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State health officials not expecting a surge in COVID hospitalizations this winter

A registered nurse fills a syringe with the Johnson & Johnson COVID-19 vaccine at a pop-up vaccination site in the Staten Island borough of New York, April 8, 2021.
Mary Altaffer
Associated Press File
A registered nurse fills a syringe with the Johnson & Johnson COVID-19 vaccine at a pop-up vaccination site in the Staten Island borough of New York, April 8, 2021.

The cold weather is returning, which means a lot of Vermonters are spending more time indoors.

State health officials say the threat of COVID remains quite low in the state. At the same time — there are indications that the current dominant strain of the virus is more contagious, with less severe symptoms than many previous strains.

So what’s the outlook for this winter?

Bob Kinzel, Vermont Public's senior political correspondent, has been looking into the issue, and he sat down with host Jenn Jarecki to discuss his findings. Their conversation below has been edited and condensed for clarity.

Jenn Jarecki: It's hard to believe, Bob, but we're approaching year four with COVID in our lives, and at times the threat of the virus has been severe, and other times it's been more mild. Where do things stand today in Vermont? 

Bob Kinzel: Isn't it amazing that it's been four years — it kind of feels like about a decade. But in any case, Vermont health officials say we're at a low rating at this time. And this rating is based on a number of indicators, including hospitalization rates, our emergency room and urgent care visits, information from nursing homes and from schools and some limited wastewater treatment testing. Vermont Health Commissioner Dr. Mark Levine says these indicators are all looking good right now.

Dr. Mark Levine: Because we're not seeing that increase in hospitalizations, we're not seeing that increase in people presenting to urgent care settings with severe symptoms. You know, when we know every new strain probably establishes itself because it becomes a little more transmissible than the previous strain. So, that's what we're seeing, and we're not seeing greater severity. 

Bob Kinzel: Jenn, I should mention that this low rating is also true for virtually all of New England and for most of the country. Now, at the same time, Vermont is keeping a very close watch on this situation because if it suddenly gets worse, it has the ability to put a lot of pressure on the state's healthcare system. State epidemiologist Dr. Patsy Kelso explains.

Dr. Patsy Kelso: What we need to know is how many people are having healthcare encounters, either going to the emergency department or being hospitalized because of that disease. So, I think it does -- the measures that we have now are able to tell us what's most important for us to know. And if we start to see big increases in those measures, then we know there's a problem. 

I wouldn't want to characterize it as vaccine fatigue just yet. It's been a slower rollout than I think anyone would have wanted...
Dr. Mark Levine

Bob Kinzel: So the bottom line is that health officials are not expecting a major surge in COVID cases this winter. But we know the circumstances can change in a relatively short period of time.

Jenn Jarecki: Bob, Dr. Levine mentioned that the case is summer and fall from the current COVID strain are more contagious and less severe than in previous years. Can you talk to us about why that's the case? 

Bob Kinzel: Well, Dr. Levine says there are a number of reasons. And the basic one is that a vast majority of people in Vermont have received at least some COVID vaccinations. And at the same time, a sizable number of Vermonters have also been infected over the last almost four years. And Dr. Levine says this situation can affect the severity of COVID symptoms.

Dr. Mark Levine: Over 97% of people in this country now have immunity to COVID, either through having had the virus themselves or having had the vaccine or a combination of both. So, even though we know that isn't totally protective in terms of getting a case, that continues to help with regard to preventing the more serious outcomes from the conditions. 

doctor doing the covid 19 vaccine at home for omicron variant
franckreporter/Getty Images File
Doctor administering the COVID-19 vaccine at home to work against the omicron variant

Bob Kinzel: And Jenn, Dr. Kelso says there's another important factor. It's one that I find to be a little spooky, it's this: The basic goal of a virus is to continue to spread as far and as wide as possible. So, it doesn't want to kill off all the people it infects because that would lead to its eventual demise. Now in scientific terms, it's described this way, the virus has an evolutionary pressure to become more transmissible, and that results in the development of a strain that has milder symptoms.

Dr. Patsy Kelso: If a virus causes such severe illness, that people are bedridden and at home and not exposing lots of other people, then the virus is not going to spread efficiently. So, if it causes milder illness, and people are still doing daily activities and interacting with other people, it's going to spread more readily. It's pretty cool when you think about it.

Bob Kinzel: I don't know Jenn, does this sound like the plot from a science fiction movie to you?

Jenn Jarecki: Kind of sounds like the plot of an X-Files episode. 

Bob Kinzel: Doesn't it? Well, you know, I can tell you, Jenn, from personal experience, that when I got my second case of COVID back in early October, the symptoms were considerably less severe than my first case back in January of this year, there really was quite a difference. And I've heard from a number of people that this has been their general experience as well. Now, this is not to say this is the case across the board for all people, but it's definitely an emerging trend.

There are other things you can do like wearing a mask, and frequent hand hygiene to protect people who are especially vulnerable. 
Dr. Patsy Kelso

Jenn Jarecki: So health officials are encouraging folks to get the new COVID vaccine, right? That's been available for several weeks. But so far, only 10% of eligible Vermonters have gotten their shots. Why do you think this is the case? 

Bob Kinzel: Well, Jenn, I asked Dr. Levine, the state's health commissioner about this low vaccination rate, and if perhaps there was a sense of COVID fatigue settling in for many Vermonters but he really doesn't think this is the case. Instead, he blames it on a lack of vaccine availability in many parts of the state, because there's a different distribution system being used this year. And that's because COVID is no longer considered to be "a federal public health emergency." And he says this new system puts much more pressure on individual pharmacies, it's been very difficult for some of them to keep up with demand.

More from Vermont Public: Struggling to find flu, COVID or RSV shots? Vermont is hosting these vaccination clinics

Dr. Mark Levine: I wouldn't want to characterize it as vaccine fatigue just yet. It's been a slower rollout than I think anyone would have wanted, due to the new commercialization of the vaccine, and the lack of the federal government's involvement in getting it out expeditiously to states.

Bob Kinzel: And state epidemiologist Dr. Kelso says that she understands that the lack of vaccines might be stressful for some people with many holiday gatherings coming up. And she wants people to know that things should be fine if folks take basic precautions if they're going to be around higher-risk individuals.

Dr. Patsy Kelso: But if you can't get an appointment to be vaccinated before then I don't think it's a great cause of concern. Certainly, as we say each year, be aware of who you're gathering with and whether anyone is particularly vulnerable. There are other things you can do like wearing a mask, and frequent hand hygiene to protect people who are especially vulnerable. 

Bob Kinzel: So Jenn, the key advice is to be aware of who you're going to be around at holiday gatherings. If you're going to spend time with older family members or friends who have compromised immune systems, then it's probably a good idea to wear a mask and take what you feel or other necessary precautions.

Have questions, comments or tips? Send us a message.

Bob Kinzel has been covering the Vermont Statehouse since 1981 — longer than any continuously serving member of the Legislature. With his wealth of institutional knowledge, he answers your questions on our series, "Ask Bob."
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