Despite new federal limits on who can get a Covid-19 vaccine and the arrival of the cold and flu season, many Vermonters can still get a booster, though details surrounding Medicare reimbursement and federal recommendations remain uncertain.

In a late August post on X, Health and Human Services Secretary Robert F. Kennedy Jr. announced the Food and Drug Administration approved Covid-19 booster shots, but only for those 65 and above or with existing health risks. 

Vermont state officials are now awaiting a recommendation from the Centers for Disease Control and Prevention, which typically guides public health directives and insurers’ coverage, for those who want to get a fall booster shot.  

“Really the best thing that I can recommend is either to go online and see if you can set up an online appointment (for a vaccine), or call pharmacies in your area to see if they’re available,” said Julie Arel, the state’s interim commissioner of health.

In Vermont, pharmacies are moving forward with administering the vaccine. Kinney Drugs and CVS have the updated Covid vaccines in stock. Pharmacies order directly from the manufacturer. Providers — doctors’ offices and other clinics — often get vaccines through the state, which is not yet able to order the vaccines from the CDC. 

Kinney Drugs’ spokesperson Alice Maggiore confirmed that the stores can administer the 2025-26 vaccines to people above 65 and individuals between 12 and 64 who attest to having one of the qualifying conditions, as outlined by the CDC. 

CVS is able to vaccinate anyone over 5 years old, who attests to eligibility under the same CDC’s preexisting conditions list, or anyone older than 65, according to a company executive, Amy Thibault. 

The underlying risks outlined by the CDC range from asthma or a smoking history to mental health disorders, like depression obesity, or physical inactivity. Patients do not need a doctor’s prescription to confirm the underlying condition at Kinney or CVS, both spokespeople said.

Typically, insurers cover vaccines received in a pharmacy. Whether some private and government insurers will be able to cover the vaccines remains uncertain. Even if people can get the vaccine by walking into a pharmacy, it’s unclear if they will have to pay for it:  “It’s a little bit mind boggling,” Arel said. 

Blue Cross Blue Shield of Vermont, the state’s largest private insurer, plans to continue to cover the vaccine for any member, at no cost and with no prior approval, said Andrew Garland, a vice president and spokesperson for the insurer. Blue Cross Blue Shield of VT intends to do so through 2026, as well. MVP, the state’s other private insurer selling plans on the marketplace, also does not anticipate changes in its vaccine coverage policy, said Elizabeth Boody, a spokesperson for the company. 

What employer-sponsored insurers and providers like Tricare, the military health system, might be able to cover, is still unclear.

Since the FDA has already approved the vaccine for those over 65, it is likely that Medicare, which covers the same age group, will cover the vaccines. Dorit Reiss, a vaccine policy expert at the University of California Law, San Francisco, told NBC News that once the FDA approves a vaccine, Medicare has the authority to cover it.

Generally a Covid vaccine undergoes three steps for approval: First the FDA authorizes the new vaccines — which it did in August. Then a panel within the CDC called ACIP (short for Advisory Committee on Immunization Practices) issues a recommendation on the vaccine. It is scheduled to meet Sept. 18-19, to do so. This year many are holding their breath ahead of ACIP’s announcement, since Kennedy gutted the panel and replaced it with many vaccine skeptics. 

The state is weighing whether and how it will need to break from that typical process, and is currently exploring what Vermont statute allows for breaking with that process.

While it is quite common for providers to prescribe a drug outside of what the FDA has authorized them for, it’s not typical, however, for that to happen with vaccines. The FDA’s lack of formal guidance on what qualifies as an underlying condition leaves room for interpretation surrounding who qualifies for the vaccine.

“There’s some flexibility in there, but because it’s not as clear as usual, there is going to be hesitancy, in all likelihood,” said Arel. “And anytime there’s hesitancy, anytime there’s confusion, it’s going to lead to lower immunization rates. We really want to try to avoid that.”

The Department of Health is also looking to Vermont’s neighbors in the Northeast for direction, Arel said. In August, the department joined with other state health departments in the region to build a coalition ready to respond to shifts in federal guidance. Though the group has no unified recommendation, she says it’s something they are considering to help mediate the current disjunctive state of vaccine recommendations and approvals. 

“If as a region, we can become more aligned, it helps people across the whole Northeast region to feel a level of confidence in their state public health department’s decisions and how we’re moving forward,” she said.

In Massachusetts, Gov. Maura Healy required in-state insurance carriers to cover the vaccines recommended by the state’s Department of Public Health, even if they are outside of the federal recommendations. The state’s commissioner of public health also issued a standing order that allows pharmacists to issue Covid shots to anyone over the age of 5. 

In response, Arel said Vermont is watching its neighbors and looking into where state statute might allow for potential action. 

“Getting clarity and having a message be clear and simple, is going to be the most important thing we do,” Arel said. “Unfortunately, we are still working through all of that, but we are committed to finding our way through it and making it as simple and easy as possible.”

Read the story on VTDigger here: As feds tighten Covid vaccine rules, Vermont works to maintain access .

The Vermont Conversation with David Goodman is a VTDigger podcast that features in-depth interviews on local and national issues. Listen below and subscribe for free on Apple Podcasts, Spotify or wherever you get podcasts.

The Centers for Disease Control, the nation’s top public health agency, is in chaos following the firing of its director by President Donald Trump and the resignations of its top leaders last week. Nine former CDC directors wrote in the New York Times this week that Health and Human Services Secretary Robert F. Kennedy, who spearhead the purge of the CDC and is a longtime leader of the anti-vaccine movement, is “endangering every American’s health.”

States are increasingly spurning Kennedy and taking health matters into their own hands. Northeastern states, including Vermont, have formed a regional health coalition in response to concerns about federal vaccine guidance. The governors of California, Washington and Oregon declared this week said that the CDC has become “a political tool that increasingly peddles ideology instead of science … that will lead to severe health consequences.” The three western states are banding together to coordinate their own vaccine policy.

Meanwhile, the state of Florida has just announced that it will become the first state to do away with all childhood vaccine mandates, eliciting strong objections from public health experts.

Can Vermont trust the health advice coming out of the federal government? What are the leading threats to public health confronting the state and country?

“It pains me to say, I don’t know that you want to trust the CDC,” said Dr. Becca Bell on The Vermont Conversation. Bell is associate professor of pediatrics at the Larner College of Medicine and a pediatric critical care physician at the University of Vermont Children’s Hospital. She is the immediate past president of the Vermont Medical Society and of the Vermont Chapter of the American Academy of Pediatrics. (Bell noted that she is speaking in her personal capacity, not on behalf of the organizations with which she is affiliated).

Bell said that “the officials that have left the (CDC) have really raised the alarm that … we shouldn’t trust what’s coming out of the CDC in terms of some immunization guidance in particular.”

She encouraged families to look to other sources for accurate information, especially the parenting website of the American Academy of Pediatrics, which represents 67,000 pediatricians. She also recommended the Vermont Department of Health and the Children’s Hospital of Philadelphia.

“Then I ask families to talk to their own child’s doctor, because that’s going to be a great source as well.” 

Kennedy, the Health and Human Services secretary, announced in May that the CDC would no longer recommend a COVID shot for healthy children. The American Academy of Pediatrics has issued contrary guidance, recommending a COVID shot for all children under the age of 2 since they are “especially vulnerable to severe COVID-19.”

Bell credited Vermont with being proactive “about how we can keep Vermonters safe,” but added that she feels “really sad” for the future of child health in the United States. “I think that we’re going to see a lot of disparities, not just with access to vaccination but access to health care in general, with the big Medicaid cuts that are coming up as well.”

Bell warned that Medicaid cuts, which will result in some 45,000 Vermonters losing health insurance, will fall hardest on children. One third of Medicaid enrollees in Vermont are children.

“What we’re about to see with that One Big Beautiful Bill Act (is) a huge transfer of resources from low income folks to the highest earners in this country,” said Bell. “Accessible, affordable health care is what kids need to succeed and for families to succeed, and so we are deeply concerned about the future of pediatric health care because our foundation is Medicaid. This is how we care for kids. It’s what supports our clinics.”

“The lack of investment in children is just really concerning and very short sighted.”

Read the story on VTDigger here: Vermont Conversation: Dr. Becca Bell on the chaos at the CDC, and the uneven future of vaccine access.

Representatives from Vermont’s Department of Health and seven other Northeastern states met last week to form a regional public health coalition that can respond to challenges passed down from the federal government amid dramatic changes brought on by the administration of President Donald Trump, such as disparities in vaccine recommendations or losses in lab funding. 

Vermont’s interim health commissioner, Julie Arel, confirmed that she and her principal adviser went to the meeting in Providence, Rhode Island, as did the state epidemiologist, lab director and other senior staff members in the Department of Health. The meeting was first reported by the Boston Globe.

Arel described a collaboration in its preliminary stages: “The intent of that meeting in Rhode Island was to start to say, ‘What is this thing?’ We haven’t really defined it. We haven’t really decided what it is we’re doing with this.” 

Still, she sees an increasing need for interstate collaboration as the federal Centers for Disease Control and Prevention restricts funding for lab testing and departs from scientific consensus on its immunization messaging. 

“The biggest issue for public health right now is the uncertainty coming from the federal government,” Arel said. “That level of uncertainty is really hard for entities that are as heavily funded by federal grants as we are.” 

No more than a week after the regional meeting, the federal center’s director, Susan Monarez, was forced out of the position, reportedly due to her objections to Health and Human Services Secretary Robert F. Kennedy Jr.’s efforts to change vaccine recommendations. On Wednesday, Monarez’s lawyers posted a letter on X that claimed her ouster was due to her refusal to “rubber-stamp unscientific, reckless directives and fire dedicated health experts.” 

The CDC’s chief medical officer, the director of the National Center for Immunization and Respiratory Diseases, the director of the National Center for Emerging and Zoonotic Infectious Diseases and the director of Office of Public Health Data, Surveillance and Technology all resigned that same day.

On Thursday, Vermont Sen. Bernie Sanders called for a bipartisan congressional investigation into Monarez’s firing, citing in his statement the dangers to public health posed by what he called a “reckless” and “dangerous” decision. 

The regional meeting last week centered on questions of infectious disease epidemiology, vaccines, laboratory sciences and emergency preparedness, Arel said. The coalition included all of the New England states except New Hampshire, as well as New Jersey, New York and Pennsylvania.

“There may be times where we are looking to provide more information than maybe the CDC is. But every state is going to need to do its own thing,” she added, explaining that the idea is that the regional coalition could be a source of guidelines and resources for states to act on independently. 

Attendees were particularly interested in discussing how states might navigate a situation where the CDC’s vaccine recommendations split from state health officials’ scientific consensus, Arel described. 

On Wednesday, the FDA issued approvals for updated Covid vaccines and removed emergency authorizations for their use, which had broadened access to the shots. Kennedy posted on X that the current authorization makes the Moderna, Pfizer and Novavax vaccines available to patients over 12 years old after consulting with their doctors. Still, the end of the emergency designation is expected to make it more challenging for individuals to get the shots without that approval. 

In a Thursday email to VTDigger, Vermont Department of Health spokesperson Kyle Casteel added that what qualifies as an underlying condition to make someone eligible for the vaccine, and how it is proven to someone administering the vaccine, remains unclear. 

The CDC is still expected to issue a recommendation for who should receive those vaccines. In June, Kennedy replaced the vaccine panel at the CDC with vaccine skeptics, and many worry that the panel’s recommendation may further limit access to Covid immunization when it meets in mid-September. 

“The approval of this fall’s COVID vaccine has not followed the typical approval process, and we are still assessing recommendations and potential impacts so we can provide guidance to Vermonters about who can get the vaccine and where,” Casteel wrote. “We are working to reduce any access barriers as much as we can and will keep sharing information as it becomes available.”

He added that the state will continue to communicate with counterparts in other states to inform how to move forward with the confusion surrounding the federal directives. 

Officials at the coalition meeting discussed areas of collaboration in which states can find efficiencies by acting as a larger group — such as buying bulk lab supplies as a region, which would bring cost savings to Vermont as a small state. When the loss of federal funding reduces resources for the state Department of Health, those savings can make a big difference, Arel said. 

Other ideas for collaboration would leverage regional cooperation in less tangible ways — like brainstorming and coordinating messaging, public information campaigns or collectively  strategizing on how to overcome public health challenges as they arise. 

The collaboration Arel described is still at the stage of laying the groundwork and relationships for when the need to collectively act arises: “We don’t want to get out ahead of anything,” she said. “A lot of it has been making those relationships stronger.” 

Read the story on VTDigger here: With CDC in chaos, Vermont joins regional coalition to navigate public health challenges.

Vermont’s opioid overdose deaths fell for the second year in a row in 2024, hitting their lowest annual tally in four years, according to the latest opioid annual report from the Vermont Department of Health. 

The department reported 183 Vermonters died of opioid-related overdoses in 2024, compared with 236 deaths in 2023. The drop was paralleled by falling deaths at a national level, according to data from the U.S. Centers for Disease Control and Prevention.

Deputy Health Commissioner Kelly Dougherty said her team was happy to see the decline in deaths, but noted they remain high — higher than pre-Covid-19 pandemic levels and higher than in 2015 when then-Gov. Peter Shumlin raised alarms about a rising rate of overdoses in the state.

Health officials had been encouraged by a drop in overdoses in 2019, only for the trend to reverse during the pandemic, when Vermonters saw their lives upended in a variety of ways. Recent years have also seen a continued rise in potent opioids like fentanyl and xylazine, often in combination with non-opioid drugs like cocaine. 

