This is the second story in a two-part series that looks back on the impact of Covid-19 in Vermont after five years. The first story, “New technology, and mistrust, is legacy of Covid-19 for Vermont public health,” can be found here.
Patsy Kelso, Vermont’s state epidemiologist, remembers hearing about Covid-19 for the first time through the “routine channels.” The Centers for Disease Control and other public health entities regularly share information about emerging infectious diseases, from mpox virus circulating worldwide to Ebola outbreaks in Uganda.
But there was nothing, at first, that suggested Covid would be the one to shut down the world. “It did take me by surprise, personally, how quickly things ramped up,” Kelso said.
The spread of Covid within the United States was so misunderstood that the focus of many experts was on preventing transmission from international travelers. In reality, the virus had been spreading nationwide for months.
Vermont officials recommended hand washing and staying home when sick, but masking and social distancing were not yet on the horizon for the general public. In fact, only three days after Vermont’s first Covid case on March 7, 2020, hundreds of people attended a University of Vermont basketball game. At least 20 confirmed Covid cases were later linked to the event.
But the situation was quick to change. On March 15, 2020, Gov. Phil Scott ordered K-12 schools to shut down to prevent Covid’s spread. A flurry of other closures followed, until Scott issued a blanket order on March 24: “Stay home” and “stay safe.”
Covid tracing in the state began with a whiteboard in Kelso’s office listing individual Vermonters’ initials and their test results. Then she had to bring in a second whiteboard. Then the entire office was sent home, and the department was forced to rapidly come up with a system for tracking hundreds of people and tests.
On the testing side, Helen Reid, director of health surveillance at the Vermont Department of Health, was scrambling to scale up Covid laboratory testing. Early shortages of basic testing equipment — pipette tips, plastic — hampered their progress.
“It was hard to anticipate the scale that this would go to,” she said. “So with every new piece of information, we were sort of pivoting and adjusting our approach, and doing it pretty quickly.”
Along with supplies, the department was in desperate need of more staff. Officials put out a call early on for “basically anyone in state government who had a microbiology degree,” Reid said. Still, she recalled working extremely long hours in the early weeks of the pandemic.
“We went from, I think it was, testing about 56 specimens a day in the early days of Covid, to our team testing 1,500 per day by the end of May, because we didn’t really have a choice at that point,” she said.
As the health department scrambled, state officials tallied the numbers. Early Covid press conferences featured charts of hospital capacity and the amount of need under “best case” and “worst case” scenarios. In those early months of the pandemic, Vermont did not come close to hitting its hospital capacity. In fact, cases ebbed into the spring and summer months, and the state reported zero deaths for months.
Anne Sosin, a health equity researcher and lecturer at Dartmouth College, recalled Vermonters in that time beginning to talk about the state as an “escape community,” protected from Covid by its relative isolation and rurality. But she said she had reason to be skeptical since her research in health equity suggested rural areas can be uniquely vulnerable to illness.
Many people think about disease risk as “distances between houses and physical infrastructure,” but rural communities often have tight-knit bonds and anchor institutions like schools and employers that bring them together, she said.
Rural areas also have more essential workers and fewer hospital beds and other health infrastructure. Yet she was sympathetic to those who wanted to return to their pre-pandemic lives.
“None of us want to alter our daily lives for months or years on end,” Sosin said.
Vaccine goals
The vaccination campaign in 2021 marked a new stage in the pandemic. After rolling out the vaccine to older and high-risk Vermonters, Scott announced that May a benchmark-based plan to reopen Vermont: If 80% of Vermonters get vaccinated, he said, he would lift major Covid restrictions.
“Admittedly, this would be an ambitious goal for most,” he said at a press conference announcing the initiative. “And to be honest, most states won’t come close to reaching it. But I believe Vermont can show the country how it’s done.”
On June 14, 2021, the state hit that goal, and Scott followed through on his promise. Once again, Vermonters enjoyed a summer light on Covid limitations.
Vermont remains close to the top of the nation in its initial Covid vaccination rate, tied with three other states, according to USAfacts.org. Kelso praised the policy, saying that it helped limit deaths later in the pandemic.
“I think that was a strong policy that resulted in both large uptake of the vaccine, and also quickly, because Vermonters wanted things to reopen,” she said.
But once again, the Covid ease was not to last.
That summer, the more severe and infectious Delta variant began circulating through Vermont. Cases and deaths surged in the fall. Then Omicron hit. The less severe, but extremely contagious, variant spread quickly nationwide. In Vermont, reported hospitalizations topped the state’s hospital bed capacity, forcing them to take emergency staffing measures for weeks.
Scott pushed forward with reopening despite the rise. Just as Omicron began to wane, he announced the end of school mask mandates, citing the need for children to return to normalcy.
Three years later, Sosin remains critical of this policy. She said the state leadership early in the pandemic was “fast and effective,” but “lost discipline in responding to the pandemic in later stages.”
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She argues that masking, tied with other Covid-concious policies, actually helped to keep schools open during the worst of the pandemic.
“None of us thought that we should shut the state down the way we did in March 2020,” she said. “We knew a lot more and had many more tools to respond to the pandemic.”
Kelso took a more positive view of the state’s response, but said the restrictions and regulations were a balance that had trade offs.
Statewide and public health policies in Vermont contributed to the state having the lowest death rate in the nation, she said, but there were downsides to some of them as well.
“Limiting visitation in long-term care facilities, for example, really helped reduce introduction of the virus into a facility where it could then spread quickly and result in terrible outcomes, but that also had devastating impacts on individuals’ lives,” Kelso said.
Vermont might have had a comparatively low death rate, but that’s not how Sosin thinks when evaluating the state’s performance. “I never think about it in terms of Vermont versus Texas. I think about it in terms of lives that didn’t need to be lost,” she said.
“I always think we measure this on our own terms, and we would not resort to lowest-common-denominator metrics in thinking about public health, or the preservation of human life,” Sosin said.
Read the story on VTDigger here: A visual history of Covid-19’s path through Vermont.