Weekly Update - April 30, 2021 - Nashua, NH

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Weekly Update - April 30, 2021 - Nashua, NH
Weekly Update - April 30, 2021
Dear Community Partners,

As the chief public health strategist for the Greater Nashua Public Health Region (GNPHR), the Nashua Division
of Public Health and Community Services (DPHCS) will continue to send weekly updates to inform our
community on the current status of the rapidly evolving COVID-19 situation, the response efforts by the City of
Nashua and Greater Nashua Public Health Network (GNPHN), and any additional updates related to the health
and safety of our community.

   COVID-19 Data Update

   We continue to experience substantial community level transmission of COVID-19 in the City of Nashua.
   Substantial community level transmission is determined by three metrics established in conjunction
   with the State of New Hampshire Department of Health and Human Services (DHHS) and the Centers
   for Disease Control and Prevention (CDC). When any one of the metrics exceeds the set threshold, a
   community is designated as "RED" or substantial. Currently we are exceeding the thresholds set on one
   metric: new infections per 100k.

                                                                      Total Cases: All confirmed or probable
                                                                      COVID-19 cases, either active or recovered.

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

                                                                      New Infections per 100k: Number of new
                                                                      cases within 14 days standardized by
                                                                      population size to compare across groups.
                                                                      This shows how quickly disease is occurring
                                                                      in the community or the incidence of
                                                                      disease.

                                                                      7-Day Total Test Positivity Rate: Number
                                                                      of PCR and Antigen tests that are positive
                                                                      compared to the number of PCR and
                                                                      Antigen tests that are negative over the
                                                                      past 7 days. A rising positivity rate
                                                                      indicates a rising number of infections in
                                                                      the community.

                                                                      Public health officials are strongly urging
                                                                      everyone to stay home if you are sick
                                                                      (except to get medical care), avoid social
                                                                      gatherings, maintain physical distancing of
                                                                      six feet or more, wear face coverings, and
                                                                      wash your hands frequently.

   Johnson & Johnson Vaccine Pause Lifted

   The CDC and FDA have lifted the national “pause” on use of the Johnson and Johnson (J&J) Janssen
Weekly Update - April 30, 2021 - Nashua, NH
COVID-19 vaccine and recommend that use of this vaccine resume for people 18 years of age and older.
The Nashua DPHCS will being using our allocated Janssen vaccine soon!

There are no new recommended restrictions on use based on age, gender, or risk factors; however,
clinicians need to be aware of the potential very low risk of thrombosis and thrombocytopenia
syndrome (TTS) and appropriately inform vaccine recipients (see below).

The CDC’s Advisory Committee on Immunization Practices (ACIP) met on Friday, April 23rd to review
updated information about cases of TTS after the J&J Janssen vaccine.
      Meeting information, including presented data, can be found online here.
      Experts believe that the pathogenesis of TTS is similar to autoimmune heparin induced
      thrombocytopenia (HIT), but the exact mechanism of the syndrome after receipt of the J&J
      Janssen vaccine is not yet known.
      The risk of TTS after receipt of the J&J Janssen vaccine is believed to be very low, and ongoing
      investigation continues.
      No cases of TTS have been identified after receipt of the Moderna or Pfizer COVID-19 vaccines.

As of April 21st, there have been 15 confirmed TTS cases out of 7.98 million J&J Janssen COVID-19
vaccine doses administered (1.9 cases per million people vaccinated). All have been female, the
majority of which were aged 18-49 years of age (n=13); 3 people have died.
       The rate of TTS in females aged 18-49 years of age is 7.0 cases per million vaccinated
       Median age is 37 years (range 18-59)
       Median time to symptom onset is 8 days (range 6-15 days)
       No cases have occurred in pregnant or post-partum women
       12 cases of TTS involved cerebral venous sinus thrombosis (CVST)
       Other contributing risk factors for TTS after J&J Janssen vaccination are not known

Clinicians can resume use of the J&J Janssen vaccine, but should inform patients about the potential,
but very low, risk of TTS after receipt of the J&J Janssen vaccine. The FDA and CDC are updating
guidance to assist with informing vaccine recipients about potential risks.