The Vermont Health Department and substance use organizations across Vermont have fought back by aggressively expanding access to naloxone, a medication that can reverse opioid overdoses and prevent them from becoming fatal. Dougherty said the department has distributed naloxone throughout the state, making it available online, in schools, at job sites and even in a few vending machines. 

The department has also widely distributed fentanyl and xylazine test strips and co-created the VT Help Link, a “one-stop shop” to access services and treatment. 

Dougherty said these initiatives are reflective of a shift toward seeing opioid use and substance use disorder as a medical condition that can be targeted with harm reduction strategies. 

Vermont has a handful of community organizations that distribute clean syringes. The state legalized safe injection sites in 2024, but the first site in Burlington is still in the planning stage. 

There are limitations to the overdose data. Dougherty said deaths are falling, but little is known about whether fewer Vermonters are using opioids or have substance use disorders. 

Tracie Hauck, executive director of the drug recovery group Turning Point Center of Rutland, said focusing on death data alone could be misleading. 

“From what I see in our community, things aren’t any better,” she said. “Crime is picking up again. You’re seeing people that are struggling health wise and have no place to live and are using substances.”

Hauck said a lack of supportive transitional housing for Vermonters in recovery is a gap that can make it hard for people to stay sober. 

“A lot of people we’ve sent to rehab are homeless to begin with,” she said. “So if they don’t go to a transitional living program after they complete rehab, they’re back out on the street and there’s no housing for them.”

People without stable housing often find themselves in “survival mode,” leading them back toward substance use, Hauck said. 

“People don’t have phones. They don’t have reliable transportation. They don’t have stable housing, so they’re just in survival mode continuously,” she said. “And that doesn’t lead to real, good, solid recovery because their stress level continues to be so high.”

Hauck said a more holistic approach to substance use disorder is needed that incorporates a person’s mental and physical health, housing, and interactions with the criminal justice system. 

Dougherty echoed the need for more transitional housing along with “step-down” facilities that can help rehabilitate people after their initial medical withdrawal. 

Both urged Vermonters to look past their assumptions and judgements about drug use and consider the human beings affected by the opioid crisis. 

“These are people — 183 people who were somebody’s loved one, somebody’s friend, somebody’s family member,” Dougherty said.

Hauck said despite her reservations about focusing solely on deaths, she still favors harm reduction measures like naloxone that offer people more chances to seek help.

“I am not anybody’s higher power to decide whether they should live or die, and I don’t think any other human being is, but I just know sometimes it takes a lot for someone to go through before they make that decision to get involved in recovery,” she said. 

Hauck said she has seen people on Facebook complain about the distribution of naloxone without considering the full implications of not having it available. Anyone can risk opioid overdose when drugs like cocaine are so frequently contaminated with them.

“They’re not pausing and thinking about how tainted our supply is and how far that reaches, and to who that reaches to,” she said. “It’s not just people with substance use issues. It’s people that use recreationally.”

Dougherty said she was concerned about potential changes to the health care system being discussed at the federal level. Congress and President Donald Trump are working on legislation that could lead to Medicaid cuts. The Trump administration has proposed cuts to the U.S. Substance Abuse and Mental Health Services Administration. 

None of the Vermont Department of Health’s harm reduction services rely on federal funding, Dougherty said. But Medicaid pays for many substance use services in Vermont, so the department is worried about cuts overall, she said. 

“We’re just bracing generally at the health department, beyond substance use, because it’s like a full-out attack on public health,” she said. 

Read the story on VTDigger here: Vermont opioid overdoses fell in 2024 for the second year in a row.

Shawn Burke has been Burlington’s interim chief of police for just over a month. Two weeks into the job, he had to use Narcan, the life-saving treatment that can reverse the effects of an opioid overdose, for the first time in 10 years.

Driving around Orchard Terrace early in the morning, he witnessed a man he thought was sleeping and went to check on him. As he tried to wake him up, Burke realized the man was overdosing and ran back to his vehicle to retrieve a dose of Narcan.

“It’s sad,” he said, speaking to a crowded conference room at City Hall Wednesday night. “People have made decisions in life, but I really believe that ultimately, they never envisioned this.”

Burke’s experience, recalled during the packed Ward 3 Neighborhood Planning Assembly meeting, underscored what has become a new normal in the city of Burlington. At the meeting, more than three dozen people gathered with various city officials to discuss the city’s newly approved plan for an overdose prevention center and, more broadly, the overwhelming substance use crisis that has plagued the city’s downtown core.

On April 28, the Burlington City Council unanimously approved preliminary plans for the center, green lighting the project’s planning phase, which is expected to take nine to 12 months. It’s seen by many as a crucial development to curbing the city’s staggering overdose and substance use crisis.

“This is a hugely important step on this journey that we’ve been undergoing here as a community,” Council President Ben Traverse said at last week’s council meeting. “I think every one of us has either been directly impacted by the loss of someone to this crisis, or if not us individually, we certainly know someone who has lost a loved one to this crisis.”

Now the question becomes where to put it. Finding a location for the center could quickly become a major hurdle.

City officials and others close to the project say it makes little sense to site the facility anywhere other than downtown, which officials have called the epicenter of the substance use crisis in Burlington.

“This won’t work if it’s not somewhere downtown,” said City Councilor Evan Litwin, who represents Ward 7 — outside the downtown core — before voting on the center’s approval last week. “It’s not going to work if it’s in an area that isn’t accessible and near the folks who need the services.”

“All the studies around OPCs that are operating in other parts of the world … (show) it has to be where the activity is,” Central District City Councilor Melo Grant echoed at the neighborhood meeting for Ward 3, which is part of the Central District and includes the downtown core. “The Central District is the epicenter of the epidemic, not only in Burlington, but in Chittenden County and probably Vermont, given the number of incidents,” Grant said.

But for downtown residents and property owners, that idea will be a tough sell, and the prospect of locating the center downtown is already facing opposition. 

Neighbors say that’s in part due to their experiences with existing harm-reduction programs like needle exchanges, where sterile syringes are provided to prevent the spread of disease like HIV or Hepatitis C. There is one run by the Howard Center’s Safe Recovery program on Clarke Street and one run by Vermont CARES on Bank Street.

The Ward 3 neighborhood group approved a resolution that “vigorously opposes” the center’s establishment in the downtown core. The resolution calls for the city to place it near a medical facility, instead.

“This is for us to draw our line in the sand,” said Zach Cummings, a member of the neighborhood group. “Ward 3 residents and downtown residents cannot take anymore pressure from unaccountable … social services.”

‘It can save lives’

The idea of an overdose prevention center has been a dream of advocates for years, before newer synthetic drugs like fentanyl and xylazine started mixing into the local drug supply.

While fatal overdoses statewide have begun to decline for the first time since 2019, overdose deaths remain well over levels in years past. Centers for Disease Control and Prevention data shows that overdose deaths in the state have soared, from 78 in 2015 to 257 in 2023.

The idea came closer to a reality last year, when lawmakers established a legal framework and funding needed for the facility. Lawmakers overrode Gov. Phil Scott’s veto in June to pass that law.

The bill allocated $1.1 million from settlements with pharmaceutical companies that produced and sold opioids to fund the center in fiscal year 2025. The bill’s language also states that the funding for the project should continue to be available through at least 2028.

The center will be operated in partnership with Vermonters for Criminal Justice Reform, a Burlington-based provider of harm-reduction treatment and recovery services. 

Visitors will be allowed to smoke or inject pre-obtained illegal substances there while being observed by trained staff equipped to respond to overdoses and other emergencies. Sterile syringes will be kept in-house at the overdose prevention center for people to access.

“Somebody is there, physically present, able to reverse an overdose,” Tom Dalton, the group’s executive director, said in an interview. “That’s part of what excites me, is knowing that people are going to have an option that can help them survive.”

The center will also host a number of other services, said Theresa Vezina, the city’s special assistant on overdose prevention center implementation, including wound care and other medical services and substance use treatment options. Case managers will be on hand to direct those utilizing the center to mental health services, housing support and other social services, she said.

Vezina said the goal is to eventually have food, showers and laundry available, to create a place that can function as a one-stop shop for harm-reduction and treatment services.

“We know that this can make a difference,” she said. “It can save lives.”

But concerns and questions remain about its location, which will need City Council approval. Litwin said he expects it to be “a tough conversation.”

“There is not necessarily going to be broad agreement on the council about where to put it,” he said in an interview. “I also think we’re going to run into NIMBYism. I think some of that NIMBYism will be misplaced, and some of it will be very well placed.”

‘We already have crime’

The question of location, and community opposition to its placement downtown, represents perhaps the last major roadblock to the center’s opening.

Vezina, at the neighborhood meeting, said the new law requires the city to conduct a comprehensive service assessment for its location, with a robust public engagement process before any site decision is made.

While Vezina anticipates the center will eventually be placed somewhere downtown, she said city officials are still months away from finding a location. A major part of the planning phase, she said, will be finding a suitable building that can be retrofitted to meet the needs of the center.

She told residents that the city would prioritize engaging with the community, and noted “past mistakes” the city has made, referring to the process for locating an emergency shelter on Elmwood Avenue, known as the “pods.”

“Public discourse is going to be really important,” she said. “We don’t all have to agree. I think that there are absolutely concerns that people have that are valid. We want to make sure that we are hearing your concerns, otherwise we won’t be able to address them.”

Residents at the neighborhood meeting, however, pointed to Clarke Street, where “things have gotten worse,” Amy Kimmel, who owns property on the residential block with her partner Rob Perry, wrote in an email to city councilors. “There is constant loitering and open drug use on the Howard Center property everyday, throughout the day.”

Perry said neighbors have been at a loggerhead with the Howard Center for months over what they describe as negligence. The Howard Center has not prevented bad behavior from spilling out onto neighboring properties, nor has the center reined in syringe litter in the neighborhood, Perry said.

Perry has since garnered more than 200 signatures on a petition calling for the removal of the needle distribution program from Clarke Street.

“You talk about the drug user being the only victim,” Perry said to Burke at the Ward 3 meeting Wednesday night. “I don’t think that’s true. I think the neighborhood, the people who are around, are also victims of very clear abuse.”

The organization has operated the needle exchange program on Clarke Street for more than 20 years, “playing a vital role in advancing public health,” said Mike Glod, a senior development and communications director with the Howard Center, in a written response to VTDigger.

Glod said the site has seen a significant rise in need in the past two years and acknowledged the site has “has not been immune” to the quality of life issues, an “unfortunate reflection of the broader crisis gripping our city.”

He added that the Howard Center is committed to being a good neighbor and said they were taking steps “to safeguard both those seeking our services and the surrounding neighborhood.”

The situation on Clarke Street has drawn criticism from city officials, including both councilors Litwin and Grant.

Litwin, who commissioned a Board of Health report that calls for enhanced efforts to collect syringe litter, said, “If they’re not going to be able to operate by a standard of being a good neighbor, I don’t know how long they can operate there.”

Grant, the Central District councilor, in an interview, agreed that the Howard Center should be doing more to prevent issues on the block that affect neighbors’ quality of life.

“As a provider, they need to move people along,” she said. “Things like shopping carts and things like that, that’s not OK. As a provider, you need to take more responsibility for that space.”

But Grant noted removing the program would lead to an even more devastating health emergency. Syringe service programs have been shown to prevent the spread of diseases like HIV or Hepatitis C, according to the U.S. Centers for Disease Control and Prevention.

Drawing similarities to the debate over the overdose prevention center, she also pushed back against the logic that the needle exchange is causing the problem, rather than the drug epidemic itself.

“This idea that we’re going to have more crime — we already have crime,” Grant said in an interview. “We already have quality of life issues that already exist. The idea that this will make it worse is simply not true.”

‘Expectation setting’

Vezina stressed in an interview the importance of following research when searching for a location.

“We all know there are going to be community concerns, but we’re going to be following the data,” she said. “We’re going to be utilizing the hot spot data about where overdoses are happening.”

City officials have offered the prevention center as a solution not just to the overdose crisis, but also to broader issues such as syringe litter, the strain on the city’s emergency services, as well as on harm-reduction service providers.

“I don’t think anybody wants to stand up an overdose prevention center in their community, because at the end of the day, it means we have a serious overdose problem,” Litwin said. “But what I have tried to impress upon people is that they will benefit from this in many ways.”

Vezina said issues raised by residents could be addressed by the new facility.

“Some of these behaviors and things that are happening at other service providers’ locations, hopefully they won’t happen there anymore, because there will be an OPC,” she said.

That may not be convincing enough for residents. Christopher Haessly, a downtown resident and member of the Ward 3 neighborhood group, said the resolution the group passed Wednesday “seeks to strike a balance between those in favor of the OPC and those opposed.”

While he understands the importance and need for the overdose prevention center, Haessly said a downtown location will “adversely impact the Church Street Marketplace.”

During the meeting, Elmwood Avenue resident Trudy Richmond asked Burke for his thoughts on putting “that shoot-up site” downtown “that’s going to draw more people, unsavory folks to our area.”

Burke said there are “a lot of friction points here in Burlington because we are the hub for all the social services, regardless of what neighborhood we might be in.”

“If we’re going to incentivize and resource folks for success, what in turn should the community expect from the people?” he said. “That’s a bigger question than location, and more about expectation setting.”

Read the story on VTDigger here: Burlington’s overdose prevention center has City Council approval. Now the question is where to put it..

The United States is in the midst of a surge in measles cases driven by unvaccinated children. 

The U.S. Centers for Disease Control and Prevention has reported 483 measles cases so far in 2025. If the current pace of spread were to continue, it would make this year the worst for measles in the 21st century. 

