VDH: Dr Levine talks Omicron variant

by Timothy McQuiston, Vermont Business Magazine The Vermont Department of Health today reported 237 cases of COVID-19. This is the first report since last Wednesday because of the Thanksgiving break. From Thursday through Sunday there were a total of 1,444 cases (average 361 per day, which is on par with the recent seven-day average). Since the beginning of the pandemic, there have been 49,801 reported cases of COVID-19 in Vermont. There have been no identified cases associated with the new Omicron COVID variant in Vermont to date.

DATE NEW CASES
Nov. 24 561
Nov. 25 405
Nov. 26 103
Nov. 27 361
Nov. 28 237

The VDH today also reported four additional COVID-related deaths since last Wednesday, which stand at 410 statewide.

There were 44 COVID-related deaths in Vermont in October, which was the third-worst month on record (December 2020, 71; September 2021, 50). There are 34 fatalities so far in November.

Recent fatalities have all been among Vermonters 50 and older, with most in the oldest age band, which has been the case since the beginning of the pandemic, despite having by far the fewest number of cases.

Health Commissioner Mark Levine, MD, released the following statement on the Omicron variant, first identified in South Africa:

"The emergence of a new variant of the COVID-19 virus, called Omicron, is an important reminder that the COVID-19 pandemic is still here with us, and we will continue to monitor any new developments closely. There have been no identified cases associated with the Omicron variant in Vermont to date.

"Right now, vaccines are still our best defense against COVID-19. If you have not yet gotten your vaccine or booster shot, now is the time. Both take about two weeks to be fully effective, and as we get further into the holiday season, the more people who are protected, the better off we will all be. Visit healthvermont.gov/MyVaccine to find a location near you.

"There is a lot that is still unknown about this new variant, but it appears to be more infectious, already showing up in various countries, including Canada. Research over the next few weeks will determine whether Omicron will affect the severity of illnesses, and how effective the current vaccines are against Omicron.

"The Health Department continues to obtain genomic sequencing information on SARS-CoV-2 specimens and will report any detection of the Omicron variant in Vermont."

Also, the Department of Corrections on Wednesday reported active outbreaks at two Vermont facilities: NSCF and Northeast Correctional Complex in St. Johnsbury, where two staff and two incarcerated individuals are currently COVID-positive. Statewide there are currently 26 positive incarcerated cases and 14 positive staff cases across six correctional facilities.

Officials said that despite precautions, the relatively high level of cases in the Northeast Kingdom has resulted in community transmission that has found its way into the prisons.

Vermont cases spiked on November 11 to a record 591. The worst days have all come since mid-September, following from the Delta variant surge that began in July.

Hospitalizations today were 68 (which matches the all-time high set last week) and ICU visits were 15. Hospitalizations are relatively high but have not spiked even as case counts have risen.

The Legislature held a special session November 22 to pass a bill allowing local towns and cities to enact their own mask mandates. Governor Scott reluctantly called the session to address that issue. Legislative leaders have been clamoring instead for a statewide mask mandate in response to the recent surge in COVID cases. Scott has balked at that but held out this option as an "olive branch" to legislative leaders. He signed the bill into law November 23.

​In a practical sense, Scott said it wouldn't work. Those who are determined not to follow health guidance now, nor get vaccinated, likely would not adhere to a mask mandate anyway. Similar situations in other states prove that point, Scott said.

He added that the goal of his administration during the pandemic has been to protect the health care system, which, he said, has been successful. Even as cases recently surged, neither hospitalizations nor deaths have followed suit.

Reported cases have tended to ramp up later in the week as people get tested and results come back.

Those who are unvaccinated are some 11 times more likely than those who are fully vaccinated to be hospitalized if they contract COVID.

Vermont is a national leader in its vaccination rate, testing rate, hospitalization rate and death rate.

Vermont has the highest rate of vaccination for those 65 and over. And for that age band, cases have decreased by 14 percent.

Human Services Secretary Mike Smith noted Tuesday that 17,598 children 5-11 have either begun their vaccine regimen or have singed up. This is about 40 percent of that population. However, the rate of new sign ups have slowed. Still, this is the highest rate in the nation.


Governor Scott signs local mask mandate into law

Weinberger proposes Burlington mask mandate, exempts businesses with vaccine requirements


Vermont officials were concerned that there would be a post-Halloween spike in cases, as there was last year. Cases did increase, though the spike was not as noticeable as total cases were starting at a much higher level than in 2020.


