Weekly Update - December 11, 2020

Dear Community Partners,

As the chief public health strategist for the Greater Nashua Public Health Region (GNPHR), the Nashua Divisionof Public Health and Community Services (DPHCS) will con nue to send weekly updates to inform ourcommunity on the current status of the rapidly evolving COVID-19 situa on, the response efforts by the City ofNashua and Greater Nashua Public Health Network (GNPHN), and any addi onal updates related to the healthand safety of our community. Click on the blue bu ons throughout this update to download flyers and visitexternal resources.

We con nue to experience substan al community level transmission of COVID-19 in the City of Nashua.Substan al community level transmission is determined by three metrics established in conjunc on with theState of New Hampshire Department of Health and Human Services (DHHS) and the Centers for DiseaseControl and Preven on (CDC). When any one of the metrics exceeds the set threshold, a community isdesignated as "RED" or substan al. Currently we are exceeding the thresholds set on two metrics: newinfections per 100,000 and the 7-day total test positivity rate.

New Cases per 100k Over 14 Days: Number ofnew cases within 14 days standardized bypopulation size to compare across groups. Thisshows how quickly disease is occurring in thecommunity or the incidence of disease.

New Hospitalizations per 100k Over 14 Days:Number of new hospitalizations within 14 daysstandardized by population size to compareacross groups. This shows how quickly hospitalsare being burdened by disease.

Hospitalization Rate: The number of allhospitalizations divided by the total number ofcases. This tells us how severe illness was overthe course of the pandemic.

7-Day Total Test Positivity Rate: The number ofPCR and Antigen tests that are positivecompared to the number of PCR and Antigentests that are negative over the past 7 days. Arising positivity rate indicates a rising number ofinfections in the community.

Active Case: A case that is currently sick or inisolation due to COVID-19.

Cumulative Case: All confirmed or probableCOVID-19 cases, either active or recovered.

Due to the current rapid surge of COVID-19, public health officials are strongly urging everyone to adhere tothe following mi ga on interven ons. To reduce the spread, avoid social gatherings, maintain physicaldistancing of six feet or more, wear face coverings and wash your hands frequently. Most importantly stayhome if you are sick, except to get medical care.

Community Transmission: What does that mean?by Angela Consentino, Epidemiologist

In New Hampshire, all COVID-19 infections arecategorized by transmission type, which is definedby where or how an individual believes they mayhave gotten sick. Many New Hampshire COVIDcases are caused due to contact with someonewith COVID-19 or cluster-associated (16.8% and16.9% of all cases, respectively). These cases aretypically in individuals that live or work with aperson that was recently diagnosed with COVID-19. Some cases in New Hampshire are caused dueto international or domestic travel (6.9% of allcases). These cases are typically in individuals whohave recently traveled to an area where COVID-19infection is widespread and community-based. Inthe early stages of the pandemic, theseindividuals were traveling from China, Italy orIran. Currently, individuals traveling from areaswith higher incidence rates of COVID-19 such asNorth or South Dakota increase transmission. Theremaining 59.4% of New Hampshire cases arecategorized as community-transmission orunclear/unknown. For a case to be categorized as transmitted viacommunity-transmission, there needs to be no clear source of infection. This means that someone hasbecome infected with COVID-19 and has not traveled out of the state, has not had contact with aperson that they know has been infected with COVID-19, and has not been in a workplace or institutionassociated with an outbreak or cluster of COVID-19. This means that the individual must havecontracted the virus somewhere out in the community, and the specific origin of infection cannot bedetermined. Community-based transmission is difficult to track due to the unknown origin of cases, which is why weuse the incidence rate, new hospitalization rate, and percent positive to give us an indication of spreadin the community. The higher these indicators become, the more likely there is to be community-basedtransmission. When there are small numbers of cases, each case can be isolated and their closecontacts can be identified and quarantined. When transmission patterns change to become morecommunity-based, quarantining and isolating cases becomes less effective due to the extensiveunknown origin of cases. In areas of widespread community-based transmission, an emphasis is placedon mitigation strategies rather than on containment strategies. These community-mitigation strategiesfocus on slowing the spread of infection, such as staying home when sick, proper hygiene, practicingsocial distancing, and wearing a face mask.

Save the Emergency Room for Emergencies

Planning for the Holidays? You are Safest at Home!

This year, think carefully about making holiday plans, itcould save a life. To protect your loved ones, it is bestto stay home and celebrate with people who live inyour household. Video chatting extended familymembers and friends is a great way to connect over theholidays! If you do host an in-person get-together, keepit small, limit time together, stay outdoors (if possible),wear a mask, and keep a distance of at least 6 feet fromothers.

Travelling increases your chance of getting and spreadingCOVID-19. If you can, stay home this Thanksgiving. If youneed to travel, prevent possible spread of infection bypracticing healthy behaviors such as wearing a mask,keeping a distance of 6 feet from others, and washingyour hands often. Travelers, visitors, and residents ofNew Hampshire who travel outside of New England mustquarantine for 14 days or quarantine for 7 days followedby a negative PCR test result.

