VDH: COVID cases break single-day mark with 487, six more deaths

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VDH: COVID cases break single-day mark with 487, six more deaths

Thu, 11/04/2021 - 2:14pm -- tim

Vermont Business Magazine The Vermont Department of Health is reporting today that the state shattered the record for COVID-19 cases with 487 cases. This is an increase of 289 from Wednesday and the first time they've surpassed 400 in a single day. The 10 worst days have all come since mid-September. There also were six additional COVID-related deaths, for 380 statewide.

In response to today's case count, Governor Phil Scott issued a statement urging Vermonters to get vaccinated. He said in part, "The simple fact is, this pandemic is being driven by the unvaccinated, including 53,000 eligible adults. The three lowest vaccinated counties account for 25% of today’s cases, yet they only make up 10% of our state population. Unvaccinated Vermonters are up to 5 times as likely to contract COVID in Vermont and they account for 70-85% of our hospitalizations and ICU stays. Unvaccinated adults are directly contributing to the strain on our hospital capacity. Enough is enough, it’s time to step up and get vaccinated – something over 90% of your fellow Vermont adults have done."


Governor Scott responds to record case count: Get vaccinated, protect others


Ben Truman, Public Health Communication Officer for the Vermont Department of Health told VBM that there was no one reason that caused today's case count.

"Today’s reported case numbers are the highest one-day total reported since the start of the pandemic," Truman told VBM in an email. "The continued high number of cases reflect a concerning level of ongoing community spread of the virus. With Sars-CoV-2 and the Delta variant, we are dealing with a very different creature than other viruses in the state – a highly infectious respiratory virus that is exceptionally good at moving from person-to-person."

"From the data perspective, there are no glitches or delays, associated with today’s numbers. I do want to note that one factor in the high numbers reported today is the spike and dips we see in positive reports on a given day. For example, we are finding in general that fewer people tend to get tested over the weekend than later during the week. This means that, relative to the positivity rate, we would see more positive cases reflected in the results that are reported later in the week – which contributes to the one-day jumps."

Cases were especially high in the Northeast Kingdom, which has had elevated case rates in recent weeks. Caledonia County reported 50 cases today, Essex County 13 and Orleans County 58.

Orleans also has the highest single rate in the state at 1,0867 per 10,000 people. Bennington has the second highest rate (926.2) and Essex has the third (907.2). Only Addison (411.7) and Orange (494.5) have rates under 500.

Of the COVID-related deaths, two were in the 80+ age band and four were among those 70-79.

Meanwhile, the CDC gave final approval late Tuesday for Pfizer vaccines for children 5-11 and parents could start signing up their kids starting Wednesday morning (for vaccine information or to register CLICK HERE). Shots for 5-11 are available starting Friday at some state clinics and as early as Sunday at some pharmacies.

There are about 44,000 kids in the 5-11 age band in Vermont. Human Services Secretary Mike Smith said there will be plenty of first and second doses available for all who sign up. The doses are a third of the strength of the adult dose and like the adult Pfizer regimen will require a followup shot for full immunity.


Vermont launches 5-11 vaccination drive


See locations of vaccine clinics and case dashboards below.

There are 52 people hospitalized (up three) with 17 in the ICU (up three). Hospitalizations are high but have been stable.

There have been 16 deaths since last Wednesday. Of those reported by the VDH today, one was in the 80+ age band, three in the 70-79, zero 60-69 and 1 in the 50-59 age band. Recent fatalities have all been among Vermonters 50 and older. 

There were 39 COVID-related deaths in Vermont in October, which is the third-worst month on record. There are six already in November.

The five worst days for cases have all come since mid-September, as the Delta variant has taken over since early July. 

Financial Regulation Commissioner Michael Pieciak said both the case counts and fatalities have not shown dramatic reductions, as they have in other parts of the nation, particularly the South, or even in southern New England.

While the health experts do not understand exactly why this is, given Vermont's high vaccination rate, Pieciak said the three Northern New England states are all showing a similar pattern. 

Vermont also has surpassed a milestone with 90.4 percent of eligible Vermonters (504,200) having received at least one dose of vaccine (80.5 percent have completed the vaccine regimen or 465,600) and a million shots given.

In addition, Health Commissioner Mark Levine, MD, continues to urge Vermonters to get their booster dose, especially if they're over 65. The immunity appears to wane over time and older Vermonters and those immunocompromised were among the first vaccinated last winter.

The elderly have been especially vulnerable to COVID, with the vast majority of fatalities coming among those 80 and over (199 total deaths, while having by far the fewest number of infections for any age band.).