Governor Scott: Get vaccinated to help keep you and everyone else safe


Emergency Housing

Human Services Secretary Mike Smith told VBM this week that the state is seeking to expand shelter space. The pandemic has exacerbated both the need to emergency housing during bad weather and ongoing housing from the homeless.

Smith said in an email:

"Adverse Weather:

"The Department for Children and Families announced last week that the Adverse Weather Conditions policy has been updated. The Adverse Weather Conditions policy annually relaxes eligibility for the GA Emergency Housing program. This year, from November 22 to March 1, the policy will be implemented without weather conditions criteria, allowing for enhanced predictability during the coldest months. Individuals who meet income, resource eligibility, and have not voluntarily left appropriate housing, will no longer have to meet categorical eligibility. They will be housed through the cold weather season even in excess of the 84-day limit. From now until November 22 and after March 1, the Adverse Weather Conditions policy will be in effect but dependent on weather conditions.

"Shelter Space:

"DCF is actively working with the Department of Buildings and General Services (BGS) to identify possible vacant facilities that may be leased to provide much needed emergency shelter capacity. This could include unused dorms or other sites. Once located, the State would then partner with community organizations to operate emergency shelters in these locations. The search is currently focused in counties with the greatest capacity concerns. Identifying and partnering to expand shelter space is an important solution to the immediate needs of Vermonters experiencing homelessness. Ultimately, permanent housing solutions, not simply emergency housing and shelters, are needed."

On November 10, the Department for Children and Families announced that, to enhance predictability and stability for program participants, the Adverse Weather Conditions policy for the General Assistance Emergency Housing Program will be applied for a 100-day period from November 22, 2021, through March 1, 2022.

The Adverse Weather Conditions policy has historically been applied on a day-by-day basis, based on weather forecasts and conditions. To reduce the need for beneficiaries of the program to reapply on a daily basis, the State will open eligibility during this time period, which is historically when it sees the most use.

During this period, Vermonters will have to meet eligibility criteria, which include:

  • an urgent need for housing,
  • income guidelines, and
  • a lack of adequate financial resources available to secure housing on their own.

However, enhanced predictability through the Adverse Weather Conditions policy will be achieved through the following flexibilities

Qualifying for temporary shelter will not depend on the day-to-day weather conditions.

People will not have to fit into one of the categories below to get assistance:

  • individual over 60 or with a disability,
  • person fleeing domestic violence,
  • family with children or pregnant, or
  • lost housing due to a natural disaster (e.g., flood, fire, or hurricane).

Shelter space will be utilized as a first option for individuals – unless there are safety concerns related to domestic violence.

Beginning on March 2, 2022, Adverse Weather Conditions will remain in effect but will revert to the traditional weather conditions for shelter criteria.

Before the pandemic, the General Assistance Emergency Housing Program typically served about 250 individuals on any given night. Current eligibility is significantly expanded from pre-pandemic standards, and the program currently serves over 1,500 people. The Adverse Weather Condition policy allows people who do not meet current categorical eligibility to use the program, provided they meet the other eligibility requirements.

The General Assistance Emergency housing program is not an ideal setting for people experiencing homelessness. The State and DCF continue to work to help transition people who are in the program into stable, long-term housing, which is better for the health and safety of Vermonters.

To learn more go to: https://dcf.vermont.gov/benefits/EA-GA.

COVID Cases

Governor Scott and Health Commissioner Mark Levine are emphasizing not only vaccinations and boosters, but the use of rapid antigen testing, especially for those for are visiting or being visited for the holidays. Scott said rapid testing of COVID could be with us for the foreseeable future, even as the pandemic turns into an endemic.

Cases have been more prevalent in younger people, with 5-11 having the highest rate. But hospitalizations and deaths are most common among older people. Recent cases at Long Term Care facilities are down.

See locations of vaccine clinics and case dashboards below.

Cases have been especially high in the Northeast Kingdom, which has had elevated case rates in recent weeks. Bennington and Rutland also have seen increases recently. Orleans, Essex and Bennington counties have the highest rates of infection per capita, with all three over 1,000 cases per 10,000 people. The next highest counties are all under 800/10,000. Addison is the only county with under 500/10,000. The next lowest are Grand Isle, Orange and Windsor.