If we all do our part, we will get through thistogether. To find out more information on celebratingThanksgiving safely, please visit the CDC website. If youare staying home and need groceries, the United Way ofGreater Nashua has created a volunteer-driven onlinesystem for grocery shopping for individuals and familieswho are quarantined or cannot access publictransportation. Individuals and families can submit theirgrocery list online here. Learn more about thisprogram here.

Holiday Safety(ENG)

Holiday Flyer (SPA) Holiday Flyer(PORT)

Equity Corner: The History of Racial Bias and Discrimination in Healthcare

This column will highlight the history of racial biasand discrimination in health care and provideapproaches to make sure more people of colorget tested and cared for during the pandemic.

Black, Latino and Native American populationshave been hurt more than any other communityaffected by COVID-19. Across the board, datashow that they have had more cases,hospitalizations, and deaths and their experienceshave been made worst by discrimination andbarriers to get testing and treatment. See full infographic from National Institute for Health CareManagement (NIHCM) here.

Protect Your Loved Ones: Choose Safe Gifts this Season

It's that time of year again! If you are buying toys and gifts foryour loved ones this season, it is critical to consider the safetyand age range of the toys. According to the U.S. ConsumerProduct Safety Commission, an estimated 251,700 toy-relatedinjuries were treated in United States hospital emergency roomsin 2017. Unfortunately, most of these injuries happen tochildren under age of 15. Before you buy, think of the safety ofany gift you're giving, especially if it's a gift for a child.

Consider the following when buying gifts for your loved ones:Inspect all toys before purchasing. Avoid toys with sharp, protruding, or projectile parts.Check labels for age recommendations and be sure to select gifts that are appropriate for a

child's age and maturity.For children younger than three, avoid toys with small parts to avoid choking.If the piece can fit inside a toilet paper roll, it is not appropriate for kids under three.

Look for labels to make sure the toys have passed a safety inspection – “ATSM” means the toyhas met the American Society for Testing and Materials standards.Riding toys, skateboards, skates, and any sports equipment are great gifts but should always beaccompanied by protective gear (helmet, knee pads, etc.).Keep kids safe from lead in toys by:

Learning about lead exposure from toys, symptoms of lead poisoning, and what kinds oftoys have been recalledBeing aware that old toys may be more likely to contain lead in the paint - have yourchildren wash their hands after playing with toysCalling your doctor if you suspect your child has been exposed to lead

Avoid toys with ropes and cords or heating elements.Avoid crayons and markers unless they are labeled “nontoxic”.High-powered magnet sets are dangerous and should be kept away from children. Whethermarketed for children or adults, building and play sets with small magnets should be kept awayfrom small children.Remember food allergies and other allergies when gifting food items.

After the gifts are open...Immediately discard plastic wrapping or other toy packaging because it could be dangerous forchildren to play with.Keep toys appropriate for older children away from younger siblings.Battery charging should be supervised by adults.Make sure children have appropriate supervision when playing with potentially hazardous toysor games.Children can choke or suffocate on deflated or broken balloons. Keep deflated balloons awayfrom children younger than eight years old. Discard broken balloons immediately.

For more information, visit the American Academy of Ophthalmology and American Public HealthAssociation.

Additional COVID-19 Resources

Nashua COVID-19 Hotline:603-589-3456

New Hampshire COVID-19 Website

Nashua COVID-19 Website

Greater Nashua DataDashboard

CDC Resources

Upcoming Events

DPHCS COVID-19 Testing ClinicDecember 15, 3 PM - 5 PMElm Street Parking Garage (14 Elm St., Nashua)Register Here

SSANADecember 14, 10 AM - 12 PMBetween Temple St. & Cottage St., Nashua

Immunizations (Including Flu) & Child Lead TestingDecember 15, 3 PM - 5 PMElm Street Middle School Front Parking Lot(117 Elm St., Nashua)

Immunizations (Including Flu), HIV/HCV/STDTesting, & Child Lead TestingDecember 16, 10 AM - 12 PMNashua Public Library (2 Court St., Nashua)

SSANADecember 16, 2 PM - 4 PM29 Temple St., Nashua

(English)

CDC Resources (Spanish)

Immunizations, HIV/HCV Testing, SSANADecember 18, 1:30 PM - 3:30 PMLayton House (28 Railroad Sq., Nashua)

Weekly Clinic Schedule

Additional COVID-19 Testing Sites

Public Health MattersBobbie Bagley, RN, MPH, Director of Division of Public Health and Community ServicesNicole Tsoukalas, NP, Altrix Primary Care

Nashua Division of Public Health and Community ServicesGreater Nashua Public Health Network

www.NashuaNH.gov/DPHCS