CONCORD — State epidemiologist Dr. Benjamin Chan on Wednesday reported a fourth coronavirus-related death as the number of people who have tested positive for COVID-19 has surpassed 400.

A total of 59 people have been hospitalized, but that figure and the death toll may trail the actual numbers, given the fluid situation, Chan said.

Without providing details, he also said the state is investigating instances where a cluster of cases have been reported in institutional settings.

In Greenfield, a resident of Crotched Mountain center’s adult program died Sunday and two other residents and three staff members also have the disease, spokesman David Johnson told The Keene Sentinel.

Chan joined Gov. Chris Sununu in a news conference where state residents were urged to brace for a worsening pandemic.

“The next month will be a challenge like this state has never seen,” the governor said.

He urged people not to let their guard down, and to continue to practice social distancing and to avoid non-essential outings.

Early on in the outbreak, most cases of the disease could be traced back to a particular person who got the virus through travel or contact with an infected person.

Now, it’s frequently spread through an indeterminate contact with someone who isn’t identified — so-called “community spread,” Chan said.

“At this point, we believe it’s widespread and present in most communities throughout the state,” he said.

Sununu has advised a 14-day quarantine period for out-of-state visitors who plan to stay in New Hampshire for an extended time.

On Wednesday, he said there has been good compliance with this advisory, and he doesn’t see the need to make it mandatory and enforceable, but would hold this as an option should it be required.

He also said he wasn’t going to close park areas like Mount Major, which has continued to be popular despite the pandemic. The governor said hiker cars may crowd a parking lot but people have been social distancing on trails.

Aside from the health ramifications, the disease has blown a hole in the state budget, the governor said in response to a question.

“We haven’t seen the final numbers for March, but no doubt it will be a large gap, not just at the state but at the town level,” he said.

He said cutbacks will ultimately be needed. A tax holiday for property tax payers is being discussed.

Sununu also announced an emergency order freeing up funds designed to protect young people and people suffering from domestic abuse.

He said that while the volume of calls for the Division of Children, Youth, and Families Child Abuse Hotline has been down during the pandemic, the number of domestic violence and substance abuse referrals have gone up.

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