The state announced last Thursday night that boosters for Moderna (like already approved Pfizer, six months after second dose) and Johnson & Johnson (two months after first dose) would begin immediately. The CDC is also allowing people to change/ mix and match vaccines.

The FDA Tuesday approved the low-dose Pfizer vaccine for children 5-11. Human Services Secretary Mike Smith said if the CDC approves it tonight then the state will allow parents to sign up their kids as early as 8 am tomorrow morning with doses being available as early as Thursday.

He said that in addition to the usual vaccination clinics, the state will also be bringing the vaccine directly to 112 schools around the state, especially to those in outlying areas where transportation or fewer pharmacies could make it more difficult for kids to get their shots.

Dr Rebecca Bell, President, Vermont Chapter of the American Academy of Pediatrics, at the governor's press conference Tuesday, sought to alleviate parents' fears.

She said the efficacy of this lower dose children's vaccine is still 91 percent. And unlike with adults, children in the control group did not show any of the flu-like symptoms that some adults have experienced. 

Parents should also take comfort that a vaccinated child would no longer have to quarantine if they were a close contact to someone that tested positive. This issue has kept many kids out of school even though they never contracted COVID.

The Northeast Kingdom has the highest case rate of any region of the state, with Orleans County having the highest county rate, with over 1,000 cases per 10,000 residents. Bennington has the second highest rate with over 900 per 10,000.

Smith said the state will reinstitute pop up vaccination sites in the NEK to increase vaccination rates, which are the lowest in the state. See list of upcoming NEK clinics HERE and see below for statewide list of clinics.

COVID cases reported today were high in southern Vermont, with Bennington County alone reporting 34 and Rutland County 24.

But with all three boosters now available, vaccines for kids available and cases apparently declining, Governor Scott said Tuesday, "I'm more hopeful today than I have been in weeks."

Education Secretary Dan French announced Tuesday that the state was once again delaying the roll out of the 80 percent rule for ending school mask mandates. It will not happen go into effect until January 18, 2022, when students return to school after the Martin Luther King Holiday break.

The governor and his staff reiterated that these are recommendations only, because there is no State of Emergency, not mandates. The local school districts, like local businesses and individuals, must make their own rules.

As the Delta variant continues to be active in Vermont, Governor Scott is calling on all Vermonters to act responsibly.

The new school guidance reads:

"To allow school districts time to calculate the percentage of currently eligible students who have received two doses of a two-dose vaccine, schools should require universal masking for all students and staff when indoors until January 18, 2022.

"Currently, all Vermonters ages 12 and older are eligible to be vaccinated.

"After January 18, 2022, masks should no longer be required for all those eligible for vaccination when the vaccination rate (two doses of a two-dose vaccine) among students is equal to or greater than 80% of the school’s currently eligible population.

"Masks should be required indoors for students younger than 12, who are not eligible to be vaccinated at this time.

"Masks, when required, may be removed when needed for instructional or operational purposes.

"Masks are currently required for all passengers on buses per federal regulation, regardless of age or vaccination status.

"Masks should not be required outdoors. Guidance will be updated when vaccine eligibility expands."

The state also released school sports guidance Tuesday.

See Vaccination & COVID-19 Dashboards & Vaccination Sites Table Below

Addison County

New Cases: 6

Recent Cases 14 days: 83

Bennington County

New Cases: 45

Recent Cases 14 days: 302

Caledonia County

New Cases: 50

Recent Cases 14 days: 185

Chittenden County

New Cases: 65

Recent Cases 14 days: 594

Essex County

New Cases: 13

Recent Cases 14 days: 82

Franklin County

New Cases: 42

Recent Cases 14 days: 227

Grand Isle County

New Cases: 1

Recent Cases 14 days: 22

Lamoille County

New Cases: 9

Recent Cases 14 days: 114

Orange County

New Cases: 22

Recent Cases 14 days: 175

Orleans County

New Cases: 58

Recent Cases 14 days: 346

Pending Validation

New Cases: 59

Recent Cases 14 days: 60

Rutland County

New Cases: 48

Recent Cases 14 days: 335

Washington County

New Cases: 30

Recent Cases 14 days: 227

Windham County

New Cases: 14

Recent Cases 14 days: 189

Windsor County

New Cases: 25

Recent Cases 14 days: 228

Most cases in Vermont are in the younger age groups with the 20-29 reporting the most, with nearly 7,300 total cases out of 37,100+, but only one death. The over 79 demographic has the fewest cases (just over 1,200) but by far the most fatalities with 188, or more than half the state total.