The governor has repeatedly said this is now "a pandemic of the unvaccinated," and said the transmission has been largely through smaller gatherings. Halloween parties at St Michael's College in Colchester, for instance, are blamed for a surge in cases there last week, even though the vaccination rate among college students is over 90 percent.

Meanwhile, the CDC gave final approval November 2 for Pfizer vaccines for children 5-11 (for vaccine information or to register CLICK HERE). Already in the 5-11 age band, 15,991 have either signed up or started their vaccine regimen, or about 36 percent of the 44,000 children in that range.

Governor Scott said the White House is sending more doses to Vermont, which so far has the highest uptake of any state. 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.


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


Based on record high cases this past week, Governor Phil Scott recently 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."


Vermont launches 5-11 vaccination drive


Some of the recent surge also could be due to a waning of immunization. Vermonters and New Englanders were among the first to get vaccinated, the governor said, and so the immunity may be wearing off.

Dr Levine 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.

Dr Levine and Governor Scott have said that if you feel at all at risk of getting COVID, you should get a booster.

The elderly have been especially vulnerable to COVID, with the vast majority of fatalities coming among those 80 and over (211 total deaths, while having by far the fewest number of infections for any age band.).

The CDC is also allowing people to change/mix and match vaccines.

Vermont has the highest booster rate in the US. And people who have been vaccinated can mix and match their boosters. Governor Scott, who originally received the one-dose Johnson & Johnson vaccine, told VBM November 3 that he opted for the Moderna vaccine for his booster.

Dr Rebecca Bell, President, Vermont Chapter of the American Academy of Pediatrics, at the governor's press conference November 2, 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.

Education Secretary Dan French announced in late October 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: 11

Recent Cases 14 days: 216

Bennington County

New Cases: 11

Recent Cases 14 days: 472

Caledonia County

New Cases: 20

Recent Cases 14 days: 351

Chittenden County

New Cases: 51

Recent Cases 14 days: 817

Essex County

New Cases: 6

Recent Cases 14 days: 90

Franklin County

New Cases: 15

Recent Cases 14 days: 419

Grand Isle County

New Cases: 3

Recent Cases 14 days: 51

Lamoille County

New Cases: 15

Recent Cases 14 days: 155

Orange County

New Cases: 4

Recent Cases 14 days: 137

Orleans County

New Cases: 8

Recent Cases 14 days: 216

Pending Validation

New Cases: 2

Recent Cases 14 days: 8

Rutland County

New Cases: 19

Recent Cases 14 days: 748

Washington County

New Cases: 14

Recent Cases 14 days: 335

Windham County

New Cases: 27

Recent Cases 14 days: 243

Windsor County

New Cases: 31

Recent Cases 14 days: 499

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 de ath. 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.

Booster Shots

Get extra protection with a booster shot if you are 18 or older and you received your

  • second dose of Pfizer or Moderna vaccine at least six months ago, or
  • Johnson & Johnson vaccine at least two months ago.

It's especially important for anyone 65 or older to get a booster. For Pfizer and Moderna boosters, you should get a booster if you are under 65 and feel at risk of getting COVID-19. The CDC defines risk as:

  • having certain medical conditions, including mental health conditions,
  • working in a job that increases your risk of COVID-19 because you are indoors, exposed to the public and to other workers,
  • living in a long-term care facility, group home, college dormitory or other congregate setting, or
  • if you are Black, Indigenous or a person of color (BIPOC) or live with someone who is BIPOC

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 Drugs, CVS, Walgreens, Northfield Pharmacy, or UVMMC Outpatient Pharmacies.

If you are 12 to 17 years old, look for clinics that offer the Pfizer vaccine and bring a parent or guardian with you. For children ages 5-11, look for a clinic that offers Pfizer (Ages 5-11). Please make an appointment for your shot. If you walk in to a clinic without an appointment, you are unlikely to get a vaccine.

ASL interpretation is available by video at all state-run vaccination clinics.

There will be first, second and booster doses for the vaccine type that is available at the clinic site you choose. Check the “Vaccine Type” column to see if the site has Pfizer (Ages 5-11), Pfizer (Ages 12+), Moderna or Johnson & Johnson.

Vaccination & COVID-19 Dashboards