NH DHHS Announces New Recommendations For COVID-19 Testing And Patient Management

Concord, NH – The New Hampshire Department of Health and Human Services (DHHS) has announced new recommendations to help healthcare providers determine who should be tested for COVID-19. These new recommendations acknowledge that providers and first responders nationwide lack the equipment they need to safely and accurately test any person who may be exposed to the novel coronavirus. The recommendations also acknowledge that more than 80% of people who have COVID-19 have mild symptoms and current inventory in all states should be directed to people with severe illness as well as healthcare workers.

Given the nationwide shortage of personal protective equipment (PPE) and other testing supplies, healthcare providers in New Hampshire must prioritize the State’s existing inventory of these materials to care for patients who will develop severe COVID-19 illness, and exposed health care providers and exposed first responders. Any significant decline in the healthcare workforce will have a negative impact on residents’ access to treatment for COVID-treatment and other health needs.

“The coronavirus has placed an unprecedented burden on our healthcare system, and signs of strain are showing,” said DHHS Commissioner Lori Shibinette. “Everyone who works in healthcare wants to test New Hampshire residents who have symptoms of COVID-19. Testing capacity at the State Public Health Laboratories (PHL) and commercial testing companies is not the issue. However, the challenge for our providers and first responders is national shortages in PPE, nasal swabs and retesting agents. Healthcare providers require access to these supplies to collect a specimen for testing. Until national supply chains are able to meet the demand for testing supplies, New Hampshire, like all states, will be forced to limit testing to those most at risk of severe symptoms and those healthcare employees who are critical to ensuring we can serve our residents’ health needs.”

“COVID-19 continues to spread in New Hampshire, and while most cases continue to be identified in people with recent international or domestic travel, there is now evidence of community-based transmission occurring in several areas in New Hampshire,” said State Epidemiologist, Dr. Benjamin Chan. “As this outbreak expands, it is important for people to stay home when not feeling well, even at the earliest symptoms of illness. It is not possible to test everybody with respiratory or cold symptoms for COVID-19, so as this outbreak expands, people that develop mild respiratory illness should stay home for at least seven days after symptoms first appear and should not go out until at least 72 hours have passed after symptoms begin to improve and any fever has gone away off fever-reducing medications. Everybody should continue to practice social-distancing and frequent hand hygiene to help protect themselves and their communities.”

As COVID-19 becomes more common in our communities, testing every person presenting with mild symptoms of fever or respiratory illness becomes impractical and does not change how a person’s illness is managed. Therefore, DHHS has shared the following recommendations for COVID-19 testing:

People who are 60 years of age and older, or those with chronic medical problems are at higher risk for hospitalization and death from COVID-19 and should:

• Stay at home and away from public places.
• Avoid any domestic or international travel.
• Call a provider if you are experiencing symptoms. If not severely ill, please call ahead before showing up at a hospital or emergency department.

People who have mild symptoms of COVID-19, even if not tested, should stay home until:

• At least 7 days have passed since symptoms first appeared.
  AND
• At least 72 hours have passed since recovery; which is defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms.

People who do not have symptoms but have been notified that they may have been exposed through close contact with a person with COVID-19 or a person presumed to have COVID-19 (without testing), and any persons who have traveled from countries with widespread sustained transmission should:

• Stay home (self-quarantine) for 14 days from the last day of potential exposure. It can take up to 14 days from the time someone is exposed to develop symptoms of COVID-19.
• Not be tested for COVID-19 because it doesn’t change the need for a person to self-quarantine even if testing is negative.
• Help us preserve our medical supplies by not asking to be tested.

Symptoms of COVID-19 most often include fever or respiratory illness, such as cough. Early mild symptoms can include fatigue, headache, and muscle aches. Fever may not develop until several days into illness, or not at all, but people can still transmit the novel coronavirus very early in their course of illness.