About 97% of cases have been in unvaccinated people or people with unknown vaccine status, the CDC reported. Three-quarters of cases have been in people under the age of 20. Seventy people have been hospitalized, and one school-aged child has died in Texas. Another death is under investigation.

Cases have been highest in Texas and New Mexico, according to the CDC. Vermont has been mostly spared thus far, with only one travel-related case reported by the state Department of Health. 

But health officials here are worried about one key statistic: The state’s measles vaccination rate for incoming kindergarteners has been below 95%, the critical “herd immunity” threshold that can prevent individual cases from becoming outbreaks. 

For the 2023-24 school year, the most recent year available, 93% of kindergarteners in public or private schools were up-to-date on their MMR vaccines, which provide protection against measles, mumps and rubella, according to health department data. Adults are also recommended to receive the MMR vaccine if they do not have evidence of vaccination or immunity. 

Even fewer, 91%, were fully immunized with all the required childhood vaccinations, which also include protection against diphtheria, tetanus, pertussis, chickenpox, polio and hepatitis B. 

“If we have 95% of people vaccinated, it would stop the spread,” said Merideth Plumpton, the department’s immunization program director. “Right now in Vermont, we’re below that.”

The measles vaccination rate for kindergarteners in Vermont is similar to the nationwide one, according to a research paper from the CDC. But the state has the second-lowest measles rate in New England, above only New Hampshire. It’s also lower than neighboring New York state. 

While 93% may sound close to 95%, that gap makes a real difference when it comes to herd immunity, Plumpton said. The 95% threshold is effectively a tipping point where vaccinated people act as a buffer, keeping the 5% of the community from coming into contact with each other.

“It just means that if we have a case, the likelihood that it’s going to spread is pretty high, especially if the child goes to school or child care during their infectious period,” she said.

Among all school-aged children, the rate of vaccination was higher, about 96% for the MMR vaccine. But facility-level data, which VTDigger obtained from the health department, shows that the statewide vaccination average was only part of the picture — in reality, many schools are far below the average.

About 26% of K-12 schools and 23% of child care facilities did not meet the 95% vaccination threshold for measles, the department data showed. In three counties — Lamoille, Orleans and Washington — the percent of facilities that do not meet herd immunity rose above 33%.

Vermont requires children entering child care facilities or K-12 schools to receive five vaccines that protect against nine potential childhood illnesses. Students at residential schools, also known as boarding schools, and incoming residential university students are also required to receive the vaccine against meningitis. 

But children can be exempted from those requirements for three reasons: provisional admittance for children with upcoming vaccination appointments, a medical exemption approved by a health provider or a religious exemption where parents attest to “holding religious beliefs opposed to immunization.”

For the 2023-24 school year, only 0.2% of children were medically exempted, 3% were provisionally admitted and 3% were exempted for religious reasons, according to the health department. 

Plumpton said the lowest vaccination rates tend to be found in the state’s most rural areas. “It could be a combination of lack of access and attitudes towards vaccines,” she said. 

Independent schools, which includes private and religious schools, also tend to have lower vaccination rates than public schools, according to the department data. 

Vaccination hesitancy has been bolstered in recent years by anti-vaccine sentiment connected to the Covid-19 vaccine, Plumpton said. The Trump administration has also placed the longtime anti-vaccine activist Robert F. Kennedy in charge of the U.S. Department of Health and Human Services, one of the most powerful public health roles in the nation. 

Plumpton emphasized that most Vermont families still choose to have their children vaccinated. But it’s natural for parents to have questions about the vaccines they’re giving their children, she said. 

“As a parent, I want to make the best decision that I can for my child, and I can only make that decision based on the information that I have,” she said. “And we’re in an age where there’s information everywhere, so it’s really hard to know what the correct information is or where to go to get good, solid, sound, scientific information.”

She encouraged parents to check out reputable websites like Vaccinate Your Family and VaccineInformation.org, which both have thorough FAQs about the safety and efficacy of each vaccine. 

She also encouraged them to discuss their child’s vaccine schedule with their primary care provider or pediatrician. Vermont provides recommended vaccine doses for children and adults at no cost to health care providers. 

But her message to Vermont parents was clear: Measles is a highly contagious virus that can lead to severe illness and death, and “vaccines are the best defense against the illnesses that you’re getting vaccinated against.”

“They’re not going to prevent 100% of the diseases,” she said. “That’s not the way vaccines work. But they’re really highly effective at preventing hospitalization and really serious illness. And there’s a reason that we have these vaccines.” 

You can use the tool below to browse school and child care vaccination rates, or check out the Department of Health’s vaccination dashboard for a fuller picture by year and county.

Clarification: This story was updated to note an additional death under investigation.

Read the story on VTDigger here: Hundreds of Vermont schools and child care facilities do not meet herd immunity threshold for measles.

This is the first story in a two-part series that looks back on the impact of Covid-19 in Vermont after five years. The second story, “A visual history of Covid-19’s path through Vermont,” can be found here.

Five years ago, Vermont health officials announced the first confirmed case of Covid-19 in the state. 

Since then, 1,200 Vermonters died from Covid, countless residents were infected and hundreds of thousands of Covid jabs were put in the arms of Vermonters. 

Last month, the health department announced that it would stop publishing Covid death and case data after years of daily and weekly tracking. The change is the latest shift in how Vermont now views Covid as an “endemic” disease, more like the flu or other seasonal illnesses than a pandemic that stands as the forefront of public health priorities. 

Vermonters have gotten older, but has the state gotten wiser? Are officials better and more prepared to tackle public health crises as they arise? Or is Vermont primed to repeat a cycle of needless suffering and death?

The legacy of Covid goes well beyond the impact of the virus itself. Covid has left Vermont with tools that could help address longtime public health challenges along with emerging threats — and with vulnerabilities in public trust and health systems. 

Officials at the Vermont Department of Health say that Covid was the most daunting challenge they have ever faced, but it left them with new tools and structures that they have implemented in their day-to-day work. 

They also celebrated the state’s track record with the virus. Vermont has one of the lowest Covid death rates in the nation, behind only Hawaii and Puerto Rico, according to the U.S. Centers for Disease Control and Prevention.

But that’s not how Anne Sosin sees it. A lecturer at Dartmouth College and health equity researcher, Sosin reflected on how Covid revealed disparities in Vermont society that continue to today. 

Sosin said Covid has added to the “burden” of illnesses like flu and RSV on hospitals and health care workers in the winter months. It has also added a “large footprint” of disability, she said. While long Covid is the most well-known aftereffect of contracting Covid, experts are just beginning to understand how a Covid infection can cause long-term health impacts on multiple body systems. 

Covid has left Vermont — and the nation — with a lasting legacy of mistrust and misinformation, one that appears to be affecting public health response at a federal level, Sosin said. She said the measles outbreak spreading in the U.S. has been fueled by vaccine skepticism that began long before the Covid pandemic, which then amplified it. 

“We’re gonna see a lot of tragedies over the next few years,” Sosin said. “It’s going to get a lot worse before we, ultimately, recognize we have to rebuild.”

Mark Levine, the outgoing commissioner of the health department, echoed that concern in an emailed statement.

“While when compared to national data Vermont remains a leader in immunization – even with numbers I would not brag about – it worries me that the uptake on preventative measures like vaccination has declined so shortly after the pandemic reminded us why they are so necessary,” he wrote.

Pandemic-era innovations

Covid has left a mark on how the health department is able to respond to other public health challenges, staff said. 

One of those developments has been Covid wastewater surveillance, which allows state and local governments to measure virus levels in a community by taking samples at wastewater treatment plants. 

“Wastewater surveillance was done in academic institutions and for research purposes prior to Covid, but it really became a public health tool during Covid,” said Patsy Kelso, the state epidemiologist. 

The department’s public health lab is now gearing up to use wastewater surveillance to measure mpox, seasonal influenza and Candida auris, a hospital-related illness, she said. 

The scientific community is also investigating how to utilize mRNA vaccines, developed for Covid, on other infectious diseases like the flu as well. Antigen tests that can detect both Covid and the flu are already on the market. 

Helen Reid, then the state director of health surveillance, said the pandemic also revealed the need for the state department of health to work more closely with community groups that represent marginalized Vermonters. Covid had a disproportionate impact on Vermonters of color, older residents and people with disabilities. 

“The very first year of Covid really sort of laid bare what we’ve known for a long time, which is that health disparities have an impact on high-risk populations and underserved populations, and we saw that in Covid time and time again,” said Reid, who now leads the health department’s infectious disease division. 

Vermont responded by targeting vaccine outreach to those individuals, and some of that effort has changed the way that the health department continues to collaborate with marginalized communities. The health department just had its first “tabletop” exercise — an emergency-preparedness simulation — with community groups like Migrant Justice and Bridges to Health, she said. 

Sosin also noted the importance of community organizations in responding to Covid in a different way. Early in the pandemic, local efforts like mutual aid groups formed an integral part of helping to reach vulnerable Vermonters. 

“Early in the response that communities would … have a telephone tree, and they would see who was at risk, and they would shop for groceries (for those people),” she said. “We don’t sometimes think of that as public health, but those are the things that enable people to comply with public health.” 

The pandemic response at a state and federal level included a vast expansion of social programs that directly — and indirectly — affected people’s health. 

“We saw the unprecedented use of housing policy as a tool for pandemic control” with the housing of unsheltered Vermonters in motels and the moratorium on evictions, Sosin said. 

The federal government expanded Medicaid eligibility, extended the Child Income Tax Credit and provided several stimulus payments. Those initiatives had a concrete impact on child poverty in the years they occurred. 

The federal government also lifted restrictions on telehealth, which was beneficial to rural health access, she said. “Unfortunately,” she said, that flexibility is about to end unless the federal government extends it — one of many programs Sosin said was at risk. 

‘Emerging threats’

In the early months of 2025, President Donald Trump issued executive orders withdrawing the U.S. from the World Health Organization and cutting foreign health aid. His administration announced hundreds of millions of dollars of funding cuts to institutions conducting health research, something that has Sosin worried about the country’s ability to prepare for future health challenges. 

“We need to be able to generate evidence in real time in response to emerging threats. And research institutions play a critical role in that,” she said. “The existence of research infrastructure was critical to really understanding Covid-19 and to developing tools to respond to it” — from therapeutics to testing to vaccines. 

Those threats include bird flu or H5N1, which has infected poultry and dairy livestock nationwide and sickened humans, primarily farm workers. The U.S. has also recently seen a surge in measles cases led by an outbreak in western Texas. Experts have linked the rise in measles to a decline in childhood vaccination rates. 

“There’s been some conversation around (bird flu) and its pandemic threat potential. And to some extent, I think that that’s the wrong question,” she said. “The question is not about just the pathogen and what its trajectory will be, but rather, how prepared we are to respond as a state in the absence of the policy response and federal infrastructure? How are we going to do this without the federal resources coming our way?”

She referenced newly confirmed U.S. Secretary of Health and Human Services Robert F. Kennedy, Jr., who has a long track record of anti-vaccine activism. Kennedy has recently recommended unproven health supplements to treat measles while casting doubts on the safety of the measles vaccine amid a growing outbreak. 

“There is a large political economy that’s fueled the rise of RFK and other extreme figures,” she said. 

Sosin said the “abdication” of health response at the federal level has highlighted how important state leadership will be going forward. “The state needs to prepare for the vacuum of federal leadership.”

Levine — who declined to be interviewed by VTDigger on the Covid anniversary, citing travel plans in the days prior to his departure from his role at the health department — shared similar concerns about the federal government to Sosin in an emailed statement. 

“The turbulence we are seeing in public health at the federal level only underscores the point that here in Vermont, we have to be willing to do what it takes to be good neighbors to each other and protect our communities,” Levine said via email. 

His top takeaway: Vermont, get vaccinated. Despite the state’s initial progress on the vaccine, uptake for Covid and flu shots have fallen in recent years.

“My hope is that what we are seeing in our vaccination rates is a temporary setback, and that it will not take another dire public health emergency to find out if we have learned the right lessons,” he wrote. 

Correction: An earlier version of this story was wrong about the current job title of a public health official with the Vermont Department of Health.

Read the story on VTDigger here: New technology, and mistrust, is legacy of Covid-19 for Vermont public health.

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, then 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,” said Reid, who now heads the department's infectious disease division. “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.” 

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. 

Correction: An earlier version of this story was wrong about the current job title of a public health official with the Vermont Department of Health.

Read the story on VTDigger here: A visual history of Covid-19’s path through Vermont.

The Vermont Department of Health has confirmed a case of measles in a school-aged child in Lamoille County — the first to be discovered in 2025. 

The unnamed child became sick after travelling internationally with family. The risk to the public is believed to be “low,” but Vermonters who may have been exposed to the child at the Copley Hospital emergency department may need to take action to protect others, according to a Tuesday press release from the department. 

The child tested positive Monday after visiting Copley Hospital in Morrisville the day prior. Anyone who was inside the hospital’s emergency department between 3:15 p.m. and 6 p.m. on Sunday should confirm their immunity to measles through vaccination or previous infection, and monitor for symptoms through March 30, according to the release.

If you cannot confirm your immunity by contacting your health care provider or requesting your immunization records, you should call the health department at 802-863-7240, option 2 for guidance. 

Although this is the first case of measles reported in the state in 2025, there were two documented cases in 2024, one in 2018 and another in 2011, according to the release. 

This most recent case has not been linked to ongoing outbreaks in the southern United States and Québec, according to the department. The U.S. Centers for Disease Control and Prevention has reported more than 200 cases of measles so far this year, up from just 58 in 2023. 

Health department officials urged Vermonters to get themselves and their children vaccinated for measles. 

