COVID-19 is not yet done with Vermont

After a summer of freedom, the state tries to hold down infections from Delta variant

BRATTLEBORO — When the Scott administration ended Vermont's COVID-19 state of emergency on June 14, it seemed like a moment of triumph against a deadly virus that had killed hundreds of thousands of Americans since March 2020.

Vermonters rejoiced at the prospect of a return to normal summer activities and of living life unmasked and un-distanced.

However, the Delta variant of COVID-19, which accounted for about 1 percent of all cases in the United States when the state lifted its restrictions, now is responsible for nearly 94 percent of all new infections, according to the Centers for Disease Control and Prevention (CDC).

As a result of this much-more-virulent version of the virus, the number of daily new cases nationally has risen to more than 100,000, and the number of daily new deaths has climbed to more than 600 - levels not seen since the spring, when vaccines were just beginning to be rolled out in the U.S.

The CDC said on Aug. 15 that, since July 1, there has been a 700-percent increase in new COVID-19 cases nationally in their week-over-week average. In late June, 10,000 new cases a week were reported; as of Aug. 15, the weekly average is closer to 125,000.

Vermont and the rest of the Northeast have seen increases in new infections, but not at the levels seen in states such as Florida and Texas.

The difference here is that high rates of vaccination, combined with a robust public health system, has meant the state has so far been spared the worst of the Delta virus explosion.

According to the Vermont Department of Health, as of Aug. 17, 26,397 cases have been reported in Vermont since March 2020. There have been 1,498 cases in Windham County, with 69 new cases over the past two weeks.

Just the same, public health officials in Vermont are concerned about the rapid spread of the Delta variant, particularly among the unvaccinated.

“This isn't where we want to be, but we have to accept that we're going to be managing this for quite some time,” Gov. Phil Scott said at his Aug. 10 news briefing in Montpelier.

At the same time, Scott is confident that Vermont remains in an enviable position compared to other states, and he does not foresee a return to any of the restrictions that were part of the state of emergency.

The best defense

Vaccinations remain the key defense against COVID-19, according to Health Commissioner Dr. Mark Levine. The three vaccines in wide use in the U.S. - Moderna, Pfizer, and Johnson & Johnson - have proven highly effective at preventing severe illness or death from Delta or other variants.

CDC data show vaccinated people rarely need hospitalization, and those who do get sick have a significantly lower chance of being seriously ill or dying from the virus - an eight-fold lower risk of infection, and a 25-fold lower risk of hospitalization or death.

“It's not politics, it's not agenda, it's public health, medical science, plain and simple,” Levine said on Aug. 11.

While cases over the last six weeks have increased significantly, Scott said that Vermont's high vaccination rate - 85.1 percent of eligible Vermonters over age 12 have received at least one dose as of Aug. 16 - has made a big difference in helping the state avoid a medical catastrophe.

According to Vermont Department of Health data, between July 1 and Aug. 11, six deaths have been recorded in Vermont, the fewest of any state. Hospitalization rates are still relatively low, and few patients require stays in intensive care units.

Conversely, the delta variant is spreading fastest in states with low vaccination rates, and more than 95 percent of deaths in the U.S. over the past two months have occurred among the unvaccinated, according to the CDC.

In Vermont, 98 percent of all COVID-19 cases, 96 percent of the hospitalizations, and 93 percent of the deaths in the state since January have been among the unvaccinated, according to the Health Department.

“This is truly a pandemic of the unvaccinated,” Scott said.

As for “breakthough” cases, people who have gotten sick despite being vaccinated, the Health Department said that only 0.15 percent of cases fall into this category - with 630 cases resulting in 18 hospitalizations and eight deaths since January.

The highest rate of infection has been among Vermonters under age 19, with nearly one quarter of all cases coming in that age group.

This is also the age group that is the least vaccinated, mostly due to those under age 12 not being eligible for vaccines, and for low vaccination rates among those between 12 and 19.