In patients with suspected TTS after receipt of the J&J Janssen vaccine, consultation with a
hematologist is strongly recommended to assist with diagnosis and management. The American Society
of Hematology has developed guidance for assessment and management of TTS identified after receipt
of the J&J Janssen vaccine. Health care providers are asked to report adverse events, including
suspected cases of TTS, to the Vaccine Adverse Event Reporting System (VAERS).

If you received the J & J Janssen vaccine, for three weeks after receiving the vaccine you should be on
the lookout for rare, but possible symptoms of a blood clot with low platelets. These include:
        Severe or persistent headaches or blurred vision
        Shortness of breath
        Chest pain
        Leg swelling
        Persistent abdominal pain
        Easy bruising or tiny blood spots under the skin beyond the injection site
        Seek medical care right away if you develop one or more of these symptoms.

           Fact Sheet: Recipients                                       Fact Sheet: Providers

        If your organization interested in hosting a closed vaccination clinic for staff and clients
                         OR your organization anticipates having extra vaccine:
                 email Patty Crooker at crookerp@nashuanh.gov for further discussion.

DPHCS Hosts Second Dose Vaccination Clinic for Teachers & Child Care Staff

This weekend, we administered 2,406 second
doses of the Moderna COVID-19 vaccine to
teachers, school staff, child care providers,
youth camp staff, and individuals 50 years of
age or older in Greater Nashua.
Weekly Update - April 30, 2021 - Nashua, NH
We are immensely grateful to this weekend’s
clinic staff, which includes a large number of
volunteers. Thank you Fidelity Investments
for the continued partnership in the efforts to
vaccinate our community!

Even after vaccination, we want to remind
our community that it is important for
everyone to continue to be vigilant and
practice public health recommendations to
ensure maximum protection against COVID-
19.

We Still Need to Make Good Choices

Although COVID-19 mitigation
strategies are being lifted on a state
level here in New Hampshire (NH),
we still need to continue to be
vigilant.

Until enough people in the Greater
Nashua Region and State of NH are
fully vaccinated against COVID-19
(two weeks past their last dose), we
need our community to understand
that people still need to take
precautions when they are around
people they do not live with.

As of Monday, April 26th, 33,614
(38%) of individuals in Nashua have
been vaccinated with one or more
doses and 17,938 (20%) are fully
vaccinated.

This is a reminder that 80% of the
Nashua population are still not fully
vaccinated against COVID-19.

Even with vaccination, we know that some people who are fully vaccinated may still get sick, this is
because no vaccine is 100% effective. We also know that there are multiple variants of the virus that
causes COVID-19 circulating globally and within the United States (US).

In the US, there are currently five variants of concern, including:
       B.1.1.7: Initially identified in the UK and first identified in the US in December 2020.
       B.1.351: Initially identified in South America and first identified in the US in January 2021.
       P.1: Initially identified in travelers from Brazil, who were tested during routine screening at an
       airport in Japan, and first detected in the US in January 2021.
       B.1.427 and B.1.429: Initially identified in California in February 2021 and were classified as
       variants of concern in March 2021.

These variants seem to spread more easily and quickly than other variants, which may lead to more
cases of COVID-19. An increase in the number of cases will put more strain on health care resources,
lead to more hospitalizations, and potentially more deaths. So far, studies suggest that antibodies
generated through vaccination with currently authorized vaccines recognize these variants. This is
being closely investigated and more studies are underway.

While public health officials continue to study these variants, we want our community to understand
that rigorous and increased compliance with public health mitigation strategies, such as vaccination,
Weekly Update - April 30, 2021 - Nashua, NH
physical distancing, use of masks, hand hygiene, and isolation and quarantine, is essential to limit the
spread of the virus that causes COVID-19 and protect public health.

2021 Prescription Drug Take Back Day was a Success!
On April 24th, Greater Nashua participated in in the
Drug Enforcement Agency’s (DEA) 20th Annual
National Prescription Drug Take-Back Day.

This event provided the public an opportunity to
prevent misuse and theft by eliminating expired,
unused, and unwanted prescription drugs from our
community. Check out the totals below - way to go!