Financial Commissioner Michael Pieciak said Tuesday (SEE HIS FULL SLIDE DECK HERE) cases across the nation are falling fast and that the seven-day and 14-day averages in Vermont and the Northeast also are falling but at a slower rate. Vermont's seven-day infection rate is down15 percent. For the 14-day average, while overall it is down 2 percent for those who are fully vaccinated, it's up 9 percent for those who are not fully vaccinated (which includes the unvaccinated).

Cases in high vaccination regions of the country are not displaying the typical Delta variant pattern, as in India, of a spike followed by a steep drop off after a couple months.

In Vermont, Delta has shown slow growth and a long plateau. Health Commission Mark Levine suggested that the drop off here could be another couple of weeks off, but he frankly was not sure.

He and Governor Scott and Human Services Secretary Mike Smith all urged that everyone who is eligible to get a vaccine to get one now, to get a booster now and to wear a mask while at an indoor gathering.

Governor Scott said the data shows that virus transmission with Delta is occurring at things like weddings and baby showers and birthday parties, sort of small and medium events where people are gathered for a period of time. It is not happening while visiting a convenience store or other type place where you are in an out, he said. Nor is it happening at outdoor gathering events.

Pieciak, in his COVID-19 Modeling presentation, said deaths seem to have slowed down a little as Delta has taken its toll. There have been 23 in October so far (as of the 21st)   

Still, September was the second worst month for COVID-related deaths in Vermont since the beginning of the pandemic, with 45.

December 2020 was the worst with 71 and April 2020 was third worst with 35.

Meanwhile, the state is ramping up antigen testing in schools to keep kids in school who otherwise would be sent home if there were a close contact of someone who tests positive. Children now have a higher rate of infection than adults.

Governor Scott and state officials are urging all those who are eligible now to get vaccinated or get a booster shot, to do so, in order to reduce community transmission of the novel coronavirus (see clinic sites below).

As of October 1, many more Vermonters can now schedule and receive their Pfizer vaccine booster shots. He said there is plenty of vaccine supply.

“We know vaccines are safe and effective, and these additional doses add even more protection. So, I encourage anyone who is eligible to register for your booster today,” said Governor Scott. “At the same time, we continue to urge those who have not yet gotten their first dose to get vaccinated. The data shows we are now in a pandemic of the unvaccinated, and vaccines are the best way to protect yourself, friends and family, and to make sure we continue moving forward from the pandemic.”

Governor Scott said that the state will take a very broad interpretation of eligibility. 

"We've reflected on this," Scott said. "We're going to be quite lenient in terms of who should be included and if they'd like to have a booster we'd like to find a way for them to have it. So I expect that number is substantially higher at this point. So our interpretation of this will be, again, quite broad."

Addition of Rapid Testing Tools Will Help Keep More Kids in School

COVID-19 TESTING - TEST TO STAY

When a student or staff member with COVID-19 is present in school during their infectious period, the school may implement Test to Stay for unvaccinated close contacts. 

Who can participate?

Unvaccinated, asymptomatic students (ages 5 and up) and staff who are close contacts of a positive COVID-19 case.  

When should we use Test to Stay? 

When a student or staff member with COVID-19 is present in school during their infectious period, the school may implement Test to Stay for unvaccinated close contacts. When a case is identified during the school day, the following should occur: 

  1. The school should conduct contact tracing to identify close contacts. 
  2. Unvaccinated students and staff close contacts finish the school day as normal. 
  3. The following day, unvaccinated close contacts that do not participate in Test to Stay must quarantine (stay home from school). Unvaccinated close contacts who participate in Test to Stay will come to school as normal, but must be tested before beginning the school day.
    • Schools may house students in a designated area, where they will not mix with students and staff who are not testing until they have their results.  
    • Students may ride the bus to school, but must remain masked at all times, per federal regulations. If a student receives a positive antigen test, it will be the responsibility of the parent/guardian to pick the student up from school and they will not be permitted to ride the bus home, as they are now considered a positive COVID-19 case. 
  4. Close contacts will receive an antigen test until 7 days have elapsed from the date of last exposure to the case. 
  5. While students/staff are participating in Test to Stay antigen testing they should quarantine while outside of school, including over the weekend. 

Siblings of positive cases should be sent home and follow Protocols for Responding to COVID-19 Scenarios (Massachusetts Department of Elementary and Secondary Education). 

