Even Eden, a snowy paradise in northern Vermont, is poisoned by omicron.
The near-vertical rise in new coronavirus cases over the past few weeks, before peaking in mid-January, has affected nearly every mountain hamlet, every shuttered industrial town, every bucolic college campus frozen across this state despite his near-perfect vaccination record.
Of all the states, Vermont appeared to be the best prepared for the battle of the omicron: it is the the most vaccinated state in the country against covid, with nearly 80% of residents fully immunized — and 95% of residents aged 65 and over, the age group considered most vulnerable to severe risk of covid.
Yet even this super-vaxxed state has not proven impenetrable. The state in mid-January hit records for residents hospitalized with covid-19; elective surgeries at some Vermont hospitals are on hold; and schools and daycares are in freefall due to the number of staff and teacher absences and students quarantined at home. Hospitals rely on paramedics and paramedics from the Federal Emergency Management Agency.
And, in a disturbing sign of what lies ahead for the remaining winter months: About 1 in 10 covid tests in Vermont are positive, a startling increase from the summer months when the delta variant on the loose elsewhere in the country barely registered here.
“This shows how transmissible omicron is,” said Dr. Trey Dobson, chief medical officer of Southwestern Vermont Medical Center, a nonprofit hospital in Bennington. “Even if someone is vaccinated, you’re going to inspire them, they’re going to replicate, and if you test, you’re going to be positive.”
But experts are quick to note that Vermont also serves as a window into what’s possible as the United States learns to live with covid. Although near-universal vaccination could not prevent the highly mutated omicron variant from spreading across the state, Vermont’s collective measures appear to be protecting residents from the worst harm from the contagion. from Vermont covid-related hospitalization rates, although higher than last winter’s peak, it still ranks last in the country. And the overall death rates are also relatively low.
Children in Vermont are testing positive for covid and pediatric hospitalizations have increased. But a concomitant decline in other seasonal pediatric illnesses, such as influenza and respiratory syncytial virus, and vaccinated status of the majority of eligible children in the state has eased the strain on hospitals that many other states face.
“I have to remind people that cases don’t mean disease, and I think we’re seeing that in Vermont,” said Dr. Rebecca Bell, pediatric critical care specialist at the University of Vermont Health Network in Burlington, the only pediatric critical care hospital in the state. “We have a lot of cases, but we don’t see a lot of serious illnesses and hospitalizations.”
She added: “I did not admit a vaccinated child to hospital with covid.”
Vermont in many ways embodies the future that the Biden administration and public health officials aim to usher in: high vaccination rates for all races and ethnicities; compliance with ever-changing public health guidelines; and perseverance and social cohesion when the virus swarms. There is no “good enough” in Vermont, a state of just 645,000 people. While vaccination efforts in adults and children have stalled elsewhere, Vermont is pushing to improve its near-perfect score.
“We have a high percentage of children vaccinated, but we could do better,” Dobson said.
He continues to urge unvaccinated patients to come to his weekly vaccination clinic. First-time buyers seem to have held back due to schedules or indifference rather than major reservations about vaccines. “They’re nonchalant about it,” he said. “I ask, ‘Why now?’ And they say, ‘My job required it.’
Replicating Vermont’s success can be difficult.
“There’s a small-town dynamic to New England,” said Dr. Tim Lahey, director of clinical ethics at the University of Vermont Medical Center in Burlington. “It’s easy to imagine the impact of your behavior on your neighbor and the expectation that we take care of each other.”
While other rural states in the Midwest and South have struggled to increase vaccination rates, New England, in general, is ahead of the pack. Behind Vermont, Rhode Island, Maine and Connecticut have the highest percentage of fully vaccinated residents in the nation.
“It’s something beyond size,” said Dr Ben Lee, associate professor at the Robert Larner, MD College of Medicine at the University of Vermont. “There’s a sense of community responsibility here that’s kind of unique.”
In a state whose motto is “Freedom and Unity”, freedom has largely given way to unity, and the state’s response to the pandemic has been met with eagerness. “The general attitude here has been enthusiasm to be safer,” Lahey said.
Lahey gives credit to the state’s Republican Gov. Phil Scott, who has been “unambiguous about pro-vax messaging.” Combined with a “tendency to trust the vaccine, you get a different outcome than places where political leaders exploit that minority voice and anger people.”
Vermont medical chiefs advise state leaders to move from a covid war footing – surveillance testing, contact tracing, quarantines and lockdowns – to a rapprochement: covid test only if result will change how doctors treat a patient; discontinue school-based surveillance testing and contact tracing; and recommending students with symptoms simply recover at home.
Once the omicron wave passed and fewer viruses were circulating, Dobson said, a highly vaccinated state like Vermont “could really drop almost all mitigations and society would be fine.” Vermonters will get used to taking the proper steps to protect themselves, he said, much like wearing seat belts and driving cautiously to mitigate the risk of a car crash. “And yet,” he added, “it’s never zero risk.”
Spared from the acrimony and bitterness that has alienated neighbor from neighbor in other states, Vermont may have something else in short supply elsewhere: stamina.
“We’re all exhausted,” said Lahey, the ethics director. But “we are exhausted with friends.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.