As various sectors of the economy and state are allowed to reopen, questions remain about whether wearing masks should be mandated, what it's going to look like for children returning to child care, and when it's safe to visit family and friends. This hour, join us for our regular Monday roundup of health questions and answers with Vermont's Department of Health.
Our guest is:
- Tracy Dolan, deputy commissioner for the Vermont Department of Health
Broadcast live on Monday, May 18 after Gov. Phil Scott's press conference; rebroadcast at 7 p.m.
The following has been edited and paraphrased for brevity and clarity.
Bob Kinzel: We heard that the general trend lines in Vermont look pretty good. There was a time when the number of cases in the state was doubling every three days – I think it’s now at every 40 weeks. That’s a dramatic change. How do you view things now? Are we past the peak?
Deputy Health Commissioner Tracy Dolan: I think the state is in pretty good shape. I would use the phrase “cautiously optimistic.”
Of course, we are an island. Our rates are very low, but states around us are not necessarily experiencing the same situation. We need to really think about how we maintain everything we can as we see increased congregation within our state and see more people coming into the state from other places, so that we don’t have the surge we could see.
For a timeline outlining Vermont’s response to COVID-19, head here.
How does the state encourage tourists to visit or live in Vermont for some period of time while maintaining certain health protocols?
We do it in three ways.
- Surveillance: We continue to test, to look at the numbers, and we surveille the population so we will know if things start to go in the wrong direction.
- Be Vigilant: Mask wearing should be continued even as local restrictions loosen up. We are seeing more science now, as people have had time to study it over the past couple of months, that it does reduce the chance of infection by decreasing the movement of respiratory droplets.
- Messaging: For everyone coming from out-of-state, they need to know it’s really important to abide by the 14-day quarantine, get tested, practice hand-washing and social distancing.
Should visitors planning a trip to Vermont for the 4th of July expect that they will still need to quarantine for 14 days upon arrival?
I don’t know. I’m not going to get ahead of the governor, but I think that will depend on the numbers.
As we open up the spigot, we are requiring quarantine. If our numbers remain very low, the governor may modify that.
But if our numbers start to tick up, which, from a public health perspective is very much expected, given the fact that COVID-19 is still here and is no less transmissible or dangerous as an illness. We do expect that our numbers will increase as we start to co-mingle with people from out-of-state. But if the numbers tick up slightly, and we are able to isolate and manage that increase, that could make a difference in what the governor recommends mid-summer.
"We do expect that our numbers will increase as we start to co-mingle with people from out-of-state." - Deputy Health Commissioner Tracy Dolan
As the state continues to increase the number of daily tests, is this a place where that percentage of positive rate becomes very important?
It does. The percentage of positive rate remains low, and it will probably continue to remain low as we test more and more people who are asymptomatic. We’re finding fewer and fewer cases. Early on, we only tested people who were very, very ill. Even then, a vast majority did not have COVID-19. Over time we started to test people who were moderately ill, and now to asymptomatic people.
The testing is a way for us to know where we are. The continued testing gives us a sense of what’s changing as we change our social patterns.
What do you say to people who say, “This pandemic is not raging in Vermont, why can’t we open things up?”
This is a global pandemic. It’s not just a Vermont pandemic. Right now in the United States, it’s a national pandemic. You can see a lot of activity in our neighboring states. Massachusetts and New York continue to struggle.
More from VPR: Checking In On COVID-19 In Massachusetts
It’s true that if we were just looking at Vermont numbers and were not part of a larger country – which we are – we may have a very different plan for reopening. But the reality is Vermont is very much a tourist state and people will leave Vermont in the summer and want to go back and forth. And we are living in a country and world where there is plenty of movement.
We can’t assume we are an island; we are not.
At this point, what is the danger of riding in car with another person you have no reason to believe has been exposed to COVID-19, where driver and passengers were both wearing masks? What about taking public transportation?
There is nothing that is risk-free, but certainly riding in a car with someone is lower risk, assuming that you don’t have any symptoms and the driver is not feeling ill and you’re both wearing masks.
Another way to reduce the risk is to open up the windows.
If you do take a test, and it comes back negative, will you still be asked to lie low for a while and self-isolate (particularly after riding in a car with someone else)?
Getting tested is always helpful, because then you know more about your status. There would be no reason to lie low for 14 days after that, unless you found out that one of you was COVID positive because riding in a car with someone for a long time, even with masks, could qualify as close contact. You would be asked to self-monitor if one of you became ill after that.
Even then, riding in a car with someone is relatively low risk.
When do you expect that elective procedures that require an overnight stay in a hospital will open back up?
I anticipate that will open up in the coming weeks, and maybe even as early as next week. But I know we are just opening up for outpatient.
More from VPR: Gov. Scott Says More Reopenings, Economic Recovery Package To Come Soon
What is the goal of ramping up all this testing? Is it just to see how far this coronavirus has spread within the state?
Yes, it is. And the CDC has issued a recommendation that testing should be occurring at a particular rate per 100,000 people. In Vermont, to achieve that rate, we’d be testing at about 1,000 people per day.
It’s to see how far we’ve come, and as we reopen, it’s to see if we have case numbers that are growing. The federal guidelines recommended a particular testing capacity prior to reopening, so that we can surveille on a regular basis to make sure we are not seeing a surge.
"What we are seeing here in Vermont, now that we are testing more asymptomatic people, is that we are not seeing a lot of cases among asymptomatic people who feel well." %u2013 Deputy Health Commissioner Tracy Dolan
We’ve heard officials in other states say they think that some portion of the population has or has had coronavirus but are asymptomatic. We’ve heard this also from some countries in Europe – that folks think it might be 25-30% of the population that actually would be testing positive for the virus, but show no symptoms at all. Do you think it’s likely that this is the case, based on what we’ve seen in Vermont?
We were hearing that as well. That might be presenting differently in different populations or countries.
What we are seeing here in Vermont, now that we are testing more asymptomatic people, is that we are not seeing a lot of cases among asymptomatic people who feel well. That might change: we may find some pockets, but our tests are not detecting COVID-19 in most of the asymptomatic people we are testing, in fact we are finding very, very few.
Where we may see it more, is where we find a case and test the contacts around that case. For example, if there is a case at a facility. We have seen, when we’ve tested staff, that some of those staff are asymptomatic and a few of them have been positive.
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In places where there is a higher risk, for example, among close contacts of a confirmed case, we are finding that some people are asymptomatic and positive. But in the general population, where most people are not aware they’ve had contact with a known COVID-19 positive case, we are not finding it as much.