Health officials attribute the recent uptick in measles, in part, “to an increase in the number of unvaccinated people, which impacts community immunity,” the department said in the release. About 93% of school-aged children in Vermont are vaccinated for measles — below the 95% benchmark that experts believe is essential for herd immunity. 

Measles is one of the most contagious diseases worldwide and can be deadly, especially in children under 5. One in five unvaccinated people with measles end up hospitalized for the disease, according to the release. 

Symptoms of measles include a high fever, a cough, and a rash a few days after initial symptoms appear. For more details about measles symptoms, how the virus is spread and how to get vaccinated against the disease, visit the health department’s website. 

Read the story on VTDigger here: Vermont reports case of measles in school-aged child .

The Vermont Department of Health has stopped including data on Covid-19 cases and deaths in its weekly surveillance reports. 

The department posted on its website on Feb. 19 that Covid data reporting would transition to “to a format similar to other respiratory viruses like the flu.”

The latest surveillance update contains data on emergency department visits for Covid, the proportion of variants from clinical specimens, Covid levels in wastewater sampling and a count of the latest outbreaks. 

Emergency department and wastewater data suggest that Covid levels are on the decline from a relative surge in December and January.

The department said on its website that case data has become “a less meaningful” indicator of Covid trends as individual cases have been reported on a limited basis by health care settings and laboratories. Officials have warned that case data, based on PCR testing, has been less accurate since the widespread adoption of antigen testing in 2022. The department stopped publishing daily Covid case counts in 2023. 

“Reporting of individual SARS-CoV-2 infections to public health has become increasingly sporadic as testing patterns have changed (including widespread use of at-home testing),” state epidemiologist Patsy Kelso wrote in an email when asked if there was a specific justification for the more recent shift.

A higher proportion of Covid infections now tend to be asymptomatic, Kelso said, meaning they were less likely to require health care intervention that would result in a Covid PCR test. 

Data on individual test results is no longer being analyzed at the federal level or published in the U.S. Centers for Disease Control and Prevention’s Covid tracker, a change made in 2023. The disease is still reportable on a state level, meaning health care providers, laboratories and certain other officials are required to report positive cases to the health department, according to Kelso.

When it comes to Covid deaths, the department said it stopped releasing death data because Covid has shifted from being the underlying cause of Covid-associated deaths to only a contributing cause.

When asked for more details on that shift, Kelso said 87% of deaths associated with Covid in Vermont had the disease as an underlying cause early in the pandemic, compared with 55% during the Omicron wave. Omicron has been the dominant strain of the Covid-19 virus in Vermont since early 2022. 

The final surveillance update with death data, released Feb. 12, reported that 1,258 Vermonters had died from Covid since the beginning of the pandemic, including 16 in January. The CDC continues to publish provisional mortality statistics, including for Covid, on a national basis in its database. It’s unclear what data will be published on Covid deaths from Vermont through the CDC. 

Read the story on VTDigger here: Vermont stops publishing Covid-19 death and case data.

Vermont Health Commissioner Mark Levine told lawmakers Tuesday that the risk of avian flu in the general public is overall low, although farm workers may be at higher risk of contracting the condition.

At a joint hearing of the House health care and agriculture committees Tuesday afternoon, Levine told legislators the federal Centers for Disease Control and Prevention “continues to list avian influenza as a low-risk proposition for humans and the general public.” 

“Though if you’re a human who happens to work on a farm or works in a poultry capacity, your risk is higher than low,” he added. “But it’s still not necessarily super high.”

The hearing comes amid rising anxiety over a possible severe avian flu outbreak in a nation still traumatized by the Covid-19 pandemic.

Avian flu, also known as H5N1, has been spreading in wild and domestic birds and mammals over the past two years, Levine said. The virus is particularly deadly in bird populations, Levine said, but is less so in mammals. The virus has been detected in herds of dairy cattle in multiple states — most frequently in California — but so far none in New England, Levine said. 

In Vermont, H5N1 has been detected in 100 wild birds, five backyard bird flocks — one in Franklin County and one in Windsor County — and one bobcat. 

In the U.S., fewer than 70 people have been confirmed to have been infected with H5N1, and only one — a patient in Louisiana with underlying health conditions — has died. Almost all have had “mild cases,” Levine said, and most have been workers in the dairy industry.

No transmission between humans has been detected, Levine said, and no Vermont residents are known to have contracted the virus, he said. 

Even so, Vermont is taking steps to monitor and protect residents against the virus.

The state Department of Health and Agency of Agriculture, Food & Markets have offered protective equipment to farmworkers. The agriculture agency is testing milk from dairy farms every month and monitoring when cows are moved across state lines. 

If the virus is detected at a farm, the health department will conduct testing, contact tracing and will monitor workers for symptoms. Health department officials are also monitoring flu patients in hospitals, and over the summer, the department conducted tabletop exercises simulating an outbreak on a farm.

At the hearing — which was paused once for a round of applause for Levine, who is retiring at the end of next month — the health commissioner urged Vermonters who work with livestock to practice caution.

Residents should wash their hands after contact with animals or animal products, wear boot covers or clean their boots to avoid bringing the virus indoors, and cover their eyes and mouth while spending time around livestock, said Levine, a medical doctor.

Lawmakers still expressed concern at the possibility of a larger outbreak. Rep. Brian Cina, P/D-Burlington, asked whether wide-ranging cuts at the federal government under the Trump administration could hinder the country’s ability to weather another pandemic. 

“What is the impact of federal policy and funding changes to the CDC and (National Institutes of Health) on the nation’s ability to respond to a flu pandemic or a covid pandemic resurgence?” Cina asked.  

Levine acknowledged the question was a difficult one. For the moment, though, the CDC has been left largely unchanged, he said, although a federal secretary of health and human services has yet to be confirmed.  

Either way, health officials in Vermont are keeping an eye out for what Levine called the “nightmare scenario,” in which an individual contracts both avian flu and the standard flu, and the viruses exchange genetic material and mutate to become transmissible between people.

“You can call it science fiction or science, but it is something that is potential,” he said. “But we have not seen it at this point.” 

Read the story on VTDigger here: Health commissioner tells lawmakers risk of avian flu to general public is ‘low’.

This commentary is by Mike Selick of Burlington. He is the associate director of capacity building for the National Harm Reduction Coalition, and a social worker with more than a decade of experience working at, running and supporting harm reduction programs around the country. 

Syringe service programs are a highly effective intervention that have been studied in the U.S. for decades. According to the Centers for Disease Control and Prevention, SSPs reduce HIV and hepatitis C, and connect people to drug treatment. A CDC webpage states that SSP participants “are more than five times as likely to enter treatment for a substance use disorder and nearly three times as likely to report reducing or discontinuing injection as those who have never used an SSP.” Burlington has had a SSP for nearly 25 years. The CDC’s research also proves that SSPs do not increase drug use or crime.

Despite these well documented successes, the Burlington City Council recently unanimously passed a resolution on “evaluation and improvement of syringe exchange programs, syringe litter, and the environmental impact of syringe disposal in Burlington.” While this resolution seeks to address community concerns, it makes bold assumptions insinuating that significant amounts of syringes given out in our city end up on our city’s streets.

In fact, the city’s own data shows that there have never even been more than 1,000 reports of syringes found on SeeClickFix in a year, which is substantially less than the amount of syringes that are not returned to an SSP. This is because there are safe ways to dispose of syringes without returning them to the program.

I understand people’s concern about discarded syringes as a public health risk, but the risk is much lower than most know. In the U.S., there have been no known cases of HIV transmission due to a needlestick injury from a discarded syringe and hepatitis B and C transmissions from needlestick injuries have occurred very rarely.

The risk of blood-borne infection from needlesticks is lower because of how effective SSPs are at both preventing infection and reducing syringe litter. However, if you are stuck by a syringe, you should wash the wound well with soap and water and seek medical attention to ensure you are not a rare case of transmission.

Regardless of how essential syringe service programs are, I think we can all agree that we wish there were no discarded needles or syringes on our city streets and in our green spaces. There is much our city can do to reduce syringe litter, and advocates have been recommending solutions for years.

In fact, a decade ago the Burlington Board of Health and the City’s Council’s public safety committee collaborated with city workers and providers to develop recommendations. Many of those recommendations have not been fully implemented. They include investing in more and larger syringe drop boxes in public settings, providing material support for the syringe service program, investing more in city cleanup efforts, and education and outreach about safe syringe disposal.

Syringe litter is easy and safe to clean up if you know what to do. In fact, Vermont’s Department of Health recommends that if you see a syringe, you pick up yourself. They have put together an informational video on their website to provide guidance on how to pick up a syringe, put it in a safe container, and throw it in the trash. Together, we can make an impact ourselves.

On Dec. 1, in honor of World AIDS Day, we will be meeting in City Hall Park at 10 a.m. to do a syringe litter cleanup in downtown Burlington. All volunteers interested in helping to clean up our city are very welcome. I hope that city officials will join us as well. If you would like to help. please come meet us in the park and bring heavy-duty gloves, pliers or tongs, and a thick plastic container like a laundry detergent bottle.

We will have some supplies available, but encourage participants to bring their own to ensure we have enough for everyone. Volunteers will learn how to safely pick up and dispose of syringes before we split into teams to clean up. Wear long pants and closed-toe shoes as well.

Together, we can show the power of community-driven solutions and encourage the city to join us. Let’s work to make Burlington safer, more beautiful and more enjoyable for all. I hope to see you at 10 a.m. in City Hall Park on Dec. 1.

Read the story on VTDigger here: Mike Selick: Syringe service programs work. Let’s work together on syringe litter..

When Maria Rossi started working with at-risk teens in Washington County almost two decades ago, she quickly spotted inequities that low-income pregnant people face in accessing prenatal and postpartum care.

As a caseworker at Washington County Mental Health Services, she had pregnant clients, many of whom were covered by Medicaid, the joint federal and state public health insurance program. She recalled encountering “enormous differences” between families who could afford to hire her as a private doula and the young people she was working with.

“That population just had no access at the time to childbirth education. They had no access to all of the sort of warm and fuzzy things that people with resources do like taking a yoga class. They often didn’t have transportation to their prenatal appointments,” she said in a recent interview. Many of them, she added, were in addiction recovery, requiring “a whole other layer of special care.” 

Rossi saw a need for doula services and started offering some of the clients her services for free and soon pitched the idea of a special program to make such care available to at-risk and underserved people. 

Today she runs The Doula Project, which has provided all Washington County families with free doula services since 2021 thanks to a mix of federal and grant funding. “People have just really been so grateful and happy to have the service here,” said Rossi.

Now, she is among those urging Vermont lawmakers to expand statewide access to doula services.

A bill to pave the way

Fourteen states have implemented Medicaid coverage for doula care and many others have efforts underway, according to the National Health Law Program’s doula Medicaid bill tracker.

Advocates have been pushing the state to provide Medicaid coverage for doula services for years. Prior efforts to provide the benefit in 2014 and 2019 failed. 

A bill making its way through the Vermont Legislature this year made another attempt at doing so. In its original form, S.109 would have required Medicaid to pay for doula services, but the legislation has since turned into a study. 

Doulas are non-clinical professionals trained to support pregnant people and their families before, during and after a birth. Doulas are not currently licensed or regulated in Vermont. The revised bill tasks the Office of Professional Regulation with exploring the process for professional certification or licensure, a federal requirement for Medicaid allocation. The report, due in 2025, could lay the groundwork for state regulation, legislators backing the bill explained.

Proponents of S.109 also see it as the first step toward the ultimate goal of requiring Medicaid to cover up to $850 for doula services.

The Senate passed the bill on March 13, and it’s now under review in the House Committee on Health Care. Its sponsors are optimistic it will pass this session.

One of those sponsors, Sen. Martine Larocque Gulick, D-Chittenden Central, told VTDigger she had a positive experience using a doula for herself years ago “so it was something that felt near and dear to my heart.”

“I was fortunate to be in a position of privilege and to have the financial wherewithal to afford a doula for both of my births,” Gulick said. “But I’m well aware that not everyone can do that.”

‘Work worthy of payment’ 

Those pushing for expanded doula services have made the case that doulas can play a major role in improving maternity care and addressing inequities in maternal and infant health outcomes – particularly for marginalized groups. 

They brought research to lawmakers to support their case, citing, for instance, a 2023 study outlining how doulas help create to a more positive birth experience with better outcomes. Doula-assisted mothers were four times less likely to have a baby with low birthweight, two times less likely to experience a birth complication and significantly more likely to initiate breastfeeding. Beyond the birthing, research notes that doulas help connect families to essential social services such as housing, food assistance and transportation.

The United States outranks most other developed nations in its overall maternal mortality rate, at 23.8 deaths per 100,000 live births in 2000, versus single digits per 100,000 for comparable countries. That U.S. rate is significantly higher among Black people, more than double, according to the U.S. Centers for Disease Control and Prevention. 

The country’s rate of maternal mortality — defined as a death during pregnancy or up to 42 days following its end — worsened during the Covid-19 pandemic. The CDC tallied 1,205 maternal deaths in 2021, a 40% increase from the previous year and one of the highest since 1965, according to NPR.

Recent comparisons among the states found Vermont’s maternal mortality rate over time to be among the lowest, though the annual numbers are too small for that comparison to be statistically significant. According to the state’s Maternal Mortality Review Panel, Vermont recorded an average of two or three deaths each year since 2012, though the number also spiked during the pandemic, with six deaths recorded in 2022. The majority were directly related to substance use, according to data presented to Vermont lawmakers.

Advocates make the case that doulas are a cost-effective way to improve pregnancy outcomes. In Vermont, the services can cost from $1,200 to $2,000, depending on where one lives, according to Rossi. 

