Vermont officials said they did not believe federal guidance that rated three counties as having “high” Covid-19 community levels should be cause for concern.
The U.S. Centers for Disease Control and Prevention reported Thursday that Washington, Essex and Windsor counties had high Covid community levels, while Orleans, Caledonia and Orange counties had medium Covid levels.
But Health Commissioner Mark Levine said at a press conference on Tuesday that the metrics the CDC uses can be skewed because of Vermont’s relatively small size and recent health care staffing patterns.
“Small states, especially small states with rural counties like ours, appear to have more unpredictable and variable case rates in these counties. And the difference between a count or a color on the map can literally be a few cases,” he said.
The CDC metrics are based on three data points: recent Covid cases per 100,000 people, new hospital admissions for Covid and the percent of hospital beds occupied by Covid patients, a proxy for health care capacity.
Levine said in counties like Essex, with a population of about 6,000, a “small number of cases moves to a very high rate.” Essex has reported 46 cases in the past two weeks, according to the Department of Health. That’s a rate of about 736 cases per 100,000 people.
By contrast, Washington County has reported 235 cases over that time period, according to the health department. Windsor County has reported 219. Both have a population of more than 50,000 people.
Overall, Vermont reported 87 new Covid cases on Tuesday for a seven-day average of 128 cases per day. Cases dropped about 11% in the past week but remain elevated compared with 14 days before.
The percent of PCR tests coming back positive has increased, hitting about 5.4% as of Tuesday. Most positive tests reflected in Vermont’s case count come from PCR tests rather than at-home antigen testing.
But Levine said there may be another reason Covid levels appear high in several counties. Hospitals have recently ended their contracts with traveling nurses and other temporary staff, reducing their overall capacity and making it appear that the percentage of Covid patients is rising.
“If the number of staff beds went down, but if the number of Covid cases stayed the same, (it) makes it look like you've had an increase in your hospitalization rates for Covid,” Levine said.
He did not specify which medical facilities had reduced their inpatient beds. Data from the U.S. Department of Health and Human Services shows that Central Vermont Medical Center in Washington County and Springfield Hospital in Windsor County had not changed their inpatient bed levels through March 11.
The third leg of CDC data, hospital admissions, remains relatively low in Vermont and in the three counties with high Covid levels. Vermont reported about four new Covid admissions per day in the past week, according to the weekly Department of Financial Regulation modeling update.
As of Tuesday, 12 patients were in Vermont hospitals with Covid, none of whom were in intensive care. Only four of those patients were hospitalized because of the disease, Gov. Phil Scott said.
“I think we're doing pretty well,” Scott said.
Vermont has the third-lowest hospitalization rate in the country but the second-highest case rate. That could be because of Vermont’s robust testing, Levine said.
[Looking for data on breakthrough cases? See our reporting on the latest available statistics.]
“We know a lot more about cases than any other state just because we're finding them,” he said.
Deaths also remain low. The health department has reported 13 deaths so far in March, about one-fifth of the total for February. Vermont has reported 617 deaths in total during the pandemic.
Several school districts in the CDC’s high-Covid counties have resumed mask mandates. Levine said he supported people making changes on an individual basis in response to CDC guidance, but institutional guidance should not be so quick to change based on “one piece of data at one time.”
“I would just caution people that one can get into an endless cycle of reacting, overreacting, to data without looking for good trends,” he said. “And you can be sort of panicking one week, next week saying, ‘Oh, glad we got by that one’ and then the next week go, ‘oh my god, I have to panic again,’ and that's not the way we want people to live.”
On Tuesday, the federal Food and Drug Administration announced that it would approve a second Covid booster shot for people 50 and older, along with an additional shot for immunocompromised people.
Levine said the announcement was too recent for Vermont to know any details of if or how it would roll out the program.
“We need to read closely what the FDA is saying and analyze what data they have provided,” he said.
The state recently announced it would transition away from large state-run Covid vaccine clinics and instead encourage Vermonters to stay up-to-date on their vaccines through pharmacies and doctor’s offices.
Levine said starting April 1, all state-run vaccination clinics on the health department website would be walk-in only, with no appointments available in advance.
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