FILE - In this Monday, May 25, 2020 file photo, a vile of a COVID-19 vaccine candidate on a shelf during testing at the Chula Vaccine Research Center, run by Chulalongkorn University in Bangkok, Thailand. Refrigeration, cargo planes, and, above all, money: All risk being in short supply for the international initiative to get coronavirus vaccines to the world’s most vulnerable people. (AP Photo/Sakchai Lalit, File)

NASHUA – With the impending COVID-19 vaccine, there comes hope and many questions.

A U.S. government advisory panel endorsed widespread use of Pfizer’s coronavirus vaccine Thursday, putting the country just one step away from launching an epic vaccination campaign against the outbreak that has killed close to 300,000 Americans.

Shots could begin within days, depending on how quickly the Food and Drug Administration signs off, as expected, on the expert committee’s recommendation.

And while New Hampshire heaves a collective sigh in anticipation of the COVID-19 vaccines, the state saw its largest single-day death count in more than seven months on Thursday, with 14 people dying from the coronavirus; 13 of those deaths were in long-term care facilities.

A record 248 people were hospitalized on Dec. 10 as well. State epidemiologist Dr. Benjamin Chan said healthcare facilities are being stretched as a result of increasing caseloads and a shortage of staffing.

“We know that community transmission continues to increase,” he said at a press conference in Concord on Thursday afternoon. “And without a high compliance for mask use, social distancing, avoiding travel, especially around the holidays, our rates of community transmission will likely increase.”

Also on Thursday, Mayor Jim Donchess and Public Health and Community Services director Bobbie Bagley addressed residents at a video press conference, providing updated numbers and cautioning people in Greater Nashua to continue practicing safety measures as the holiday season approaches.

Bagley said Nashua has seen “a substantial increase” in cases for the first week of December, with day care facilities, many businesses, nursing homes and long-term care facilities the hardest hit.

Once the vaccine arrives, city officials plan to enact a “tiered approach” to administering the vaccine, starting with the most at-risk people, such as healthcare workers and first responders.

Meanwhile, Dartmouth-Hitchcock Health announced this week a vaccine plan that details vaccine management, community engagement and distribution for doses of the COVID-19 vaccine as allocated by the New Hampshire Department of Health and Human Services.

Associate chief quality officer at D-HH Dr. Michael Calderwood, MD, recently shared information on vaccine plans and clarification of the new Centers for Disease Control’s quarantines guidelines.

“The CDC is reducing the quarantine period from 14 days down to 10 days,” he said. “The CDC has been reviewing the data and looking at when, after an exposure, you’re more likely to develop symptoms.”

Calderwood acknowledged that waiting until day 14, a patient is roughly 99 percent likely to have developed symptoms if they were positive for COVID-19.

“However, we know as well, that is a very long period,” he said. “That means people are out of work, out of school, and not going about their daily lives. So, reducing that period from 14 days to 10 days does add a little bit of risk, but not a lot.”

D-HH reported that most people will experience symptoms by day five if they have been exposed to the virus.

With the Pfizer endorsement, there are still other vaccines that are coming onto the market.

People are naturally excited and curious about the vaccines and have many questions, primarily when they can expect to get the vaccine and where will it be administered.

Chief Pharma Officer for D-HH Staci Hermann, MS, said the public needs to be patient as the vaccines are unrolled.

“We are following the state guidelines,” she said. “They have divvied up the state population, so to speak, into four phases. They just released this information on Dec. 9.”

Meanwhile, D-HH has established a large team of experts who sole focus is the implementation of the new vaccines in the state. Calderwood said the team has evaluated issues such as prioritization and distribution through 2021 as the health agency rolls out the vaccine to the general public.

“The Pfizer and the Moderna vaccines will require two doses,” he explained. “These are typically given 28 days apart. Both vaccines are required if they are to be effective.”

There has also been major discussions as to who will receive the vaccine first, with the immediate focus on Phase 1A.

“Phase 1A is the first group that is going to be vaccinated,” Calderwood said. “We believe that phase will begin within a couple of weeks. The focus is on high risk healthcare workers, first responders, and nursing home residents who have been particularly hard-hit by this pandemic.”

Hermann said correctional facility doctors and nurses would be categorized as Phase 1A essential frontline workers. Law enforcement officers are included in Phase 1A.

Beyond the first phase, DH-H is examining who will receive the vaccine second. Calderwood said those discussions are taking place between the CDC and other healthcare advisory groups. Considerations will also be made for individuals who are important in terms of transmission in the community. Educators, transportation workers, and food industry workers are among those being discussed.

“Phase 2 will really look at folks who may be in what is considered, a ‘transmission path,’ Hermann stated. “Teachers, who have students coming in and out of class, where there is the potential for transmission in schools, fall into that category. And also people who are comorbid or have underlying health conditions that put them in higher risk may also be prioritized.”

For our older population in their 80s, who for example, have been essentially quarantining during the shutdown and staying safe, Hermann said that the details of that plan are still being discussed at the state level.

“I don’t know for sure,” she said, “but it could involve working with a primary care physician or health system because many of us now have electronic health records. So maybe we’ll end up communicating through that mechanism.”

“There’s been a lot of discussion as to how to prioritize these individuals,” Calderwood added to the conversation. “This is not finalized. We’ll get more information on this through the month of December and we’ll be able to explain to folks where, over the months in 2021, they will fall.”

Primary care doctors will not have information on when the vaccine will be available for “quite a period of time,” Calderwood stressed.

“We ask that you not call your primary care physician to ask when the vaccine will be available,” he continued. “Instead we will work on communication and ongoing updates for patients and others in the community to let you know when it’s available for you to come in and receive.”

Hermann said that people can get information about the vaccine on D-HH’s website, www.dartmouth-hitchcock.org.

“We’re developing a website specifically to provide vaccination information,” she said. “Because we know that information is going to be changing so rapidly.”

Initially the vaccine supply will be limited. However, it is anticipated that by late spring, April into late May, that many of the high-risk groups will be inoculated.

“As we think about where we need to be, we often think about the idea of herd immunity,” Calderwood said. “We need to get to a little over 230 million people in the U.S. in order to achieve herd immunity. If people come out and are willing to be vaccinated, and if the supply is as expected, we could be there by late summer 2021.”

In the meantime, Calderwood said, people need to continue to wear a mask, socially distance and wash their hands frequently.

“In terms of safety, what we know is that the two vaccines that are coming into review by the FDA have been studied in between 30K and 40K people each,” he said. “And we’re hearing great information in terms of their efficacy. They protect about 90-95 percent of individuals. Which means you get the vaccine and you won’t get a viral infection from COVID-19.”

Of those individuals who have been infected, Calderwood said those people are less likely to be hospitalized, less likely to end up in ICU, and less likely to succumb to COVID-19.

“Even if the vaccine doesn’t fully prevent you from getting the illness,” he said, “it most certainly prevents you from getting severe illness.”

Hermann said the focus is to, “hold on.”

“Stay strong,” she said. “We will be getting to folks as soon as we possibly can. I know the governor has signed an executive order that is actually allowing pharmacists the ability to administer vaccines, which will definitely open up access as to, ‘where can I go to get it?'”

D-HH is looking at their retail pharmacies as avenues to help vaccinate once the supply is there.

Meanwhile, Donchess, although expected to do so at the Thursday press conference, did not address the ongoing discussions over the possibility of Nashua enacting a curfew, similar to the one in Massachusetts.

Supporters of such a measure propose a 9:30 p.m. curfew, the same as the one enacted in Massachusetts, saying it would prevent Massachusetts residents from coming to Nashua after their curfew takes effect.