Bold numbers are changing daily – numbers as of 9 am on May 21, 2020. All data in this article is public data released daily by the state of New Hampshire. For updates on the state of Coronavirus in New Hampshire, click here.
In New Hampshire, only 55,100 people have been tested for COVID-19 since the beginning of the outbreak in the United States. While this number may seem like a lot, it ends up just being 0.04% of the 1.4 million people in the state.
In the state of New Hampshire, there are four sites where the samples are analyzed. There are two public facilities, Dartmouth-Hitchcock and the New Hampshire State Lab, alongside two private labs, LabCorp and Quest Diagnostics.
There are testing sites all over the state, the majority located at hospitals, such as Exeter Hospital, and Wentworth Douglass in Dover.
“We have a respiratory illness clinic set up outside, in an isolated, tented area where symptomatic patients and staff can go for testing needs,” said Dawn Fernald, the Public Information Officer for the Wentworth Douglass COVID-19 Incident Command Center.
At both Exeter Hospital and Wentworth Douglass, and most testing sites, the most commonly used test is what’s called a nasopharyngeal swab test. In a nasopharyngeal swab test, a sample of nasal secretions is gathered from the back of the nose and throat.
“We have performed more than 2500 tests for patients in our community, with 150 positive results,” said Fernald
One of the first people tested in the state was Durham resident Pete Marple. Marple, and his wife Kitty, returned from a vacation in Florida during late February. A few days after they returned, Kitty developed symptoms of the virus, but didn’t think about getting tested as it was not severe, and was well before the severity of the Coronavirus in the United States. A week or so later, after Kitty had recovered, Marple began to develop symptoms, such as a sore throat, cough, and the inability to swallow. Marple, a pilot who flies frequently to New York, was told to get tested after talking to his doctor.
Marple was tested at a drive up testing site located at the Exeter Hospital. “They had a little tent and we drove up, we were the only car there at the time, because they were changing over to [testing] very severe cases and medical workers,” he said. “You drive up, you roll your window down, they ask you for your information. Then they put the swab as far up your nose as possible, and you drive out.” Marple then waited eight days for his results. They came back positive.
Around the time Marple was tested, the state was saying it was expecting to have results within 3 to 4 days of the sample reaching the lab. Now, the time has dropped to 24 hours, as the state lab has hired more workers to keep up with the number of tests coming through the door.
The state lab was analyzing an average of 441 tests daily between March 26 and April 15.
In the then, that number has increased, with the state lab analyzing around 650 new samples per day between April 16 and May 1.
It is also important to note that private labs, such as Quest Diagnostics and LabCorp, have increased their testing numbers, averaging 415 and 197 tests per day between April 29 and May 5, respectively.
But even with the increase in analyzed tests daily, the state lab has the personnel capacity to analyze more than are being sent to the state lab. “We should be able to crank out a higher number of tests [at the state lab] than are coming through the door,” said Elise Sullivan, a Durham resident who has been working full time at the state lab analyzing samples since March 26.”
“From a personnel standpoint, everyone’s trained, we’re there seven days a week. We’ve staggered shifts, so someone’s going in at 4 am to get all the equipment set up and someone’s staying until 7 or 8 pm to finish up the last tests and send out data reports.”
“We’ve really streamlined the process here,” Sullivan continued. “It’s not because we don’t have enough people or lab equipment. We can definitely handle more samples than are coming through the door, but we don’t have the reagents to guarantee that we can do them.”
Reagents are the liquid chemicals added to the sample to pull the strands of viral RNA from the mucus found on the throat or nasal swabs. Without the reagents, you have nothing to actually see the viral RNA, which makes it impossible to determine the result of a test.
“Everyone is trying to run the same tests, which makes the demand for reagents really high,” said Sullivan.
Reagents are in short supply not just in the U.S, but all over the world, with politicians in both the United Kingdom and the Netherlands claiming that the lack of reagents is the reason for delayed mass-testing of COVID-19.
In the first 16 days that Sullivan was working at the state lab, only two shipments of reagents arrived, which she says is not enough to run all the tests they are receiving. “We’ve been having to send samples to [Dartmouth-Hitchcock]… because of the lack of reagents,” she said.
But some testing sites, such as Wentworth Douglass, have started to send their samples elsewhere. “We’ve been sending our tests to the state lab, but also to Mass General and to LabCorp for processing,” said Fernald. “To help take some of the burden off the state lab.”
Even if New Hampshire increases the amount of tests conducted, the lack of reagents becomes more of a problem.
However experts say that we need widespread testing to truly understand the severity of the disease’s impact in New Hampshire. “We won’t have a good understanding of how much the disease is in the community until we get a better handle on [testing],” said Dr. Richard DePentima, the former deputy health director for the state of New Hampshire, in an interview with Foster’s Daily Democrat. “Until we do, it’s going to be hard going forward,” DePentima continued.
The state epidemiologist, Benjamin Chan, said that an increase in testing should be priority number one for the state moving forward. “Number one, (we need) much more testing, we’re working on that,” he said during a press conference on March 2.
Sullivan concluded by saying that “until we have more widespread testing, our data is going to severely underestimate what’s going on.”