That’s a fraction of the cost of a normal hospital birth without complications, which ranged last year from $9,771, in Morrisville to just under $25,240 in Burlington, or a cesarean birth which ranges from $20,276 in Morrisville to $33,762 in Burlington, according to spokesperson Rebecca Copans from Blue Cross and Blue Shield of Vermont. Those numbers reflect the total cost of care as paid by the insurer and the member.

BCBS of Vermont is currently running a pilot health equity program on doula-supported births with a goal of closing the gap on maternal health inequities, Copans said. The 30-person study will reimburse a participant up to $1,000 for expenses incurred to hire a doula.

Limited to BCBS members, the pilot has 10 spots for white people in a high-risk pregnancy (filled) and 20 for Black, Asian, Pacific Islander, or Hispanic people or refugees. Nine spots are still open, she said. It’s an effort to gauge if offering coverage for doula services would benefit the entire member population, according to a recent presentation.

Martha Churchill, the lead midwife at the University of Vermont Medical Center for 15 years, created a volunteer-run doula service for families there in 2019 and also provided testimony in favor of expanding and funding doula care, which she said is “largely mental health care.”

“Doula care is intimate, compassionate, educational and advocacy work,” Churchill wrote to lawmakers. “This work is worthy of payment and accessibility by everyone who desires it.” 

‘A long way to go’

While the health care system is focused on medical decisions, “the piece that’s missing is human companionship and connection and safety and trust,” said Sarah Teel, research director at Voices for Vermont’s Children, who also provided testimony in support of S.109. “It’s very very common for birthing people to say that they’ve had traumatic experiences during childbirth,” she said.

The Covid-19 pandemic, opioid crisis and homelessness are affecting pregnant people and infants in tragic ways in Vermont, said Rossi. When people are bouncing between motels, don’t have consistent prenatal care or have high levels of depression or untreated perinatal mood disorders, even having a birthing plan can be a luxury. And that’s where doulas can greatly help, she said.

As a small state, Rossi thinks Vermont is positioned to set the stage for what good reproductive health looks like. From an equity standpoint, however, “Vermont does have a long way to go in terms of providing access to pregnant and parenting folks,” she said. “And this is a way to do that.”

The demand for doula support is robust in Washington County, she said, with 26% of pregnant people using The Doula Project last year, a percentage that “would be higher if we had more doulas,” she told lawmakers during a Jan. 23 hearing.

Geographic equity in doula access is also an issue, according to Rossi. Advocates for expanding services have said there are doula deserts in Rutland, Bennington, Windham counties and in the Northeast Kingdom.

Among the 147 Washington County families that The Doula Project has served since 2022 is Sage Rollins, 25, who delivered her second child two weeks ago.

The Montpelier resident said she used doulas for both her pregnancies. 

They helped her with making plans, securing rides, going out to get stuff she needed at home, finding parent groups, bath time and using pressure points to lessen pain during labor. They even had a donation system going for things new parents may need, such as car seats.

Her first pregnancy was scary, Rollins recalled, and the extra support from her doula helped her feel “that everything was going to be OK.”

She started working with a doula a couple weeks into her second pregnancy and is still working with one postpartum. “Everything actually went really well,” she said. “They’re there just to listen and be another support.”

Read the story on VTDigger here: Doulas push to make their services more widely available.

BENNINGTON — One of the largest food pantries in southern Vermont will soon host a vending machine to dispense free opioid overdose medication.

The naloxone vending machine — only the second in the state — is scheduled to arrive in Bennington sometime in June through the local Turning Point addiction recovery center. The machine will be placed right outside the front door of Greater Bennington Community Services, said Bennington Turning Point Center’s executive director, Margae Diamond.

The vending machine is designed to hold up to 180 boxes of two Narcan nasal sprays, a tool that Vermont health officials see as crucial to combatting the rising number of opioid overdose deaths. The medication is designed to revive people who overdose on opioids, including fentanyl, heroin and prescription painkillers.

According to the latest available data from the state Department of Health, between January and November last year, 212 Vermonters died from an accidental opioid overdose, including 19 people from Bennington County. The statewide figure is up from 205 fatalities during the same period last year.

“It’s a health issue, and it can be overcome,” Diamond said. “No one can get better if they’re dead.”

Diamond said the Greater Bennington Community Services building, situated a couple of blocks off Main Street, is ideal for the naloxone vending machine because of its central location and the volume of people who come through its doors. Besides housing a food pantry, the organization also has a free health clinic and an emergency funding program for shelter and utility expenses.

The custom-made machine, which costs around $11,000 and will be under round-the-clock surveillance, is funded by a grant from the University of Vermont Center on Rural Addiction. The center is providing the Narcan supplies for the vending machine’s first year of operation, Diamond said, after which they will come from the Department of Health.

The center, which receives funding from the U.S. Department of Health and Human Services, is distributing five naloxone vending machines in an area that covers Vermont, Maine, New Hampshire and northern New York. 

The program’s initial recipient, Vermont’s Johnson Health Center, received its machine last August. Since then, it has dispensed 258 boxes of Narcan, equivalent to 518 nasal sprays, said Geoff Butler, executive director of the Johnson Health Center. 

The UVM Center on Rural Addiction said another machine will go to the Mi’kmaq Nation, a Native American tribe, which will place it in Presque Isle, Maine. The two other recipients are still being chosen, said Kelly Peck, assistant director of clinical operations at the Center on Rural Addiction.

Diamond expects some local opposition to setting up a naloxone vending machine in Bennington, largely on social media platforms.

“Some people think this is enabling people,” she said. “Well, if you view this as a public health crisis, then you want to make tools available for people. Period.”

“Every time we lose someone, it ripples through, and there is damage — emotional, traumatic damage to the people left behind. So no, it doesn’t solve anything for people to just die,” Diamond said.

The Department of Health plans to also distribute naloxone vending machines statewide. But according to spokesperson Ben Truman, the agency is still gathering information on cost estimates and developing a roll-out timeline.

In the meantime, people can continue getting free naloxone from community sites around the state, such as substance use recovery centers and emergency response groups. More information on naloxone sources, as well as overdose prevention, treatment and recovery, is available on vthelplink.org.

A Vermont health department standing order allows people in the state to get naloxone through pharmacists without a prescription.

Some places in the United States began installing naloxone vending machines in 2022, including Philadelphia, which ran a pilot program funded by the federal Centers for Disease Control and Prevention.

Correction: A previous version of this story mischaracterized security arrangements for the Johnson Health Center’s Narcan vending machine.

Read the story on VTDigger here: State’s 2nd Narcan vending machine is coming to Bennington.

In mid-June, a 38-year-old mother of three died in Burlington from bacterial blood poisoning due to pneumonia, which stemmed from chronic substance use.

Also a factor in her death, according to the medical examiner, was the woman’s recent ingestion of a cocktail of drugs that included fentanyl, xylazine and methamphetamine.

Those are among the drugs that state health officials have red-flagged for fueling opioid deaths among Vermonters. And the latest numbers don’t look good: Between January and June, according to preliminary state data, 115 Vermonters died from accidental opioid overdoses, up by a dozen from the same period last year.

Fentanyl, a synthetic opioid that’s 50 times more potent than heroin, remained the driving force in such deaths. It figured in 110 of the 115 fatalities, followed by cocaine (68) and the animal tranquilizer xylazine (37). Opioid-related overdoses often involve a combination of two or more drugs.

As the Vermont Department of Health reported in previous years, the highest death rates this year are clustered in the southern Vermont counties of Windham, Rutland, Bennington and Windsor. The highest number of cases are in Chittenden County, with 32 deaths, and Rutland County, with 16.

This is another year that the death toll is on track to surpass the existing record. 

“While we cannot forecast these data, we know these numbers are higher than this time last year, and Vermont has seen year-over-year increases in overdose fatalities since 2020,” said Deputy Health Commissioner Kelly Dougherty. 

Last year, 243 Vermonters died from opioid overdoses ruled as accidental or with an unknown manner of death. The annual death toll has been steadily rising since 2014, when there were 63 fatal overdoses – except for a dip in 2019, which recorded 111 such deaths.

Public health officials, law enforcement officers and recovery professionals have seen street drugs become increasingly potent in recent years. At the same time, people are still emerging from the fear, anxiety, stress, uncertainty and social isolation of the pandemic, which led some to relapse or begin using substances.

The Centers for Disease Control and Prevention said illicit drug producers often add illegally made fentanyl to other substances to make the combination cheaper, more powerful and more addictive. It also becomes more dangerous.

“It breaks my heart,” Tracie Hauck, director of the Turning Point recovery center in Rutland, said of the continued rise in local fatal overdoses. When she interacts with center clients who are still using illicit drugs, Hauck said, “you just don’t know if this is going to be the last time you see them.”

She is concerned that casual drug users might not be taking precautions, equating overdose deaths with intravenous drug users or people who identify as having a substance use disorder.

“What I worry about personally is people that may be using cocaine recreationally,” Hauck said. “Cocaine is tainted. If you’re snorting it occasionally, on a weekend, that doesn’t mean you’re not at risk for an overdose.”

Public health offices and community organizations have tried to mitigate fatal overdoses by distributing free fentanyl-test strips and naloxone, the opioid overdose reversal drug.

This year, several community organizations in Vermont also began giving out xylazine test strips. Because the animal tranquilizer is not an opioid, xylazine blunts the efficacy of naloxone — best known under the brand name Narcan — in preventing overdose deaths.

Users particularly seek out xylazine as a “cutting agent” for fentanyl because it prolongs their high, according to research. The state health department plans to also publicly distribute xylazine test strips. 

“Do not trust your drug supply,” said Dougherty, the deputy health commissioner. “The toxicity of the drugs in our communities is increasing, and it changes quickly.”

She also advised people not to use drugs when they’re alone, so that someone can administer naloxone or call for help in case of an overdose.

The monthly opioid fatality data released by the health department are preliminary and almost sure to increase as more death investigations are concluded.

Read the story on VTDigger here: More Vermonters dying of opioid overdoses as drugs become more toxic.

Vaccines that protect against new Covid-19 variants are arriving in Vermont, with shots possibly becoming available as early as this week, Vermont’s top health official said. 

The single-shot mRNA vaccine — available in two versions, by Moderna and Pfizer — is intended to provide protection against new strains of the coronavirus that have been circulating in recent months.

The Centers for Disease Control and Prevention approved the updated vaccines Tuesday. They are recommended for anyone age 6 months and older.

“It’s really being provided universally to people,” said Vermont Health Commissioner Mark Levine. “No matter what your estimation of your risk is, what your age is or anything. It’s really for everyone.” 

Rather than Covid-19 boosters, Levine encouraged Vermonters to think of the vaccines as more akin to flu shots, offered annually to protect from an ever-mutating virus. 

The new shots were intended to protect against the XBB.1.5 variant of Covid-19, which made up most cases within Vermont and the Northeast for much of the year. Other variants are now gaining ground in the state. But Levine said those new variants are relatively closely related to XBB.1.5, meaning the new vaccine will provide protection against those newer forms as well. 

“The virus keeps mutating, as it will,” Levine said. “But these most recent mutations are all within that same family tree. And that’s why the vaccine will be as effective against them as it is against the original (variant).”

After the CDC’s approval of the shots Tuesday, the vaccines are being rolled out across the country. In Vermont, large pharmacies could begin administering the shots later this week, while smaller clinics and primary care facilities will likely receive them next week or later this month, Levine said.  

The shots are free of charge. Vermonters’ health insurance should cover the full cost, and the shots are also available for uninsured people through federally qualified health centers, pharmacies participating in the federal Bridge Program, or district health department offices. 

Covid-19 hospitalizations in Vermont are still low, but they have crept up over the past two months, following a national trend.

Vermont recorded 14 Covid-19 deaths in August, the highest number since April of this year. As of Sept. 13, four Vermonters had died of the virus this month. 

As fall approaches, Levine urged Vermonters to get the new shots and to follow common-sense strategies for reducing transmission: wash your hands, stay home when you’re sick, cough into your sleeve.

“First thing is, of course, the basics,” he said. 

Read the story on VTDigger here: New Covid-19 vaccines are coming to Vermont.

Our public schools have become the focus of our efforts to support youth mental health. Many parents are stressed beyond imagination because of the Covid-19 pandemic, flooding and many other pressures, and they look to their schools to repair what’s broken.

But is it right to place the entire burden on the schools?

Teachers are teachers, not mental health professionals. The innate human skills of our best teachers can provide help and direction for children in their care, but they would be the first to say they’re not mental health professionals. And increasingly, educators seek the help of mental health professionalsin the management of difficult students and a better classroom culture.

Youth spend most of their waking hours in schools, so if we are going to find a place to meet them and deliver services, it makes sense that schools should be a part of the answer to this problem. We must reimagine our schools in ways that support students and families to enable learning.

We must also focus on the damage we’re doing to our children by allowing so many to live in poverty while jealously guarding the profits from college education ($1.77 trillion in accrued college debt.) and self-enriching healthcare ($4.3trillion). We must ask how much of the cause of this steep decline in mental health among our young is economic, how much is social, and how much is educational.

We hear the term “social-emotional learning” more and more. SEL refers to the process through which individuals learn and apply a set of social, emotional and related skills, attitudes, behaviors and values that help direct students. This includes thoughts, feelings, and actions in ways that enable them to succeed in school. In SEL, the teacher pays attention to the whole child and is trained in trauma-informed counseling to determine if adverse childhood experiences are affecting a learner’s behavior and ability to learn. Trauma-informed counseling then sets a course for engaging family and support services to help the child succeed in the classroom and in their own social experiences.

