This commentary is by Harry Chen, M.D., chair of the Vermont Covid Vaccine Implementation Advisory Board, senior adviser to the CDC Foundation Covid Corps in 2020-21, and Vermont commissioner of health from 2011 to 2017.
Have we had enough yet? “Of what?” you may ask. Covid — absolutely to a person, we have had enough.
I hate to be the bearer of bad news, but it isn’t over yet. Vermonters continue to get sick, be hospitalized, and die. And while many are presuming this may be the new normal, this would be a terrible new normal to accept.
Let’s get the facts out there. Vermont cases are at their highest point in the pandemic, as are hospitalizations. Deaths remain nearly at their highest; only one month was higher. The test positivity rate is at its highest since the very beginning of the pandemic. And while the majority of cases are in the unvaccinated, breakthrough cases are on the rise. And the Omicron variant hasn’t even reached us yet; it will.
Our health care system is stressed to the max. Importantly, Covid is not the only factor, but it is an important and modifiable contributor. Nationwide, workers are leaving health care and public health in droves due to burnout. Evidence shows that lack of control and feeling underappreciated and unsupported by one’s organization are strong factors related to burnout.
I know for a fact that the major challenge health care faces in Vermont is lack of staff. This is true for all levels of health care, from primary care to home health to long-term care to acute care hospitals.
It is not a lack of rooms, beds, or equipment, but the shortage of skilled staff to provide care. This affects all of us, with or without Covid, when our emergency departments are bursting at the seams and Vermonters can’t get the care they need.
There’s no quick fix to the staffing challenge, which is felt nationwide. Given this, we have to do everything we can to preserve the capacity of our fragile system.
Vermont had a stellar record of achievement earlier in the pandemic and its vaccination efforts are second to none. Yet this favorable trajectory has now reversed; we need leadership to act now. Vaccines are a necessary but not sufficient strategy, especially given the holidays and people gathering indoors now that winter is upon us. Waning or insufficient immunity, unvaccinated Vermonters, and new variants are major challenges to responding to the pandemic.
So, what do we do? We don’t keep hoping and waiting for our cases, hospitalizations and deaths to drop. It’s time to act.
We don’t need to lock down at this point, though countries across the Atlantic are doing just this. We need to wear masks indoors in public to protect ourselves, our vulnerable, and our frontline workers. We have done it before and know it works. I know the health commissioner and governor have come out strong for masking, but this is clearly not enough.
Given Vermont’s high levels of transmission, we need an indoor mask mandate in public places now.
We need the state to take leadership as occurred early in the pandemic. Doing this will reduce Covid cases, lowering the stress on our overstretched health care and public health systems and the valiant people who have given so much to the pandemic response. It will also relieve businesses of the burden of enforcing masking to protect their workers.
If it succeeds, it won’t need to be in place for long.
Our Legislature has stepped up to allow towns to implement mask mandates, but it is not enough. We have witnessed how woefully inadequate our nation’s 50-state approach has been. A 246-town-and-city approach defies common sense. A virus does not respect town lines!
Bringing the vitriol of the mask debate to Vermont’s selectboards and city councils is passing the buck. Protecting the public’s health requires leadership backed by science, not public opinion. Now is the time for action. We can’t afford to wait.
