Shawn Tester feels like the Northeastern Vermont Regional Hospital in St Johnsbury avoided the worst of 2020 only to be slammed this year with COVID cases.
The 25-bed hospital had eight COVID-positive patients the evening Tester, the Chief Executive Officer, spoke with Vermont Business Magazine.
“All four of my ICU beds were COVID-positive,” he said. “I’ve got staff who are out - even vaccinated staff - who are out with COVID.”
Tester continued, “We've got, I think, five or six patients lined up tomorrow for Monoclonal antibody therapy. The line for COVID testing wraps around the building the three days that we offer it. I mean, it's just crazy.”
In October, state officials ramped up vaccination efforts in the NEK after the region showed a spike in COVID cases.
According to numbers from the state Department of Health, as of November, the NEK three counties have the lowest vaccine rates. Seventy-three percent of Caledonia and Orleans residents were fully vaccinated. Essex had the lowest vaccinated rate at 60 percent. In comparison, Chittenden County had the highest vaccination rate at 86 percent.
“You go out to places like Essex County, and it's just hard to connect with people and get the message out and find avenues to help them get their vaccines,” Tester said.
Also, the community was so good at preventing the spread of COVID early in the pandemic that, in his opinion, it has little natural immunity to the more virulent Delta variant.
The protection offered by the initial vaccines is waning, he said.
Tester added that health equity is at the heart of the question of why the COVID spike?
As a poor region, the NEK also struggles with a lack of access to health care. Also, the population is also on the older end of the age spectrum, meaning it has more health care needs.
Those things together can translate into people with more acute needs, he said.
Added to that mix, the hospital - like many - is facing a staffing crisis, especially regarding nursing staff. This crunch is leading to wage inflation, he said.
Along with stretching NVRH’s capacity to care for patients, the pandemic has also battered the facility’s finances.
For approximately a decade, the hospital has remained financially stable, according to Tester.
“We've always, with the exception of maybe one year, always had a positive margin,” he said. “Always razor-thin margins, but they're always positive.”
Last year that changed. COVID contributed to what Tester called an “$8 million gaping hole in our budget.”
Luckily federal funds helped close that gap, he added. This year NVRH has applied for additional federal support.
“I think there are some serious headwinds coming,” he said. “We are seeing inflation like we've never seen it, and that includes supplies and drug prices. Things that you need to run a hospital have all jumped.”
Tester said he recently reviewed cost estimates to renovate the emergency department.
“The numbers that we're getting back for cost estimates are just eye-popping,” he said.
In general, NVRH is beyond capacity.
Tester adds this isn’t all COVID’s doing. The hospital was close to capacity pre-COVID.
“Before we got hit with this Delta wave, in August, we were also full,” he said. “And we had no COVID patients. But acuity was much higher. We're caring for much sicker people.”
Tester worries that this part of Vermont’s health care story is lost among the din created by COVID.
“COVID has this really devilish way of finding the cracks in our system and exploiting it,” he said.
He added, like the health care system, the stress caused by chronic poverty, and even the lack of housing.
Tester asked community members to remember to thank their health care workers. They are exhausted from this pandemic and all its ripple effects, he said.
He also wanted to remind people that their mental health system is in crisis. A crisis the pandemic has only exacerbated.
“I'm so bummed that here we are over a year and a half into this, and all we can seem to talk about in our healthcare systems is COVID,” Tester said. “There are so many other issues that we could be talking about.”
Olga Peters is a freelance writer from Windham County.