We have an opportunity here in Vermont to bring a new level of informed leadership to the issue of social-emotional learning. With many educational leadership positions open across the state, there is discussion about certification for trauma-informed principals.

We must come to understand that teaching and mental health services to learners must become more intertwined. Educators must learn new ways to promote mental health and create a learning classroom by better understanding how to engage students and their families, and how to better plan how and where in the school infrastructure student/family support meetings can be held.

Children in need of mental health counselling need private places within schools to meet with teachers and healthcare professionals. Schools with limited space often end up using inappropriate spaces like storage and janitorial spaces for meetings with children and families.

Schools that have no available office space are experimenting with discrete drop-in pods where counseling meetings can occur. At a cost of $20,000, they are considerably less expensive than new construction. An elementary school in Burlington has installed such a pod and Green Mountain Mobile Therapy Center has a portable office in a trailer that it can bring on site.

In May, I wrote about the precarious state of the wellbeing of our young people. It was a hard piece to research, to write and, I’m told, to read. It detailed the many ways statistically we have failed our young here in Vermont and in the nation.

In a recent report, the U.S. Center for Disease Control and Prevention says 57% of U.S. teen girls feel persistently sad or hopeless. One hundred percent of all teens report increasing mental health challenges. Nearly 1 in 3 seriously considered suicide in 2021. Fifty-two percent of LGBTQ+ people have experienced poor mental health and 22% attempted suicide last year. Forty-one and a half percent of Americans under 30 are experiencing anxiety and depressive disorder symptoms.

To get an overview of the extent of malaise plaguing our young people, one need only watch the new documentary Anxious Nation, available to screen on Prime, Apple and Google. NAMI Vermont is showing it for free across the state in September and October. It’s a sobering documentary and received positive reviews from scientific journals.

Have the economic burdens imposed by under-employment, poverty, hunger and homelessness put such pressure on parents and their children that families fall prey to our failures? Unless they come from a shrinking background of economic and social privilege, many of the young people I speak with have lost any hope of going to college or ever having a house and raising a family in it.

Are the social norms that once regulated to some degree a common sense of community behavior and encouraged achievement so eroded by our screen and celebrity cultures that our young people are now lost?

When I get discouraged about the choices we often make as a society — essentially pitting profit against community wellbeing — I look to the accomplishments and success of our young people as a sign that all is not lost and that our world may well have a future.

The recent success of the 16 young Montanans, from 5 to 22 years old, in the Montana Supreme Court who claimed that “climate change has jeopardized their recreation, traditions, mental and physical health” greatly lifted my spirits. Our young people spoke out and the law required us to listen.

Watching some 30 kids recently gather in a formal garden in Craftsbury to perform Shakespeare’s Twelfth Night and therefrom elicit all the underlying nuance, comedy and farce made my summer.

I try never to miss a performance of the Youth Opera Company of Vermont. Just watching teens studying and performing grand opera lightens my spirit and refuels my hopes for our world.

The Vermont Youth Orchestra Association brings children to the community and healing of great music performance as well. More than 300 musicians in grades 1-12 from 63 regional schools gather to learn, study and perform music in performing ensembles, orchestras, training programs and a private lesson program.

The Vermont Youth Conservation Corps works with diverse young people to create experiences in the natural world that teach mutual support and team building, create a culture of belonging and mutual accountability, and safety.

The Mental Health Initiative integrates and shares the resources of over 150 Vermont community-based mental health resources and initiatives to shine the light on local resources and collaborations for family, friends, and neighbors.

Although these successes may lift our spirits and hopes for our young people, we must not deceive ourselves into believing that all is okay with our coming generation.

Read the story on VTDigger here: Bill Schubart: Our young people and the imperative of social-emotional learning.

This story, by Report for America corps member Carly Berlin, was produced through a partnership between VTDigger and Vermont Public.

Use extreme caution around floodwaters

Many roads are still impassible because of floodwaters, which continue to rise in some areas. Do not drive into flooded areas.

If you can reach your home, avoid entering floodwaters: they can contain things harmful to human health, including downed power lines, sewage, and hazardous chemical waste. According to the Centers for Disease Control and Prevention, entering contaminated flood water can cause wound infections, skin rashes, gastrointestinal illness, and other complications. 

If you do need to enter floodwater, wear rubber boots, rubber gloves, and goggles. The CDC also advises washing with clean soap and water as soon as possible afterwards, taking care of wounds, and washing clothes in hot water.

Cut off your power and gas, if possible

It’s important to cut off electrical power and natural gas or propane tanks in your home to avoid fire, electrocution, or explosions, according to the CDC.

If your main power switch is in standing water, do not power it off yourself – or use any electric appliances. The CDC advises calling an electrician if you need to enter standing water in order to access your main power switch. If you can get to it from a dry location, it’s okay to turn it off, according to the CDC.

Don’t turn your power back on before having an electrician check your house’s electrical system.

Beware of potential gas leaks. If you smell gas, turn off the main gas valve, open up windows and leave your home. Notify the gas company or your local fire department. Don’t turn on the lights or do anything that could create a spark.

If your power is out, and you’re considering using a generator, be careful about potential fire hazards and carbon monoxide poisoning. Never use a power generator inside your home.

Food: When in doubt, throw it out

Consuming food that’s come into contact with floodwater can make you sick. The CDC says it’s best to throw away any food with an unusual odor, color or texture; any food that’s stored in packages that aren’t waterproof; any food in cardboard containers, including baby formula; and anything with a screw cap, snap lids, twist caps, and more.

It’s also important to sanitize dishes, utensils, refrigerator drawers or kitchen countertops – any surfaces that have come into contact with floodwater. The CDC advises using a combination of hot, soapy water to rinse and then soaking items in diluted bleach. 

Some items can’t be properly sanitized and should be thrown out, including wooden cutting boards, baby bottle nipples, and pacifiers.

Drinking water safety

Floodwater can contaminate drinking water by getting into groundwater supplies.

If you rely on a municipal water system, follow local guidance on whether the water is safe to drink. If you have a private well, get your water tested before using it.

If you’re concerned that your water might be contaminated, don’t use it to wash dishes, brush your teeth, prepare food, wash your hands, or make baby formula. Use bottled, boiled, or treated water instead.

Before cleaning up, document the damage

Once it’s safe to enter your home, document the damage by taking photos before you start cleaning up. This is an important step for filing a flood insurance claim, if you’re covered, or for applying for recovery aid through the Federal Emergency Management Agency.

Be extensive. FEMA recommends taking photos and videos of both the inside and outside of your home; getting images of the inside of cabinets and closets; and recording the serial numbers of large appliances like washes, dryers, and refrigerators.

Dealing with mold

After documenting the damage, start preventing mold. Air out your home by opening up windows, and remove water-damaged items like furniture.

If you’re not able to dry out your home within 24 to 48 hours, you should assume you have mold growth, according to the CDC. You’ll need to completely dry everything and clean the mold.

Exposure to mold can be harmful to human health, causing asthma attacks, eye and skin irritation, along with allergic reactions. You may want to consider hiring a professional to clean the mold from your house. If you opt to do it yourself, wear personal protective equipment like an N95 mask, gloves, and goggles. Use a wet vacuum to remove water from floors, carpets, and hard surfaces. 

Open windows and doors to allow airflow while you work, if the weather permits; and use a dehumidifier if electricity is safe to use. If you use a fan, make sure it’s pointing outside; if it’s pointing inside, it can spread mold in your home. Clean mold with water and a detergent. 

For more detailed instructions, see the CDC’s mold cleanup guide.

Returning to a flooded car

If your car was partially submerged in floodwater, avoid starting it right away, according to State Farm insurance – that can cause more (and expensive) damage if there’s water in the engine. 

Start drying your vehicle as soon as you can; call a towing service to get it to higher ground, if possible. File a claim with your insurance company to determine the extent of the damage.

Read the story on VTDigger here: What to know about returning home after a flood.

Vermont reported almost 3,000 more deaths from 2020 to 2023 than would have been expected were it not for the Covid-19 pandemic, according to data from the U.S. Centers for Disease Control and Prevention — but less than one-third of those deaths have been directly attributed to the virus.

The increased mortality points to a rising tide of challenges Vermonters experienced during lockdown: delayed access to health care, isolation and a worsening of the state’s decadeslong opioid crisis.

The additional deaths could also point to a hidden cause — Covid-related deaths that were not recorded as such, according to Steven Woolf, a population health researcher at the Virginia Commonwealth University School of Medicine.

Woolf’s team analyzed what researchers call “excess deaths,” or the number of deaths in a population beyond the average or the expected amount during a given time period. It’s a common technique for measuring the toll of large-scale disasters such as hurricanes, when the official death toll might be an undercount.

In the first year of the pandemic, the United States as a whole reported a death toll 23% above the expected figure, according to Woolf’s paper from 2021. Vermont itself had a death toll 8% above normal. Less than a third of those deaths that year can be attributed to officially reported Covid deaths.

But 2020 was only the beginning of Vermont’s struggles with the virus, according to CDC data. The number of excess deaths ticked up throughout 2021 and reached a peak in January 2022 during the height of the Omicron variant wave. 

Even as the state recovered and reopened in 2022, there continued to be more deaths than would have been expected, according to the CDC. The state’s death toll that year rose to 22% above the expected estimate.

It’s too soon to say how Vermont has fared in 2023, since it takes time for officials to finalize death certificates and share them with the federal government. (At the close of 2022, the state had attributed 877 deaths to Covid. As of this week, that number had risen to 967.)

Woolf’s research suggests that excess deaths early in the pandemic — particularly during those first few months of lockdown — were the most likely to be Covid deaths misattributed to other causes.

“There was confusion at the beginning about what exactly Covid-19 did,” he said. “We did not realize, at the beginning, its effect on the heart, the kidneys, many other body systems. So, understandably, I think some patients who died of Covid-19 may have been classified as deaths from heart disease or kidney failure, or some other kind of factor like that.”

Vermont takes several steps to ensure its Covid deaths are fully tracked, such as flagging Covid-like illnesses and testing people for Covid post-mortem, if necessary, Elizabeth Bundock, the state’s chief medical examiner, told VTDigger in 2022.

Woolf said the true driver of excess deaths is just as likely to be the effects of lockdown and an overburdened health care system. 

“A person who would develop chest pain and was scared to call 911 and died of a heart attack would be counted among those deaths, even though they were never infected by Covid-19,” he said. 

The number of deaths from heart disease rose about 15% in 2021 compared with 2019, according to the CDC. 

Researchers also believe the pandemic affected people with chronic health issues, along with causing or worsening mental health issues and substance use disorders, he said. Vermont Department of Health data shows that the state has seen opioid overdose deaths rise continuously since 2020. 

Conversely, deaths from non-Covid respiratory illnesses, such as influenza and chronic lower respiratory illnesses, fell during the pandemic. 

“Masking and social distancing (decreased) the spread of influenza and pneumonia … and those kinds of respiratory pathogens are very problematic for people with chronic lung disease like emphysema or asthma,” Woolf said.

Ultimately, Woolf thinks the number of deaths from Covid, compared with other causes, matters as much as the fact that “we need to develop better systems for providing health care and dealing with other health issues during public health emergencies.” 

The lack of investment in primary care meant that few people had a primary care doctor to fall back on when hospitals were too busy to visit. Primary care practices were “overwhelmed” and not ready to handle telehealth, Woolf said.

“A lot of people developed complications from diabetes and heart disease and so forth because they were not able to get their medicines,” he said. “They were not able to get their chronic conditions checked.”

The United States also has a “frail” mental health care system with too few mental health professionals, he said. Many people experiencing mental health challenges during lockdown were met with waiting lists and were stuck calling around to practices with no openings.

The toll of the pandemic does not just include deaths, Woolf said, but a broad swath of people living with health conditions brought on by the pandemic that they might live with for decades to come. 

The most obvious one is long Covid, a condition that has been demonstrated to affect almost every organ of the body, Woolf said. There are also the children who grew up under the stresses of the pandemic. 

He likened it to the famine years of the Soviet Union, which had a measurable impact on the health of generations of people. 

“Someday there will be a body of research like that about what happened to the Covid-19 generation, in terms of its ripple effects over time,” Woolf said.

Life expectancy in the U.S. was dropping even before the pandemic due to the opioid epidemic, alcohol-related deaths, suicides and cardio-metabolic illnesses such as heart disease and diabetes cropping up in young and middle-aged adults, he said. 

“The reasons for that didn’t go away during the Covid-19 pandemic. They rolled right into the pandemic,” Woolf said.

What has changed is the emphasis on infectious disease as a major public health concern. Coming up in his career, Woolf said, diseases such as polio and smallpox had been “conquered” with antibiotics and vaccines.

“People like me were taught in medical school that now we’re in a new generation, where the leading causes of death are chronic diseases, not infectious diseases,” he said. “So we’ve got that under control, and then suddenly we ended up with a virus that created mass societal changes on the scale of Covid-19.”

Read the story on VTDigger here: Thousands more than expected died in Vermont during the pandemic. Research points to delayed care, isolation and uncounted Covid deaths..

Vermont’s Covid-19 community levels were “low” over the past week, the state Department of Health reported Wednesday.

The department reported a new drop in the number of hospital admissions for the disease, with only 10 reported in the past week. That’s the lowest number of admissions since summer 2021, prior to the arrival of the Delta and Omicron variants. 

Vermont currently has the lowest hospitalization rate in the nation, according to a New York Times analysis of data from the U.S. Centers for Disease Control and Prevention.

The department also reported a new low in Covid cases, with 116 cases reported in the past week. However, Covid case data is based primarily on PCR tests and does not include at-home antigen testing, making it hard to make direct comparisons with earlier years of the pandemic when PCR testing was much higher.