       City of Nashua - # of Boxes Filled: 13
       City of Nashua - Weight in Pounds: 387.1
       Greater Nashua - # of Boxes Filled: 62
       Greater Nashua - Weight in Pounds: 1830.3

Cinco De Mayo - Safer at Home

Cinco de Mayo is an annual celebration held on May
5th. The date commemorates the Mexican Army's
victory over the French Empire at the Battle of Puebla,
on May 5, 1862, under the leadership of General
Ignacio Zaragoza. The catchy name and associated
celebrations made it's way into American culture and
celebrations about two decades ago.

The Mexican culture is rich in music, colorful clothing,
and celebration, so let's honor our neighbors to the
south with healthy celebrations in recognition of this
holiday.

       Cook together as a family! Enjoy some Mexican favorites such as burritos, enchiladas, tacos, and
Weekly Update - April 30, 2021 - Nashua, NH
quesadillas. Check out this enchilada sauce recipe - you will never buy canned again! Love
       guacamole? Buy your avocados now so they are ready for your cooking fest!
       Order take-out from your favorite local Mexican restaurant. Greater Nashua has a lot to offer!
       Create your own Mexican music playlist. Try YouTube or Spotify for suggestions.
       Decorate your kitchen with colorful streamers, pom-poms, and tassels. Make it a family activity.
       Have kids? It is a great time to open up a piñata outside.
       If you do decide to visit a bar or restaurant, dine outside if possible and drink responsibly.

If you are preparing a meal at home, keep it food safe! After food is cooked, hot foods should be kept
at 140˚F or warmer, and cold foods at 40˚F or colder to prevent foodborne illness. Learn more about
preventing foodborne illness on the CDC's website.

Staying Safe this Prom Season

It’s almost that time of year! Prom can be a highlight
of the high school experience. It is an important and
exciting milestone for a young person.

In preparation for this exciting event, parents and
students need to understand the law, the risks
associated with underage drinking and drug use, and
make plans to celebrate safely.

The Nashua DPHCS wants to share the following tips to
help students make smart decisions to look and feel great, stress less, and stay protected.

What can students do to look and feel great?
There are many ways students can look and feel great without harming their health.
       Indoor tanning is dangerous on skin and should be avoided.
       Trying any new hair color or cosmetic product can cause a reaction. Always test new products in
       a small area first, stop using the product if problems develop, and follow all label directions.
       While high heels may be in style, they can increase your chance of falling. Prevent injury and
       wear comfortable shoes that won’t affect how you walk or dance.

What can you do to stress less and protect yourself?
Prom is an important night, and it can be stressful for both students and parents.
       Leading up to prom night, plan ahead for safety. Tell your loved ones and family members what
       your plans are for the day and evening. Any change of plans during should be communicated
       back home.
       ​Make a plan to agree with friends to check on each other throughout the evening.
        Some people feel pressured to drink, smoke, use drugs, or have sex on prom night. However,
        underage drinking and drug use is against the law. Alcohol and drugs impair judgment and may
        result in being harmed or harming others. Drinking is also responsible for over 4,500 deaths
        among young people each year and is associated with sexually transmitted diseases and
        unintended pregnancy. Just because your friends do something, doesn’t make it a good idea or
        right for you. It’s OK to say no.
        Teen drivers ages 16 to 19 years old are four times more likely than older drivers to crash. You
        should never drink and drive, never get in a car with a driver who has been drinking, and always
        wear a seat belt. If you are put into an unsafe situation, call someone you trust for a ride home.
        Asking for a ride will bring you home safely without judgement or punishment.
        Dating abuse is a very real issue for many young people. This abuse can be verbal, emotional,
        physical, or sexual. Respect yourself and others. Call 911 if you or someone you know is being
        abused.

