Inside a New Hampshire hospital overwhelmed by COVID

COVID infections are surging in much of the country, especially in parts of New England. And New Hampshire is at the epicenter.

More than half of patients who show up in the emergency room at Monadnock Community Hospital in southwest New Hampshire are testing positive. And doctors are having a tough time finding beds for all the patients who need more specialized care.

"What we're seeing is just unprecedented," said Dr. Eric Lasky, medical director of the emergency department at the hospital in Peterborough, about 70 miles northwest of Boston. "And it's been progressively getting worse."

On a recent day, Lasky treated a 38-year-old woman who was having trouble breathing. He put her on high-flow oxygen and said she was very close to needing intubation. There was no beds free in the rest of the hospital, so Lasky and his team kept her in the ER. They weren't sure whether she would survive.

"I hope she's still alive," he said, after his shift concluded.

Typically, when very sick patients come in, Lasky's job is to stabilize them — and then move them to a larger hospital. He has a list of some 30 hospitals to call across New England. But lately, none of them has had room.

"Right now we have every bed in the five-state area filled," Lasky said.

COVID cases are multiplying in much of the country, including New England, despite the fact that most people are now vaccinated.

New Hampshire, like Rhode Island and Massachusetts, now has one of the highest rates in the country. Many hospitals are struggling to keep up. According to New Hampshire state officials, fewer than 1% of staffed intensive care unit beds are available statewide.

Medical experts say the surge of cases in New England is partly due to the cold weather, which is pushing people indoors, where the coronavirus spreads more easily. Daniel Perli, chief medical officer at Mondanock, expects infections to climb even higher as winter sets in and people gather for the holidays.

"We haven't seen the worst of this yet, unfortunately," Perli said.

In addition, Perli and many other doctors are concerned that too many people remain unvaccinated. They say that the vast majority of patients seeking care in the emergency department — especially the sickest ones — haven't had the shot.

"And some will say, 'Well, can I get vaccinated now?' " Lasky said. "And you know, it's a little too late for that."

Lasky argues the region is largely suffering "a pandemic of the unvaccinated." He says we could bring the pandemic to an end if only more people would get the shots.

About two-thirds of New Hampshire residents are fully vaccinated. That's above the national average, but the lowest rate in New England and below the rates for dozens of countries.

Andrew Smith, who directs the University of New Hampshire Survey Center, has tried to find out why. Smith said his polling found that one in five New Hampshire residents claim they won't get the shot — no matter what.

"It's not changing, even as cases go up again," Smith said. "They're just not going to be budged."

One resident who refused to get vaccinated was 74-year-old Lorraine Stenersen.

"It's because they don't like being told what to do," said Stenersen, who lives in New Ipswich, New Hampshire. "They're like, 'Nobody's telling me what to do.' "

But then Stenersen got COVID. She was sick to her stomach, dizzy and struggled to breath. Stenersen ended up at Monadnock Community Hospital for 11 days. She's doing better now — and tells anyone who will listen to get the shots. "I learned my lesson," she said.

Studies show vaccination rates are especially low in rural counties. In New Hampshire — the "live free or die" state — there's also a streak of libertarianism, which embraces the primacy of personal choice.

But doctors on the front lines of the pandemic say residents' individual choices not to get vaccinated is having dire consequences for their neighbors. Hospitals are filling up with COVID patients and are putting off other types of medical care. Some health care workers have become so exhausted they have retired or left the industry, leaving many hospitals understaffed.

Cynthia McGuire, the chief executive of Monadnock Community Hospital, calls it "a convergence of problems."

"We have more patients, more critically ill patients and much less staff to support the process," McGuire said.

When fully staffed, McGuire's hospital has about 580 employees. But now there are about 90 vacancies.

"We have burnout of our staff," McGuire said. "They've been working long hours for almost two years now."

Like many other hospitals, Monadnock is having trouble finding new workers, which has a lot to do with the pandemic and the relentless pressure of COVID.

With winter approaching, and the emergence of more infectious variants like omicron, doctors there worry that pressure will only continue to grow.