But other metrics from the health department suggest low transmission in the state. The department tracks the number of people coming into emergency departments with Covid-like symptoms. The percent of visits for Covid-like illnesses remains lower than at this point in 2020, 2021 or 2022, according to the department.

All wastewater testing sites that send data to the CDC reported a drop in Covid viral levels in recent samples compared with the beginning of 2023. 

The CDC also reported that 13 of Vermont’s 14 counties had “low” Covid levels, while Rutland County had “medium” levels. The levels are based on a combination of hospital admissions, Covid case rates and the percentage of hospital beds taken up by Covid patients.

The health department reported two additional Covid deaths this week, for a total of 16 deaths in April, slightly above March’s 15 deaths. Additional deaths may be added retroactively due to delays in processing Covid-related death certificates.

In total, 962 people have died from the disease since the beginning of the pandemic.

Read the story on VTDigger here: Vermont Covid levels ‘low’ as hospitalizations decline to 10.

Vermont’s Covid-19 community levels were “low” in the past week, the state Department of Health reported Wednesday.

The department reported 17 hospital admissions for the disease in the past week, the same as the week before. Overall, hospital admissions have fallen from a peak of about eight admissions per day in mid-December to between three and four per day in recent weeks.

There were 142 Covid cases reported in the past week, similar to the 139 cases reported the week before, according to the department. Case data is mainly based on PCR testing and does not include at-home antigen tests.

The U.S. Centers for Disease Control and Prevention reported that 13 of Vermont’s 14 counties have “low” Covid levels, while Rutland County rose from “low” to “medium” Covid levels this week.

CDC community levels are based on three factors: hospital admissions, the weekly case rate and the percent of hospital beds occupied by Covid patients. It recommends that high-risk people in medium-level counties wear masks and take other steps to protect themselves.

The health department reported nine additional Covid deaths, bringing April’s total to 11 deaths so far from the disease. If that trend continues, it would put April on track to exceed March’s 15 deaths.

In total, 957 people have died of Covid in Vermont since the beginning of the pandemic.

Read the story on VTDigger here: Vermont Covid levels ‘low’ as state announces 9 deaths.

Vermont’s Covid-19 community levels were “low” over the past week, the state Department of Health reported Wednesday.

The department reported only 17 hospital admissions for the disease during this period — the lowest seven-day total the state has reported since at least May 2022. There were 23 hospital admissions the previous week.

The state also reported 139 Covid cases, down from 265 cases the week before. Case data is primarily based on PCR testing and does not include at-home antigen tests.

All 14 of Vermont’s counties reported “low” Covid levels last week, the U.S. Centers for Disease Control and Prevention said Friday.

The state health department reported three additional Covid deaths this week, bringing March’s total to 15 and April’s total to two deaths. March had the lowest monthly death total since July 2021.

Vaccine dashboard retired

The health department announced on its website Wednesday that it would stop publishing new Covid vaccine data as of this week. 

The vaccine dashboard, separate from the Covid data dashboard retired last year, posted weekly updates on the number of Vermonters vaccinated for Covid, including demographic data and data broken down by dose and county.

Since the dashboard was launched in December 2020, Vermont has administered roughly 1.7 million doses of the Covid vaccine, including both the initial vaccine doses and booster shots. About 500,000 Vermonters, or 80% of the population, completed the primary vaccine course, according to the department.

But progress on subsequent vaccine campaigns has slowed. The 80% of Vermonters figure has barely budged in recent months, and a far lower percentage of the population age 5 and older — 35% — has remained fully up-to-date on Covid shots, including the recommended bivalent booster.

The biggest disparity is by age group: Only 17% of 5- to 11-year-olds are up to date on their booster vaccines, compared to 73% of people 75 and older.

The health department said that, in the fall, it would introduce a new dashboard that combines Covid and flu vaccine data to align “with our goal of streamlining information sharing about respiratory viruses.”

Read the story on VTDigger here: Covid hospitalizations drop; Vermont retires vaccine dashboard.

The overdose crisis in Vermont continues to worsen. Last month the Department of Health reported that a record number of Vermonters were lost in 2022 due to an overdose involving opioid drugs. The Centers for Disease Control and Prevention reports that, in the 12 months through October 2022, there were 262 fatal overdoses in Vermont. In 2010, there were 78 such fatalities.

It should be cause for alarm among policymakers at all levels.

Vermont’s Opioid Settlement Advisory Committee recently outlined recommendations for spending opioid settlement funds that would enhance some important efforts, but left out several key harm-reduction interventions. Despite pleas from some advocates to use settlement proceeds for rolling out overdose prevention centers and drug-checking services, those requests were left off the list.

For Vermonters who may be at extreme risk of overdose right now, and for families who fear their loss every day, the lack of investment in these proven harm-reduction strategies could be disheartening.

While improving access to naloxone, opioid treatment medications, fentanyl test strips, and outreach workers (all recommended by the committee) is necessary and important, it’s increasingly clear that bolder solutions are also needed, and that the status quo of criminalizing people for drug use and leaving people to use in unsafe situations is not working.

If there’s agreement to distribute fentanyl test strips, it’s hard to understand not including the funding for more robust drug-checking services that can provide far more detailed information about the composition of a substance. Expanding availability of naloxone is vital, but it should be complemented by services that can prevent some overdoses from happening.

Increasing the number of outreach workers is great, but it’s hard to understand withholding support for overdose prevention centers, which encourage people who use drugs to come into a fixed location where they can get basic health care, have their substances checked for contaminants, and be revived by trained professionals if they overdose.

For over five years, proposals to authorize overdose prevention centers have been advanced by community members, yet the state Health Department seems reluctant to offer a proposal to deploy such centers throughout the state and provided little opportunity to discuss funding them during the Advisory Committee process. Instead, the commissioner suggests that the committee will hold discussions about them in future meetings.

Overdose prevention centers and drug-checking services are evidence-based solutions. They have been effective in saving lives throughout the world for decades, and they help build bridges to treatment and recovery by developing trusted relationships and compassion-centered care. Such centers are presently operating and saving lives now in New York and will soon be operating in Rhode Island.

Community drug-checking programs using spectrometers and other portable testing technologies are operating across the world, including many locations throughout Massachusetts as part of the StreetCheck program, providing people who use drugs with meaningful information about substances that may lead them to change how (or whether) they might use them. 

Decriminalization of small amounts of drugs for personal use is happening now in Oregon and has been shown effective in other countries for decades. Oregon’s 2020 decriminalization ballot measure has already made over $300 million of cannabis tax revenues available to vastly expand harm reduction and treatment programs throughout the state.

Ending the use of the criminal penalties to deal with drug possession in Oregon is not only helping reduce stigma, overdose risk caused by incarceration and other harms of criminalization, but will also result in even more funds being reinvested into health, housing and treatment services in future years.

For many Vermonters, there is no more time for study. There are lives on the line right now as these proposals continue to get kicked down the road. It’s time we stop relying on archaic systems of rationing care and stigmatizing drug use through criminalization, remove barriers (such as the threat of arrest) that drive people away from needed services, and instead provide more wrap-around supports.

Meaningful solutions to the overdose crisis require a full commitment to building a public health response to drugs. Other states are implementing these proven strategies and Vermont should join them by moving forward on overdose prevention centers, drug checking and eliminating criminal penalties for low-level drug use and possession. There is no time to waste.

Read the story on VTDigger here: Grey Gardner: Vermont keeps kicking important drug reforms down the road.

On any given day, Alexandra Bannach, a pediatrician in Newport, will have three or four patients scheduled to see her for a check-in about ongoing mental health treatment, most commonly for depression or anxiety. That’s true of her three colleagues as well. 

Meanwhile, about half of the annual visits with teens and pre-teens throughout the rest of her work day reveal symptoms that might result in a mental health diagnosis. The number of those cases and their severity has increased dramatically in the past half decade, she said. That led her practice team to decide last year to extend the amount of time they take with each adolescent patient.  

“We just needed more time in those rooms,” said Bannach, who has worked at North Country Pediatrics for 18 years. “It’s not just doing a physical (exam) anymore and saying, ‘you’re cleared for sports.’ You have to address mental health issues and with those, obviously, there’s no blood tests. It’s really sitting down and talking.”

Until last summer, Bannach and her colleagues were largely on their own to try to meet the growing need — a daunting task, for which, until very recently, primary care residency programs provided little to no preparation. 

She educated herself and treated what she felt she could. In some cases, she would refer patients to a child psychiatrist. But those referrals frustrated her, as well as her patients, as waitlists for those appointments can range from six months to a year. 

Now she calls VT CPAP. 

Short for the Vermont Child Psychiatry Access Program, VT CPAP is the brainchild of Greta Spottswood, a child psychiatrist at Community Health Centers of Burlington and director for the grant-funded program. 

The free service is a high-quality telephone hotline for primary care providers who see children and youth. It offers professional feedback on diagnosing, treating and finding resources for their patients with mild to moderate mental health challenges. A social worker answers the phone every weekday from 9 a.m. to 3 p.m. and coordinates the support, which range from scheduling conversations with a child psychiatrist to sharing up-to-date information about mental health resources in the provider’s community.

The need for the hotline became clear to Spottswood soon after she started her practice in Vermont in 2017 after a residency and fellowship in Boston. Within a matter of months, her own waitlist to see patients grew to more than half a year. It was impossible for her to keep up.

Full-time equivalent pediatricians and general family practitioners outnumbered board-certified child psychiatrists in Vermont by 12 to 1 in 2018, the latest year a physician census was undertaken in those fields by the state Department of Health. The ratio may have improved since then due to a new residency program at the University of Vermont’s Larner College of Medicine, but the basic math has not. 

“You can have a lot more psychiatrists and still not meet the need as we are providing care currently,” she said. “We have to change the system rather than just trying to see more patients.”

This is not a new idea. Similar kinds of support hotlines are offered across the country. But it is new for Vermont. 

The additional resources are badly needed, Haley McGowan, a child psychiatrist at the medical center and the medical director of the Child, Adolescent and Family Unit at the state Department of Mental Health, told the House Committee on Health Care last month. 

Nearly half of all youth in the U.S. will meet criteria for a mental health disorder, either in childhood or adolescence, McGowan said. Around a quarter will develop a mental health disorder that will result in severe impairment or distress. 

On Monday, the Centers for Disease Control and Prevention released results from its annual national survey of high school students. In 2021, almost 60% of female students reported feelings of sadness or hopelessness every day for at least two weeks that disrupted their normal activities.

“As you might guess, limited access to mental health resources here in Vermont means that primary care providers — pediatricians, family medicine doctors — end up providing that care often in ways that feel far out of the range of their expertise and training,” said McGowan, praising Spottswood’s new program.

Since it started in June, 79 clinics with 387 providers have enrolled in the service, McGowan said. “This really does help to save a lot of that child psychiatry workforce for those more acute cases,” she added.

It also helps primary care providers feel more equipped to provide ongoing mental health care. Bannach estimates that among the four providers in her practice, one of them calls the hotline at least once a week, where every work day they can reach a dedicated social worker and board certified child psychiatrist. The interactions and the ongoing support and training provided have made a huge difference, she said.

“I don’t know if I can communicate … how much having the program has helped us in feeling comfortable and more confident that the care we provide is actually appropriate,” Bannach said. “It’s really been an absolute game-changer.”

She and her colleagues are not the only ones using the service. Since it started in June, the hotline received 217 calls from providers, an average of two a day. Use is growing as more practitioners become aware of what the service can provide, Spottswood said. In late January, the program had its busiest day, fielding 10 calls. 

Because of the dedicated staff, “it’s not just a 30-second phone conversation,” said Bannach. “They can really explore that case with us.” She can also call back and speak to the same psychiatrist a month later about the same patient. (Information sharing between providers both bound by federal medical privacy laws is allowed.)

In total, over the first seven months, 55 providers called at least once, with an additional 42 support staff calling, according to data being collected to evaluate the program. 

The calls were most often about specific cases, though some were more general and medication-related, or seeking help for a therapist referral. The majority of the changes in care recommended after a discussion with the psychiatrist were related to medication management, but also involved diagnoses or sharing vetted screening tools.

In between taking calls, the social worker on staff spends time responding to requests for general educational resources, and compiles and updates lists of classes and support groups available in different parts of the state. A lot of the person’s time is also spent checking in with therapists about their availability to take on a new patient, either in person or virtually. 

“Keeping tabs on local resources and tracking down therapists is a Herculean effort,” said Ellen Arrowsmith, one of three who work part time. She estimates she usually calls between 15 and 20 therapists in order to find two or three options for a family to consider for their child. But that groundwork is essential. 

“The fewer barriers there are, the more likely that the family is going to actually engage in treatment,” Arrowsmith said. “So many people get so discouraged by having to wade through so much of ‘no’ and no response.”

The program currently costs just under $500,000 annually to operate, Spottswood said. It is funded through several multi-year grants, including two through the Vermont Department of Mental Health and private matching funds through the Vermont Community Foundation. She and staff at the department are seeking a source of sustainable funding to maintain the service and keep it free. 

Other states with similar programs have been able to expand the focus to nurses and therapists practicing in schools. Spottswood said VT CPAP would like to consider that once the primary care support is established and ongoing funding is secured. 

Bannach does not want to imagine losing access to the support. With a therapist based in her practice and VT CPAP, she now feels capable of managing cases that she previously would have referred out. 

Providing the full range of mental health care in primary care settings has a wide range of benefits. For Bannach, she sees that it increases access, and reduces the sense of stigma some still feel in seeking professional help. Also, it benefits other aspects of her practice.

