Ever since Gov. Phil Scott's administration announced the first positive test result for the coronavirus on March 7, the numbers — and testing — have continued to rise. This hour, we get an update on the case numbers in Vermont and how the state is handling COVID-19 testing.
Our guests are:
- Dr. Mark Levine, Vermont Health Commissioner
- Dr. Louis Dandurand, Director of Emergency Medicine, Northwestern Medical Center
Broadcast live at noon Monday, Mar. 30, 2020; rebroadcast at 7:00 p.m.
A Q&A with Dr. Louis Dandurand
On March 27, Northwestern Vermont Medical Center announced that an employee had tested positive for COVID-19. What impact has that incident had on hospital operations?
Dr. Dandurand: Not much. We have already been preparing for this possibility and there was not much risk for exposure. We have been able to continue our regular operations.
How do you prepare for the possibility that you will see a reduction in staff during a pandemic?
Dr. Dandurand: In preparing for an influx of patients that could potentially have COVID-19, we had already redesigned our system to intake patients that have a higher risk of infection.
At the very start of our encounter with patients as they come in, whether by ambulance or as a walk-in, at the emergency department or at their primary care provider's office, we sort them through pre-screening to a place that is safe for them to be evaluated for staff and for others.
There are universal precautions we are taking for all patient encounters, but we are also able to take additional precautions through pre-sorting patients [according to their symptoms] at the door.
Even without weating a surgical mask or N-95, there are things we can do in our behavior to reduce the risk of infection.
It's a constant process of educating staff to reduce the risk when it comes to patients who are coming in for reasons unrelated to the coronavirus, but who could still have it.
Do you have enough personal protective gear? What are the hospital's specific needs?
Dr. Dandurand: At this time, yes. As this epidemic develops, it's hard to tell where the peak will be. Are we going to have enough PPE [personal protective equipment]? It's hard to say, but my personal opinion is that we will not.
What are you doing to prepare for COVID-19 patients who have pre-existing conditions?
Dr. Dandurand: We have done a lot of preparation for that to keep them safe and seen. We have decreased our patient volume in response to the epidemic, but the medical conditions of this community haven't changed, and we still need to accomodate those folks.
Where are we now in flu season? Is it still a concern?
Dr. Dandurand: We are starting to see a seasonal decline in the number of flu cases. The way we test for flu is couple with testing for RSV (respiratory syncytial virus). We have seen both, and the latter tends to be most severe in younger children.
A Q&A with Health Commissioner Mark Levine
What can you tell us about the fatalities Vermont has seen so far?
Commissioner Levine: Seven of the 12 deaths were at Burlington Health and Rehab. The deaths that occurred outside of that facility were generally hospitalized. Right now the fatality rate is in the 1 percent range. It's high compared to the fatality rate of the flu, but low compared when compared with other coronaviruses SARS and MERS.
What are the protocols for staff at long-term care facilities?
Commissioner Levine: Staff can wear masks. They won't fully protect you from getting ill, but if you are ill, they will block droplets [which may carry COVID-19].
How many people have recovered? If you have gotten the virus and recovered, are you immune now?
Mark Levine: We don't know yet because most of the cases are very recent. With regard to immunity: I wish we knew more. The World Health Organization's answer is 'We don't know.'
People talk about mild, moderate and severe cases of COVID-19. How mild is "mild" for symptoms?
Commissioner Levine: If you've had a mild cough and a low-grade temperature, that probably constitutes mild symptoms [of COVID-19].
Should kids get tested?
Commissioner Levine: They should avoid it unless they have symptoms of a much more severe illness.
Do you expect to get a continual supply of testing supplies?
Commissioner Levine: If the cost is that we run out of tests prematurely, we will still benefit from the information and data we get from broadening the scope of who we are testing.
What have you been advising morticians?
Commissioner Levine: Use a lot of caution. The virus can only be viable for so long in someone who is deceased, but morticians need to review the guidance that is in place.