Scenario 1 – Individual is symptomatic, antigen test negative

When a student or staff member is symptomatic, they will get an antigen test. If the antigen test comes back negative:

  • the individual should still be sent home and receive a confirmatory in-school response PCR test before they leave school. If an in-school test in unavailable, the school may provide a Take Home PCR Test, (see test type 3) to be self-administered at home and either mailed that same day to the lab via UPS or other courier service, or returned to the school for shipping
  • close contacts do not need to be identified yet, and other students and staff members will continue their day as normal
  • if the symptomatic individual’s PCR test comes back positive/, the school commences a Test to Stay Program for unvaccinated close contacts who chose to participate until seven days post exposure
  • If the PCR test comes back negative, no antigen testing is necessary
Scenario 2- Individual is symptomatic, antigen test positive

When a student or staff member is symptomatic, they will get an antigen test. If the antigen test comes back positive:

  • the individual should be sent home and go into isolation for 10 days
  • Test to Stay should start for unvaccinated close contacts the next day
  • antigen testing should continue for 7 days since the date of last exposure
Scenario 3 – Procedures upon learning of a positive PCR result.

When a student or staff member receives a positive test result, regardless of whether they are symptomatic or not:

  • the individual should be sent home (or not come to school) and go into isolation for 10 days
  • Test to Stay should start for unvaccinated close contacts the next day
  • antigen testing should continue for 7 days since the date of last exposure
How are results reported? 
  • Schools will be using SimpleReport for all rapid antigen tests. It can accommodate all antigen test types and links directly to VDH so that test results to do not need to be reported separately
  • SimpleReport is a free web tool created by the CDC that helps make COVID-19 rapid testing and reporting easier for schools
  • More information about the registration process is available in the Test to Stay Onboarding Checklist. Please use this guide to register and onboard.  
  • Please note that there is an option to do a bulk upload of participant data, rather than asking families to preregister. 
  • This reporting tool includes the option for test results to be sent in real time via text or email to parents/guardians. 
Test Type:
  • Rapid antigen tests. Both CLIA and non-CLIA waivered test kits may be available depending on the supply chain.
  •  Test kits are nasal swabs, which can be self-administered by individuals ages 15 and up. An adult must collect the swab for students ages 5 through 14.
Recommended Use Cases:
  • In elementary schools: classrooms and any additional close contacts
  • In middle and high schools with less than 80% of the eligible population vaccinated contract tracing should be done first to determine close contacts: 
    • If the close contact is vaccinated, then they would not participate in TTS and will not be required to quarantine. Instead, it is recommended that they complete a PCR test 3-5 days after their exposure
    • If the close contact is unvaccinated and asymptomatic, then they can participate in TTS or opt out and follow the protocols for quarantine either with or without a PCR test on day 7. 
  • Not recommended for middle and high schools where more than 80% of the eligible population is vaccinated.  

Information can be found on the Agency of Education’s COVID-19 Testing Family Resources webpage and COVID-19 Response Testing At-A-Glance.

Vaccine Booster Medical Conditions

Note: The list below does not include all potential medical conditions that could make you more likely to get severely ill. Rare medical conditions may not be included below. However, a person with a condition that is not listed may still be in more danger from COVID-19 than persons of similar age who do not have the condition and should talk with their healthcare provider.

To get a booster you must have first received both Pfizer shots at least six months ago.

Medical Conditions in Adults

  • This list is presented in alphabetical order and not in order of risk.

  • CDC completed an evidence review process for each medical condition on this list to ensure they met criteria for inclusion on this webpage.

  • We are learning more about COVID-19 every day, and this list may be updated as the science evolves.

Cancer

Having cancer can make you more likely to get severely ill from COVID-19. Treatments for many types of cancer can weaken your body’s ability to fight off disease.  At this time, based on available studies, having a history of cancer may increase your risk.

Get more information:

Chronic kidney disease

Having chronic kidney disease of any stage can make you more likely to get severely ill from COVID-19.

Get more information:

Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension

Chronic lung diseases can make you more likely to get severely ill from COVID-19. These diseases may include:

  • Asthma, if it’s moderate to severe

  • Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis

  • Having damaged or scarred lung tissue such as interstitial lung disease (including idiopathic pulmonary fibrosis)

  • Cystic fibrosis, with or without lung or other solid organ transplant

  • Pulmonary hypertension (high blood pressure in the lungs)

Get more information:

Dementia or other neurological conditions

Having neurological conditions, such as dementia, can make you more likely to get severely ill from COVID-19.