Due to the COVID-19 pandemic, prom may look a little different this year. To celebrate safely, students
are encouraged to:
       Review and follow all COVID-19 safety protocols at their schools event. This guidance is created
       to protect the health and safety of you, your peers, and your community.
       Quarantine for 10 days leading up to the event and get tested for COVID-19 a few days prior to
       the event.
       On the day of prom, anyone who is experiencing symptoms of respiratory illness or has been in
       contact with someone with COVID-19 in the past 10 days.
Weekly Update - April 30, 2021 - Nashua, NH
If you develop symptoms after the event, it is important to get tested for COVID-19.
       While attending prom, wear a mask over your mouth and nose at all times, except when you are
       eating or drinking, to protect yourself and individuals around you. Do your best to stay six feet
       away from others at all times throughout the night. If the dance floor looks crowded, find
       another activity and wait until there are less people before you join. Make sure to wash your
       hands often, especially before and after eating.

Another layer of protection before prom is to get vaccinated against COVID-19. Currently in New
Hampshire, vaccines are available to all residents 16 years of age and older. Residents who are 16 and
17 years old are only authorized to receive the Pfizer vaccine, which requires two doses, three weeks
apart, for full vaccination. Schedule an appointment before prom at vaccines.nh.gov.

Follow these tips for a safe, healthy, and fun prom!

Attention Parents & Caregivers: Check out these great upcoming events!

EQUITY CORNER:
Nashua Local Community Raising Funds for Medical Equipment in India

The COVID-19 pandemic has seen record-level surge in India recently. The nation is seeing
approximately 350,000 cases daily with thousands of deaths a day.

Currently, the country is facing extreme shortages of medical equipment such as hospital beds,
ventilators, and oxygen. To help with this devastation, local cultural groups in New Hampshire are
banding together to spread the word and raise funds.

In New Hampshire, roughly 50% of the Indian American population reside in Nashua. The India
Association of New Hampshire together with the American Association of Physicians of Indian Origin
and Sewa International are collecting donations to purchase oxygen concentrators, ventilators,
providing telemedicine services, and shipping care packages for families suffering with COVID-19. “It’s a
global pandemic, so if we don’t take care, we are one family, it’s going to come back here, another
surge is going to happen here,” said New Hampshire State Representative Latha Mangipudi.
Weekly Update - April 30, 2021 - Nashua, NH
Click the links above or image below to donate essential supplies!

Heavy Metals in Baby Food - How You Can Protect Your Children

​Recent news about heavy metals found in baby food can leave parents wit​h a lot of questions. Below is
 some information from the American Academy of Pediatrics about the risk of toxic metal exposure to
 children and how to help minimize it.

Q: Can heavy metals in baby food harm my baby?
A: The low levels of heavy metals found in baby foods likely are a relatively small part of a child's
overall toxic metal exposure risk. However, exposure should be minimized. Toxic metal exposure can
be harmful to the developing brain. It's been linked with problems with learning, cognition, and
behavior.

Q: How do heavy metals get into foods?
A: Metals are found naturally in the Earth's crust. They also are released into our environment as
pollution and get into the water and soil used to grow food. Metals can also get into food from
manufacturing and packaging. Some of the most common metals that get into food include inorganic
arsenic, lead, cadmium, and mercury.

​Q: How can I reduce my baby's exposure to toxic metals?
 A: Stronger rules and regulations for testing and limiting​ the amount of heavy metals in foods for
 babies and toddlers are most important. But there are several steps parents can take now to reduce
 the risk that kids will be exposed to toxic metals in their diet, and from other sources. See below.

       Serve a variety of foods to give your child a well-balanced diet.
       Read the labels to be sure you are offering a true variety of foods.
       Switch up your grains to include oat, barley, couscous, quinoa, farro, and bulgur into your child's
       diet. Multi-grain infant cereals can be a good choice.
       Check your water and contact your local health department to have your water tested if you are
       concerned.
       Breastfeed, if possible, to help reduce exposure to toxic metals.
Weekly Update - April 30, 2021 - Nashua, NH
Avoid fruit juice and offer children sliced or pureed whole fruits instead.
       Make healthy fish choices by choosing light tuna, salmon, cod, whitefish, and pollock.
       Consider homemade baby food, but keep in mind that offering a variety of foods is just as
       important when making your own baby food as when shopping for prepared baby foods.
       Identify and address lead hazards in your home, such as peeling paint, soil, some cosmetics,
       and spices.
       Don't smoke or vape to prevent children from secondhand exposure to metals and cancer.

