BRATTLEBORO — This summer, Vermont has shut down state-sponsored Covid testing sites and scaled back its vaccination clinics, but state officials and local emergency medical services providers say that the infrastructure is there to ramp back up should infections once again soar.
In the meantime, while many might feel as though the pandemic is over - after all, maskless people are enjoying summer gatherings and the state's response to COVID-19 has quieted - nothing could be further from the truth.
In fact, COVID-19 is still very active in our area, and the response from state leadership is hard at work - although in a quieter way - as we learn to live with the virus.
Ben Truman, public information officer for the Vermont Department of Health (VDH), says that while it might appear Covid support in the state is slowing down, “there is a lot of action going on. It may appear that there is less happening, but that's not really the case.”
Truman reports that when the pandemic began, Vermont had one of the most coordinated responses in the United States, resulting in lower Covid case numbers and, most importantly, a death toll lower than that of many other states.
“As quickly as we could, we set up a scaffolding to deal with this public health crisis, and that's an ongoing situation. As we know more about this particular virus, our ways of responding with it is also evolving,” Truman says.
Drew Hazelton, chief of operations of Rescue Inc. in Brattleboro, has had months of hands-on experience with Covid numbers. As the state evolved its program, Rescue's role changed and grew, and now it's scaling back.
“We've traveled 300,000 miles without leaving Vermont,” Hazelton says. “At peak, we had five trailers on the road every day, all over the state, with 30 staff members administering vaccines and testing for the virus.”
“Rescue Inc. was a major player and a very significant partner in the Vermont Covid response and continues to be,” said Will Moran, emergency medical services chief of the VDH's Division of Emergency Preparedness, Response, and Injury Prevention.
“They provided at-home vaccination and testing. Their role became big enough that they ordered their own vaccine. They also managed their own monoclonal antivirus treatment program, the only team in the state to do so.”
Rapid response made a difference
State testing for Covid has also ended as more at-home tests have become available and physician offices do more of the testing.
“The Vermont Department of Health is working toward shifting Covid response back to general health care practice like primary care doctors and urgent care health systems,” says Hazelton.
Used as a treatment to lessen the impact of coronavirus on the body's immune system, monoclonal antibody treatments reduce the likelihood of severe illness and death from Covid. These treatments, given intravenously, were especially helpful to people who had not been previously vaccinated.
“Monoclonal treatment is artificially made to identify and boost the body's immune system's response to the virus,” says Hazelton. “We've had lots of people that it has worked very well for in lessening the severity of their illness.”
Rescue would respond to long-term care facilities in the area when a Covid outbreak would occur to administer the antivirals over the course of four consecutive days.
“Four or five patients might test positive for Covid, and our group of paramedics would go to that facility and administer the monoclonal treatment,” Hazelton says. “This most often meant that the patient didn't have to go from the facility in which they live to the hospital for treatment, a good thing all-around for the patient and for the hospital, so that more beds could stay open and available.”
Is Vermont ready for another Covid wave?
There has been concern that as Vermont pulls back on services, another variant could arrive in the fall, leaving Vermonters unprepared for the next round of Covid cases.
But Hazelton doesn't agree with that assessment.
“We're more slowed down than stopped,” he says in terms of the services the EMS provider has provided to the community thus far.
“It's more like taking a breather,” Hazelton says. “We can dial the amount of services back up if there is another surge.”
EMS teams across the state are continuing to give vaccines, mostly to younger pediatric patients, since the vaccine has recently been approved for children as young as 6 months.
Moran agrees with Hazelton's assessment of the state's ability to ramp the program back up if needed.
“We still have 30 active contracts with fire departments and ambulances in the state,” he said. “It's important to recognize that there is leadership in the state that is watching very closely.”
“We are not in that place that we were 18 months ago, so our response is different now,” Moran continues. “It's all part of the equation.”
“We're working continuously with health care providers and hospitals,” Truman said. “We're building the ongoing infrastructure. It's all been with the understanding that we're watching how much virus we're seeing and [identifying] the predominant variant. Science continues to develop and evolve, and the vaccine studies are trying to stay ahead of what we're going to be seeing this fall.”
But do we have accurate Covid surveillance numbers in the state now that people are testing at home?
Truman says yes.
“We're tracking every bit of information so that we always know what is happening in the emergency departments at hospitals and in doctor's offices around the state,” he says, encouraging people to use self-reporting forms on the state health website.
In some parts of the state, wastewater testing programs identify the amounts and changes of Coronavirus present in the waste stream.
“We have lots of different points of data that we rely upon all of which can be viewed on the website, which is frequently updated,” Truman says. “Our state is very transparent with the information so that anyone who wants to can stay informed.”
Viruses spread more easily in the winter
Though there might be changes to the response to the systems designed to keep people safe during a pandemic, Moran reminds Vermonters that the current one isn't over yet.
And winter is approaching.
“Why is flu season in the middle of winter? Viruses are easier to spread,” Moran says.
“We're hoping there won't be a new subvariant of this thing that is forever changing, but we're ready if that's what happens,” he says. “Our response is different, but it's still ongoing. We will be right there when there are new or different levels of illness.”
While he points out that we're seeing less illness, Moran said that doesn't mean there is no risk of illness.
“Covid is still very much with us, and it's going to be for a long while in Vermont, nationally and globally. The key is to be informed, to do what you feel you need to do to keep your family and loved ones safe,” he says.
He also implores people to “please remember that you may be interacting with someone who is at a greater risk of illness while out in the public.”
Moran suggests staying up to date on vaccinations, and if you feel like you are having symptoms, take a home test, call your doctor, or dial 211, the state community services referral service.
Operators at Vermont 2-1-1 “can assist you in finding a place nearby to get tested and are very helpful if you are uninsured,” Moran says. “Do what you can to stay healthy.”
Catching our collective breaths
Rescue Inc. is scaling back on its mobile vaccine clinics statewide, but the nonprofit is still fairly busy in southern Vermont.
“Over the last four months, we've been downsizing,” he adds. “However, we are still doing vaccines five days a week in Windham, Windsor, Bennington, Orange, and Rutland counties.”
Truman knows we're all tired.
“We recognize that everyone has Covid fatigue - anyone in public health will tell you that,” he says. “We've been watching a virus that is new to humanity evolve into multiple forms and transition in severity.”
“We are now at a point where there are the essential elements,” Truman continues. “Staying up to date with vaccinations doesn't feel like the emergency response it was in the beginning. The scaffolding for this health crisis is set up, and we're evolving into whatever the next phase will be.”
Moran acknowledges the many members of the statewide team, working together on the response to COVID-19.
“Every department in the EMS system, from the small fire departments to the largest ambulance services pulled together for the good of the public,” he says. “They've all worked hard as a team.”
He calls the EMS system - with its “flexibility, knowledge, versatility, and consistency” - the “Swiss Army Knife of the response.”
“We can make a direct correlation between EMS and our success,” Moran says. “Many contributed, and we worked as a team. And our team worked with all the other teams in the state - the governor's office, the Department of Health, EMS, primary care, the hospital system. Everybody is one spoke in the wheel.”
But as Vermonters move forward to the next phase in the pandemic battle, Hazelton names the elephant in the room.
“We're all wondering what will happen in the fall,” he says.