BRATTLEBORO — For many Vermonters, this summer has been a time of diminishing worries about COVID-19, but this status could change quickly as the new BA.5 Omicron subvariant is starting to drive an uptick in cases nationwide.
Vermont is reporting an increased proportion of BA.5 cases, according to the July 13 Vermont Department of Health (VDH) surveillance report. However, it does not seem to have driven a spike in overall cases in the state thus far. In New England, BA.5 made up about 46 percent of new cases as of July 2; in recent days, data from the U.S. Centers for Disease Control and Prevention (CDC) estimates it accounts for 65 percent of new cases nationwide.
“We estimate in the Northeast it's about 50 percent of all the whole genome sequencing that is being done, but we're not seeing a super high uptick in disease activity, whether you look at cases or hospitalizations or death,” Health Commissioner Dr. Mark Levine said a July 12 press conference. “So that is all good news.”
The state's report on July 13 found that the state had “low” COVID-19 levels for the fifth consecutive week, as Vermont continues to emerge from a surge in cases earlier this year driven by the BA.2 subvariant.
The CDC also reported that, as of last week, most Vermont counties, including Windham County, had “low” levels of COVID-19. Only two counties - Bennington and Rutland - were rated “medium.”
As of July 13, VDH reported an average of 65 COVID-19 cases per day and about five new hospital admissions per day, both a drop from the previous week. Hospitalizations have been the lowest levels since August 2021 with 10 people hospitalized with COVID-19 and no patients with COVID-19 in intensive care units.
Four people have died from COVID-19 this month, as of July 13, also the lowest level since the summer of 2021. With 687 deaths in Vermont attributed to the virus from the beginning of the pandemic in March 2020 to July 13 of this year, Vermont has one of the lowest death tolls in the nation.
A new variant's rise
In recent weeks, top experts at the CDC and VDH have said that new, more contagious versions of the Omicron variant could sicken 30 percent of Americans - as many as 100 million - this winter.
Last summer, as the new variants of COVID-19 began appearing around the country, state and local officials were prepared to deal with the effects of the pandemic. This summer, the latest Omicron variants have begun to appear right at the moment when many Americans think the pandemic is over and less funding is available to cover the costs of yet another wave of the virus.
As of last week, there are still about 100,000 new COVID-19 cases reported each day in the United States, with around 300 deaths reported per day. Since the start of the pandemic, according to CDC data, 88.9 million cases have been reported, and just over 1 million people have died from complications of the virus.
These figures, health officials say, are likely to be an undercount.
Most states, including Vermont, have closed their state-run testing sites and are relying on voluntary reporting of results from in-home tests, monitoring of wastewater discharge for increase viral activity, and data from health care providers to track the virus.
Mask mandates for public spaces have ended in all U.S. states, although most health-care and long-term facilities still require facial coverings for visitors.
Vaccine activity has dropped sharply also.
In Windham County, 72.7 percent of those over age 5 have received all their recommended vaccines, but only 59.9 percent have received booster shots, according to CDC data.
Hospitals concerned about fiscal health
If the latest variants of the coronavirus cause another surge of new cases and deaths in the United States, it could have significant implications for Vermont hospitals - and their finances.
“When [hospitals] construct their budgets, they use all the information they have available to project what they'll need next year,” said Michael Del Trecco, interim president of the Vermont Association of Hospitals and Health Systems. “When you throw Covid into anything, let's face it - everything is really fluid, and it's very hard to predict.”
Brattleboro Memorial Hospital officials say the institution took a more precautionary approach and built COVID-19 response into budgets.
But BMH spokesperson Gina Pattison said on July 14 that while the hospital budgeted for some Covid response, a surge that's large enough to “significantly impact staffing, force the cancellation of elective procedures, and require closure of our operating rooms would adversely impact” hospital finances, requiring “relief funds of some kind.”
Executives at the 61-bed hospital built in expenses such as expanding the infection prevention program, continuing to fund screening personnel, and maintaining a seven-bed negative-pressure unit for COVID-19 patients.
Even without another surge, the fiscal year, which runs from Oct. 1, 2022, to Sept. 30, 2023, will have its challenges. BMH is asking for a 14.9-percent rate hike, or roughly $32 million.
If regulators fail to fully approve this increase, and the rate increases sought by other Vermont hospitals, Vermonters with commercial insurance could face rising premiums next year.
For now, it appears that hospitals would have to ride out a potential surge on their own, which makes this year's budget review with the Green Mountain Care Board especially important.
State Sen. Ginny Lyons, D-Chittenden, who heads the Senate Health and Welfare Committee, said it would be difficult to offer state aid to hospitals unless Vermont gets additional federal support.
“I am very concerned that another surge will overwhelm [small hospitals],” Lyons said. “But at the same time, we have so many outstanding needs in our state, it's going to be really tough to find general fund dollars. It really will be.”
If the CDC's projections hold true in Vermont, hospitals could contend with a wave of mild infections that sideline health care workers and worsen personnel challenges at hospitals, as was the case last winter.
Those costly disruptions could push some hospitals in the state to the brink, according to Del Trecco.
“We are in a space of stabilization,” he said. “Every one of our hospitals and providers are challenged around workforce. Their fiscal year 2022 projections are not favorable, and moving into this 2023 budget cycle, the [Green Mountain Care Board's] mindset has to be to stabilize this provider community.”