For more information, visit healthychildren.org.

Make Lupus Visible

                                     This May, join lupus warriors, friends, family members, and
                                     caregivers to make lupus visible!

                                     Lupus is a chronic autoimmune disease that can damage any part of
                                     the body (skin, joints, and/or organs). "Chronic" means that the
                                     signs and symptoms tend to last longer than six weeks and often for
                                     many years.

Living with an invisible illness like lupus can be isolating, and sometimes lead to judgment from others
who don’t exactly understand the daily struggles. Most symptoms of lupus aren’t always readily visible,
but on the inside, it can wreak havoc on your body, organs, and even cause emotional and mental
strain. Just because people can't see the pain, doesn't mean it's not there. Help bring visibility to lupus,
even when it can’t be seen!

On average, it takes nearly 6 years for people with lupus to be diagnosed from the time they first notice
their lupus symptoms. We need to change this. Getting an early diagnosis of lupus is critical to
preventing long-term consequences of the disease. If someone is experiencing symptoms of lupus, they
should contact their health care provider.

Lupus Awareness Month is an annual observance to call attention to lupus and its impact on the lives of
millions of individuals and families. Take this pledge from the Lupus Foundation of America to continue
raising awareness and help us make lupus visible year-round.

For more information, check out this Lupus fact sheet here.

Additional Resources

                    Nashua COVID-19 Hotline: 603-589-3456
                                                    Upcoming Events
    New Hampshire COVID-19 Website
                                                    Harbor Care COVID-19 Testing Clinic
                                                    May 3, 3 - 6 p.m.
                                                    (45 High St., Nashua)
                                                    By Appointment: 603-821-7788
        Nashua COVID-19 Website

                                                    DPHCS COVID-19 Testing Clinic
                                                    May 4, 3 - 4:30 p.m.
           Greater Nashua Data                      Elm Street Parking Garage
               Dashboard                            By Appointment: Register Here

                                                    SSANA
          CDC COVID-19 Website                      May 3, 10 a.m. - 12 p.m.
                (English)                           Between Temple St. & Cottage St., Nashua
Weekly Update - April 30, 2021 - Nashua, NH
Immunizations, Child Lead Testing
CDC COVID-19 Website (Spanish)   May 4, 3:30 - 5 p.m.
                                 Elm St. Middle School Front Parking Lot
                                 (117 Elm St., Nashua)

   Vaccination Information
                                 Immunizations, STD/HIV/HCV Testing
                                 May 5, 10 a.m. - 12 p.m.
                                 Elm St. Middle School Front Parking Lot
                                 (117 Elm St., Nashua)
       Food Resources

                                 SSANA
                                 May 5, 2 - 4 p.m.
                                 (29 Temple St., Nashua)

                                 STD/HIV/HCV Testing
                                 May 6, 5 - 7 p.m.
                                 Lamprey Health Care
                                 (22 Prospect St., Nashua)
                                 By Appointment: Register Here

                                 PLEASE NOTE: COVID-19 vaccines are NOT offered at
                                 our mobile immunization clinics listed in this section.
                                 For information about getting vaccinated against
                                 COVID-19, please visit vaccines.nh.gov or call 2-1-1.

                                 Full DPHCS Mobile Outreach Schedule
Weekly Update - April 30, 2021 - Nashua, NH
The New Hampshire Public Health Association           NHResponds is the system used pre-register health
(NHPHA) supports science based public health policy   and general volunteers who have are interested in
and has a goal of informing citizenry of changes      responding in an emergency. Whether you are a
needed in the laws and government in order to         healthcare provider, administrative specialist, a
improve public health. They track bills and attend    retired professional - anyone ready to help in your
hearings on public health issues. Subscribe to the    community - New Hampshire needs you. Check it
”Health in All Policies” E-News on their website.     out!

City of Nashua Division of Public Health and Community Services                 STAY CONNECTED!
Greater Nashua Public Health Network
(603) 589-4500
www.nashuanh.gov/DPHCS                                                                ​     ​     ​         ​
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