COVID-19, the illness caused by the new coronavirus, is now in Vermont and people are bracing for a long period of uncertainty. This hour, we bring you stories of how Vermont and others outside the state are responding to this moment. We hear from a Vermonter who is self-quarantining, a hairdresser who is preparing for the potential of lost work, a Dartmouth-Hitchcock doctor involved in developing a new proprietary test, and many more.
Developing A New Test At Dartmouth-Hitchcock
Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire is developing a proprietary test for COVID-19.
Dr. Ed Merrens is chief clinical officer for the Dartmouth-Hitchcock Health System. In an interview with Vermont Edition Tuesday, Dr. Merrens explained that the new test would allow Dartmouth-Hitchcock to operate independently of New Hampshire's state lab, which is where it sends tests currently.
"This isn't a dissatisfaction with the state," says Dr. Merrens. "As I think we want to be able to expand our ability to test, it allows us to do that on our own."
Dr. Merrens added that the new test would also grant the hospital the ability to test more people in-house and more quickly.
Right now, Dartmouth-Hitchcock uses CDC test kits to test people who are symptomatic of COVID-19.
Dr. Merrens says the hospital is in the midst of internal validation and testing, which will take about two weeks. Then Dartmouth-Hitchock should have a better sense of how and when to roll out the new test for use in the hospital network.
A Vermont Family In Self-Imposed Quarantine
People who think they may have come in contact with the virus are worried about when and how to get tested. On Tuesday, Vermont Edition spoke with Seth Jensen, a teacher at a Chittenden County high school.
Jensen flew to Spain last month with his wife and youngest daughter. They were visiting their oldest daughter, who’s a high school sophomore in Spain. When they arrived, COVID-19 and the coronavirus was barely on anyone's radar. By the time they left in early March, the country had a few hundred cases.
Now, Spain is dealing with more than 4,000 cases and preparing to declare a state of emergency.
Jensen and his family were sick with flu-like symptoms when they left Spain. When they returned to the U.S., he says the family found out there was a case of COVID-19 at his daughter’s school there.
Fearing the worst, he called doctors and explained the family's travel and symptoms. But he says he got conflicting messages about what to do.
Stay at home. Go to the ER. His physician wanted the family to get tested for COVID-19, but they couldn't get the test due to UVM's testing protocol, which flows from the state health department's protocol.
The health department even told him his daughter, who was asymptomatic, could return to school.
“What we decided to do was to not take that advice," Jensen says. "We at that point were really trying to push for being tested, and we were kind of bounced back and forth between the health department and our primary care provider.”
With only the symptoms of the disease, no known direct contact with a known COVID-19 case, and no travel to a level 3 country like China or South Korea, Jensen says he and his family couldn’t get tested for the coronavirus. (On Friday, Spain was among nearly 30 European countries added to the Level 3 travel warning.)
“We didn’t meet any of those criteria, really, other than the symptoms,” he says.
That led Jensen and his family to self-quarantine. Not just for the family’s health, he says, but for public health.
“Being a teacher, and having two daughters in high school, we didn’t think it was responsible at all to put ourselves back in the community.”
Deputy Health Commissioner: 'We Have To Make Choices'
Deputy Health Commissioner Tracy Dolan says the health department does have specific protocols for COVID-19 testing. But they rely on people's doctors to refer tests to the state.
Though she doesn’t know the specifics of Jensen’s case, she says the testing protocol is clear.
“When physicians are recommending someone be tested, sometimes we chat with them and say, ‘hey, let’s walk through it,' but for the most part physicians are saying ‘hey, I’m seeing these symptoms, I have a concern, I know what the history is, please test,' we have the testing," she says.
Not everyone with the coronavirus has severe symptoms. So why not test as many people as possible?
"We have a health care system that’s stressed right now," Dolan says.
"We have limited test kits across the country. Almost every state and public health lab is experiencing some shortage."
With the guidance from the CDC, the number of test kits available, and the capacity of Vermont's health system, Dolan says Vermont health officials are "recognizing we need to be thoughtful about who we’re testing right now."
"We have to make choices," she says. "And right now our choices are about symptomatic patients who meet a certain criteria, recognizing that there may be more out in the community but we have to work on the priorities right now.”
She insists the health department is in no way stockpiling test kits.
“We are not stockpiling kits,” she says. “We are taking all the recommendations coming from physicians, after discussion, and we are testing every time. So we’re not stockpiling, we are using. But we also recognize we have limits, and so we need to be thoughtful about how we’re using those.”
Who Needs Testing And Who 'Would Be Better Served To Stay Home'
In a Thursday press conference, UVM Medical Center said people who may be sick with the disease but are not in severe respiratory distress or needing critical care might not get tested at all, even if it's likely they do have COVID-19.
Infectious Disease Dr. Timothy Lahey says doctors and nurses are being asked to determine just how sick someone is “to figure out who really needs that testing, and who is better served to stay home.”
As the pandemic has evolved, and test kits remain limited, the symptoms deserving of a test have been changing. Now, Lahey says, there’s agreement on what merits a test.
“If you have travel to an area that is a hot spot—Italy, Iran, South Korea, China—and you have symptoms that are sufficiently concerning to make it so that you really need care, then you can be tested.”
Others with “an unexplained, very severe respiratory illness” can also get tested, Lahey added.
Getting that test means first reaching out to a doctor. But …
“If somebody [calls in] and they realize from their physician they don’t really don’t quite meet the criteria, well then that’s good news.”
Preparing With A 'Disability Perspective' In Mind
Thursday was supposed to be Vermont's "Disability Awareness Day" in Montpelier, but like many events in the state and across the country, it was canceled over coronavirus concerns.
Sarah Launderville, executive director of the Vermont Center for Independent Living, says making that decision wasn’t easy. And as others face difficult decisions as they prepare for dealing with the coronavirus, Launderville says the public should keep a "disability perspective" in mind for the needs of people with disabilities and chronic conditions.
“We’re already really low on the number of attendants in our state, and in our nation," Launderville says, "and so those people being at risk kind of compromise how people are getting services they require to live independently.”
Stocking up on food, medications and other essentials in a time of uncertainty can be difficult for many. A reliance on public transportation, high costs and limited storage space in housing are all factors.
“People living on social security benefits are not going to be able to run out and stockpile and get lots of different supplies," Launderville says.
"There’s a lot of issues with that sort of assumption that people can just hunker down for at least 14 days or more in their own home and not have issues. We really need to make sure we’re communicating and accessing people who have disabilities, our elders, those who have chronic conditions, and might not be able to access food and supplies in the same way as others.”
Impact On The Self-Employed
How are COVID-19 disruptions affecting Vermont's self-employed?
Dana Talmo is hair stylist at Élan Hair Lounge in South Burlington. She says she is preparing for the possibility that she will have to spend time away from her chair and is toying with the idea of selling IOU gift cards to clients in order to maintain a steady money flow.
"I have to start thinking about these things," says Talmo. "I've only been self-employed for four months, so it's a lot."
Broadcast at noon on Friday, Mar. 13, 2020; rebroadcast at 7:00 p.m.