Scott said last week that vaccine mandates are on the way for some state workers, and recommended that private employers follow suit to avoid sick time and staffing issues.

“You could see major disruptions if Delta gets in, and one good way to prevent that is to incentivize and require the COVID-19 vaccine,” Scott said.

Late last week, Brattleboro Memorial Hospital followed the lead of other health care providers in the Northeast by requiring all of its staff to be vaccinated by Oct. 1 or face dismissal.

According to the hospital, about 90 percent of its 600 employees are vaccinated.

Riding out the storm

According to modeling and forecasts produced by Department of Financial Regulation Commissioner Michael Pieciak and his staff, the number of new daily cases in Vermont is expected to continue to rise to about 150 a day by the end of August, then start slowly declining.

That predicted increase in cases coincides with the start of school in Vermont. The state is sticking with its back-to-school guidance of universal masking for students and staff for the first few weeks of the school year, along with voluntary testing and an increased number of school-based vaccination clinics.

According to current Vermont Department of Education guidance, masking is recommended until a school reaches 80 percent vaccination of those students and staff eligible to receive them.

Children under the age of 12, as well as unvaccinated staff and students, should continue to mask even after the 80-percent level is reached.

The Windham Northeast Supervisory Union District Board voted last week to require masking of students, teachers, and staff to start the school year. The Windham Southeast, Windham Central, and Twin Valley school districts have not yet announced any official masking policy.

As for the wearing of face masks in public places in Vermont, the current CDC guidance recommends that people living in any county experiencing a “substantial spread” of COVID-19 should wear masks for all indoor activities.

With 69 new cases reported in the past two weeks, Windham County falls into that category, classified as 50 to 100 cases per 100,000, or a positivity rate between 8 and 10 percent.

In Brattleboro, Town Manager Peter Elwell announced on Aug. 11 that while all town government facilities “remain open to the public at this time, we have reinstituted the requirement that anyone inside town buildings must be wearing a face covering.”

In a news release, Elwell said this requirement, based on CDC guidance, “applies equally to employees and to visitors. It applies equally to vaccinated people and to unvaccinated people.”

All public meetings now are required to have a physical location, as they did prior to March 2020, but Elwell said some meetings - including Brattleboro Selectboard meetings - will continue to operate in a hybrid format, “combining both the physical location and the ability to attend and participate in the meeting via Zoom.”

The long-term forecast

In reviewing his department's Aug. 17 modeling forecast, Pieciak said that new COVID-19 cases are showing a decline in the Northeast, as well as in Vermont.

As of the week ending Aug. 16, 758 new cases were reported in Vermont - a 41-percent increase and the highest level since April 2021, but still lower than the peak of the pandemic between December 2020 and April of this year.

Pieciak said cases are still predicted to increase over the next few weeks, then slowly decline. That trend, he said, has been consistent with other places, such as Israel and the United Kingdom, that have high vaccination rates but have struggled with a rise in cases caused by the Delta variant.

Even better for Vermont, Pieciak said, was that the average number of daily hospitalizations from the virus is still relatively low and that the state's hospitals have plenty of capacity to deal with both new COVID-19 cases and the normal ebb and flow of medical care.

Vermont has the fewest hospitalizations per capita of any state, roughly about 20 cases on an average day with about 7 to 10 patients in intensive care units.

On average, about 71 percent of COVID-19 hospitalizations in Vermont are among those not fully vaccinated, according to Pieciak.

Pieciak said Vermont hit an important milestone last week, with 75 percent of Vermont's entire population - 468,620 - having received at least one dose of vaccine. It is the first, and so far only, state to have achieved this level of vaccination.

Scott said on Aug. 17 that his administration has relied on the data and made its policies based upon it.

“Vaccines are working,” he said, urging Vermonters to continue to follow the prevention guidelines and get vaccinated if they haven't, so “we won't have to take any steps backward.”

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