22/21: Sleeve Up - NH’s rural residents get vaccinated

Our work today is dedicated to the residents in skilled nursing facilities in our community and across the country. Separation from family over the past 14 months has been challenging and we keep their experience in mind.


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COVID-19 testing and positive cases in the Androscoggin Valley area are holding steady this week. The Federal Corrections Institution and Coos County Nursing Home, both in Berlin, are in outbreak status reported by NH DHHS. As variants are likely becoming widespread around the state, mask wearing, social distancing, and vaccination are very important preventative measures to slow community transmission.

NH announced 515 new cases on April 22nd. There was an average of 352 cases per day for the past 7-day period. This is a decrease compared to the pervious 7-day period, which had been rising for several weeks. See more NH COVID information at https://www.covid19.nh.gov/.

Vaccine registration is currently open to all NH residents 16+ years old. The vaccine clinic at the former Brown School in Berlin has availability on Wednesdays and Fridays. To register visit https://www.vaccines.nh.gov/, call 2-1-1, or call AVH at 603-752-2300.

#MaskUpNH video #SleeveUp with AVH and CCFHS

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THE NEXT COMMUNITY SUMMARY WILL BE POSTED May 7, 2021 of the May 6, 2021 MEETING

Health Care and Medical Services

  • Vaccine Update in Androscoggin Valley: The vaccine clinic at the former Brown School in Berlin administered 268 doses on Wednesday, including 50 first doses and the remaining as second doses. Friday will be another busy day however demand for first doses is starting to show some decline, initiating the next phase of outreach and education. NH Bureau of Infectious Disease Control reports that 48% of Granite Staters have received at least one shot of the vaccine and 28% are fully vaccinated (NHPR). NH residents 16+ years are eligible and encouraged to register at vaccines.nh.gov, call 2-1-1, or call AVH at 603-752-2300.

  • Update from Androscoggin Valley Hospital: COVID testing numbers decreased this week, however there continues to be community spread. Testing and positive cases are expected to go up and down in the coming weeks. The hospital is overall stable and there are no COVID cases among the in-patient population.

  • Update from Coos County Family Health Services: A total of 77 COVID tests were administered Monday through Thursday, holding steady to last week’s testing numbers. Three adults and six children received positive test results. Testing and positive rates are similar to last week. Strep continues to be present in the community with 5 positive strep tests.

  • Other vaccine updates: The Public Health Network (NCHC) is wrapping up its role with final 1B and 2A clinics and will transition its focus to making vaccine even more accessible to individuals in northern NH. The PHN is exploring the idea of mobile vaccine clinics with business and school partners, in a similar model to other PHNs around the state. More information to come. COVID vaccination continues to be available through the state run VINI system at the hospital and fixed sites (including Brown School in Berlin), as well as through NH retailers of Walgreens, CVS, Walmart, and Osco around the state.

  • Other updates: Data indicates that NH has done well to vaccinate older residents (65+) living in rural areas, something that is considered a challenge due to dispersed population. The vaccination rate for NH rural residents 65+ years is 5.8 percentage points higher than urban residents in NH, a data point that is leading the county. The outreach of the AV Community COVID Workgroup contributed to this effort to ensure rural accessibility to vaccine.