Get more information:

Diabetes (type 1 or type 2)

Having either type 1 or type 2 diabetes can make you more likely to get severely ill from COVID-19.

Get more information:

Down syndrome

Having Down syndrome can make you more likely to get severely ill from COVID-19.

Get more information:

Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get severely ill from COVID-19.

Get more information:

HIV infection

Having HIV (Human Immunodeficiency Virus) can make you more likely to get severely ill from COVID-19.

Get more information:

Immunocompromised state (weakened immune system)

Having a weakened immune system can make you more likely to get severely ill from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. Primary immunodeficiency is caused by genetic defects that can be inherited. Prolonged use of corticosteroids or other immune weakening medicines can lead to secondary or acquired immunodeficiency.

People who have a condition or are taking medications that weaken their immune system may not be fully protected even if they are fully vaccinated. They should continue to take all precautions recommended for unvaccinated people, including wearing a well-fitted mask, until advised otherwise by their healthcare provider.

Get more information:

Liver disease

Having chronic liver disease, such as alcohol-related liver disease, nonalcoholic fatty liver disease, and especially cirrhosis, or scarring of the liver, can make you more likely to get severely ill from COVID-19.

Get more information:

Overweight and obesity

Overweight (defined as a body mass index (BMI) > 25 kg/m2 but < 30 kg/m2), obesity (BMI ≥30 kg/m2 but < 40 kg/m2), or severe obesity (BMI of ≥40 kg/m2), can make you more likely to get severely ill from COVID-19.  The risk of severe COVID-19 illness increases sharply with elevated BMI.

Get more information:

Pregnancy

Pregnant and recently pregnant people (for at least 42 days following end of pregnancy) are more likely to get severely ill from COVID-19 compared with non-pregnant people.

Get more information:

Sickle cell disease or thalassemia

Having hemoglobin blood disorders like sickle cell disease (SCD) or thalassemia can make you more likely to get severely ill from COVID-19.

Get more information:

Smoking, current or former

Being a current or former cigarette smoker can make you more likely to get severely ill from COVID-19. If you currently smoke, quit. If you used to smoke, don’t start again. If you’ve never smoked, don’t start.

Get more information:

Solid organ or blood stem cell transplant

Having had a solid organ or blood stem cell transplant, which includes bone marrow transplants, can make you more likely to get severely ill from COVID-19.

Get more information:

Stroke or cerebrovascular disease, which affects blood flow to the brain

Having cerebrovascular disease, such as having a stroke, can make you more likely to get severely ill from COVID-19.

Get more information:

Substance use disorders

Having a substance use disorder (such as alcohol, opioid, or cocaine use disorder) can make you more likely to get severely ill from COVID-19.

Get more information:

Information on Children and Teens

While children have been less affected by COVID-19 compared with adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Current evidence suggests that children with medical complexity, with genetic, neurologic, metabolic conditions, or with congenital heart disease can be at increased risk for severe illness from COVID-19. Similar to adults, children with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or immunosuppression can also be at increased risk for severe illness from COVID-19. One way to protect the health of children is to ensure that all adults in a household are fully vaccinated against COVID-19.

GET YOUR FIRST OR SECOND DOSE OF VACCINE!

Visit www.healthvermont.gov/MyVaccine to make an appointment. You can also call 855-722-7878.

Vermonters 70 years of age and older can make an appointment for booster shots beginning tomorrow. Those aged 65 and older can make appointments beginning on Friday.

Additionally, starting on Friday, those aged 18 to 64 with underlying medical conditions or who work in certain occupational settings will become eligible for boosters. The State is awaiting guidance from the CDC on what underlying medical conditions and/or occupational settings make individuals eligible for booster shots. That guidance is expected from the CDC later this week.

Booster shots are available at all vaccination sites listed below. They are only approved for those who received the Pfizer vaccine, and six months or more have passed since they completed their second dose. If you are eligible for a booster dose of the Pfizer vaccine, an appointment is required. We anticipate Moderna and Johnson & Johnson boosters to be recommended by the CDC in the coming weeks.

Here are the vaccination sites available this week:

More ways to get your free vaccine:

Make an appointment for a free vaccine

You can also walk-in at CVS, Hannaford Food and Drug, Walmart, Walgreens, Price Chopper/Market 32, Rite Aid, Shaw’s Supermarket, or Costco or get an appointment with Kinney DrugsCVSWalgreens, Northfield Pharmacy, or UVMMC Outpatient Pharmacies.

Vaccination & COVID-19 Dashboards