“It can be incredibly rewarding care to provide,” Bannach said. “It strengthens your bond with the family and the patient and it always feels amazing if you can help.”

Correction: An earlier version of this story mischaracterized a precursor program to VT CPAP and incorrectly stated that Haley McGowan led that program.

Read the story on VTDigger here: Primary care providers get advice hotline for supporting youth mental health care.

Covid-19 community levels were “low” in the past week, according to the latest weekly surveillance report from the Vermont Department of Health. 

The department reported 273 Covid cases in the past week, compared with 293 cases the week before. Covid case data is based primarily on PCR testing, which has declined compared with previous years. At-home antigen tests are not included in the data.

In the past, officials warned that holiday weekends like Thanksgiving’s could throw off data because fewer tests would be reported. The positivity rate of PCR tests rose slightly this week, to 7.6%, compared with 5.6% the week before, and the number of tests performed dropped by about 17%.

Hospitalizations, which tend to be less affected by holiday underreporting, remained mostly flat in the past week. As of Wednesday, the department reported 27 people were in Vermont hospitals for Covid, including four in intensive care.

The U.S. Centers for Disease Control and Prevention reported that 12 of Vermont’s 14 counties had “low” Covid levels. Only Bennington and Essex counties reported “medium” levels.

CDC and state community levels are based on case rates, hospital admissions and the percentage of hospital beds occupied by Covid patients.

The health department reported no additional deaths in the past week. In total, 770 people have died in Vermont since the beginning of the pandemic, including 11 so far in November.

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Read the story on VTDigger here: Covid levels remain ‘low’ as testing drops for holiday weekend.

Vermont is back to “low” Covid-19 levels after two weeks of reporting “medium” levels, according to the state Department of Health’s latest weekly surveillance report.

Hospital admissions for Covid had risen in the past two weeks but now appear to be declining, according to the department. The number of emergency visits for Covid-like symptoms also declined and fell below visits for this point in 2021.

As of Wednesday, 44 people were hospitalized for Covid in Vermont, including three in intensive care.

There were 532 Covid cases reported in the past week, down from 595 cases the week before. The department bases case numbers primarily on PCR testing rather than at-home antigen tests. 

The U.S. Centers for Disease Control and Prevention reportedThursday that 11 of Vermont’s 14 counties had “medium” Covid levels, based on data from the previous week. Two counties, Rutland and Bennington, had “high” levels, and Windham had “low” levels.

The CDC recommends that high-risk individuals in medium-level counties wear a mask and take actions to protect themselves from Covid. It recommends the general public wear masks in high-level counties.

Cases and hospitalizations have remained mostly flat at a national level in recent weeks, The New York Times reported. Nearby New York and New Jersey report the highest case rates in the nation but lower hospitalizations and deaths.

The number of Covid deaths in Vermont rose significantly in October compared with previous months, according to the health department. The health department reported 14 additional deaths from Covid in Vermont in the past week, for a total of 25 deaths in October.

That’s compared with 12 in September and 19 in August. In total, 754 people have died of Covid since the beginning of the pandemic.

Bivalent booster uptake

Data from the health department suggests few Vermonters have gotten the updated bivalent booster vaccine for Covid, even among age groups at high risk for severe Covid complications. 

About 20% of Vermonters 5 years and older are up-to-date on their vaccines, including the bivalent shot, according to the health department. Uptake among age groups varies from 6% of people 18 to 29 years old to 47% of people 75 and older.

Children from 5 to 11 years old have particularly low uptake of the bivalent booster, with roughly 3% now considered up-to-date. Children in that age group qualified for the booster in early October, about a month later than the adult population. The low rate might also be influenced by people who delayed their shot because of a recent Covid infection or another booster that gives them immunity to the disease.

But experts have expressed concern about whether Vermonters would be slow to get the vaccine because of the belief that the “pandemic is over.”

The bivalent booster, which was authorized by the federal government in September, targets the now-dominant Omicron strain of the virus, providing increased protection against severe disease and hospitalization, experts say. It’s available at pharmacies and state-run walk-in clinics. 

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Read the story on VTDigger here: Vermont back to ‘low’ Covid levels as hospital visits drop.

Covid-19 levels in Vermont remain “low,” according to the Vermont Department of Health’s latest weekly surveillance update.

The department reported 445 cases in the past week, down from 494 the week before. 

The U.S. Centers for Disease Control and Prevention rated only two Vermont counties — Bennington and Rutland — as having “medium” Covid levels on Thursday.

There were 37 new Covid hospital admissions in the past week, a slight increase from 35 the week before. 

No deaths from Covid have been reported so far in September. Because of the delay in processing death certificates, the health department often takes days or weeks to update death data. Nineteen people died in August, 12 people died in July, 12 people died in June and 32 people died in May. 

With students back in schools throughout the state, Vermont had an uptick in outbreaks in educational settings, according to the report. As of Sept. 13, there were 17 active outbreaks in a school or child care facility throughout the state, up from two the previous week. The surveillance report defines an outbreak as three or more epidemiologically linked cases of Covid-19.

Health officials and doctors continue to urge eligible Vermonters to get the recent vaccine booster targeted at the newer subvariants of the Omicron strain. VTDigger has answered reader questions about the Omicron vaccine here. The health department also has more details about the vaccine on its website.

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Read the story on VTDigger here: Covid levels remain ‘low’ in Vermont as students are back to school.

Municipalities across Vermont are collecting data on Covid levels in their wastewater. But that data isn’t showing up in state or national data systems, befuddling government officials and contractors that are supposed to be working with the data.

In February, local wastewater treatment plants began announcing their participation in the U.S. Centers for Disease Control and Prevention’s wastewater surveillance program for Covid-19.

Public health officials and experts were excited to get access to a new type of Covid data as the number of PCR tests was declining. Some said wastewater surveillance, which measures the level of SARS-CoV-2 virus in a local sewer system, had the potential to be even more comprehensive than other data sources. 

“It allows direct estimation of Covid-19 activity for everyone using a toilet that empties to a wastewater plant,” Timothy Plante, an assistant professor at the University of Vermont’s Larner College of Medicine, told VTDigger in April.

Months later, the CDC reports that 10 wastewater plants across the state are included in its National Wastewater Surveillance System, or NWSS.

Yet on the CDC website, and in Vermont Department of Health reports, the actual data showing viral levels and change over time is muddled and variable. In the past week, there was no data at all for the 10 participants in the program.

The health department had warned that there could be a pause in data collection as the national program transitioned to a new contractor, BioBot, in April. The company would be responsible for testing wastewater samples and releasing the results.

But health department officials told VTDigger via email this week that it’s now past time for BioBot to start reporting data again, and the state is puzzled about the pause.

“Our Health Surveillance team also noticed this apparent discrepancy in the data,” health department spokesperson Ben Truman said. “We have reached out to NWSS and to Biobot to find out why we don’t yet have trend data for some of these sites, and why some appear to go offline — such as Essex Junction, which had trend data for a few weeks and now do not.”

Several local officials at participating sites told VTDigger they had no idea their results weren’t appearing in state and national data sources. They had been receiving reports directly from BioBot for a month or more.

St. Albans, for example, had reports from BioBot dating back to May 24, according to Brian Willett, chief wastewater operator for the city. 

The ten sites participating in the program, according to the health department, are Bennington, Brighton, Essex Junction, Johnson, Morrisville, Newport city, St. Albans, St. Johnsbury, Troy and Jay’s combined sewershed and Winooski. 

It’s unclear exactly which sites are appearing in CDC data, because the agency lists three sites for Chittenden County — presumably including Essex Junction and Winooski — without specifying which is which. 

The 10 sites also include St. Johnsbury, which has not started collecting data because it is awaiting the arrival of the right kind of sampler to use for the program, project manager Jim Brimblecombe said.

But of the other nine sites, only five are displayed online. Four of those have some data, but not for the most recent week, and one has no data at all.

In response to questions from VTDigger about Vermont’s participation, Brian Katzowitz, a spokesperson for the CDC, said via email that “the majority of these (sites) are submitting data. It can take several weeks for enough data to be collected to calculate the metrics displayed on COVID Data Tracker. However, state, tribal, local, and territorial health departments will still be able to track COVID-19 in their communities and make public health decisions,” he wrote.

The agency did not respond to follow-up questions about which sites were listed on the CDC website, or why sites that had been submitting test results for more than a month were not appearing online.

Jennings Heussner, the government and business manager for BioBot, said he wasn’t sure why the data was missing, either. 

“I’m honestly not entirely sure of exactly why each site wouldn’t be included,” he said.

He said that if sites are part of the program and sending BioBot sample kits, they should be on the CDC website “at some time or another.”

“At the end of the day, we are a contractor,” he said. “And we are doing all of the data generation, but we don’t have any say about exactly how CDC uses the data once it’s in their hands.”

Through the program, local wastewater officials are responsible for collecting sewage samples and sending those samples to BioBot labs via FedEx. 

Most program operators said the sample collection was not time-intensive. But Nate Fraser, chief operator at Springfield’s wastewater treatment plant, said the city passed on the chance to continue with the new contractor because the department found it too difficult to manage with its small staff.

“My staff is spread very thin on a normal day,” he said via email. “Collecting samples, labeling, washing the processed sample containers and packaging twice per week was taking time we felt was more beneficially used in other areas of our daily operation.”

Paradoxically, the only site in Vermont that doesn’t participate in the CDC data collection has also been the state’s most steady data source. The City of Burlington publishes data on a weekly basis of the viral level at its three wastewater treatment plants. 

Nancy Stetson, senior policy and data analyst for the city, said it has been reporting data since fall 2020 using a contractor who’s being paid with federal relief money. The city may be open to joining the CDC in the future, but for now, “we just have our own thing going,” she said.

That slice of data has proved useful for policymakers. The state health department and the Department of Financial Regulation have cited Burlington’s wastewater data in press conferences and reports.

Elaine Wang, the Winooski city manager, said she had noticed that when Burlington reported an uptick in wastewater data, cases in Winooski tended to rise. Wang began using Burlington’s wastewater reports to engage the city council to discuss mask mandates or other actions.

Timothy LaPara, a professor of civil engineering at the University of Minnesota, was one of the first researchers to study the ability to detect SARS-CoV-2 levels in wastewater. 

LaPara said wastewater levels aren’t a great way to determine exactly how many cases there are in your community, but they work well as a relative measure of whether the virus is trending up or down.

In fact, he believes that wastewater data is “the best way to track this disease.”

“All the other testing methods have catastrophic flaws,” LaPara said. Most people don’t get PCR testing when they’re asymptomatic, and antigen tests rarely get reported to state agencies. 

“There could be some problems with it that somebody could find somewhere, but it’s trustworthy. It’s the best we have,” he said.

Read the story on VTDigger here: Vermont’s missing Covid wastewater data is a mystery to government officials and contractors.

Vermont has had one of the highest Covid-19 case rates in the nation for nearly two months, according to The New York Times, as the highly infectious BA.2 subvariant swept through the state beginning in mid-March. 

So why would Vermont, with at least two-thirds of its population fully vaccinated and famous for low infection rates at the pandemic’s start, be the center of the nation’s latest surge? 

At a recent press conference, Health Commissioner Mark Levine said the reasons were “multifactorial.” But he pinpointed a seemingly paradoxical factor: the fact that so few Vermonters have gotten sick over the past two years of the pandemic.

“Because we continue to be a state with perhaps still the lowest rate of immunity from having had Covid, we do expect the virus to continue to spread,” he said.

Between a quarter and a third of Vermonters had contracted Covid between March 2020 and February 2022, according to new data from the U.S. Centers for Disease Control and Prevention. That’s compared to nearly 60% of the nation as a whole.

The CDC study measured the percentage of people with an antibody in their blood that only occurs through natural immunity — that is, immunity acquired by getting infected with Covid. 

The study’s wide margin of error makes it hard to say exactly where Vermont ranks nationwide, but it is clearly in the minority. Only eight other states also reported that less than half of their population had been infected with Covid since the pandemic began.

On a national level, the Omicron variant caused a sweeping rise in the likelihood of people being infected, raising the number of Americans with antibodies from about 43% to 58% in the course of a single month. 

Vermont, too, reported a rise, but starting from a lower baseline: It jumped from about 18% pre-Omicron to 29% by late February.

Laura Ann Nicolai, deputy epidemiologist at the Vermont Department of Health, said the rise in immunity during Omicron “matches up well” with what state officials had observed. 

“We were seeing exponentially higher daily case counts during that timeframe,” she said. 

The CDC study also estimated how many infections Vermont has had over the course of the pandemic based on its blood samples. Antibody samples showed the state totaled an estimated 180,000 infections — nearly double the 98,000 the health department had reported based on test results when the study was conducted.

“It doesn't really surprise me,” Nicolai said of the disparity. “We think that there were probably a lot of kids who had mild illnesses and who may never have been tested.”

The state also increased access to “home-based testing opportunities” like antigen and LAMP tests, she said, and “people aren't necessarily taking the extra step to report that” to the health department website.

The CDC didn’t release detailed age data for Vermont, but national data shows that people 17 and younger were the most likely to have gotten Covid during the pandemic, while people 65 and older were least likely.

Benjamin Lee, a pediatric disease physician at the University of Vermont Medical Center, researched the rate of Covid antibodies in children in early 2021.

His research found that, as of December 2020, less than 5% of children in the Colchester school district  had gotten Covid. During Delta and Omicron, Lee said last week, state data shows “the proportion of children who represent the total caseload has gone up a lot.”

That’s partly because the Omicron variant was so infectious, and children have the lowest vaccination rate in the state.

“We had lots of kids who still unfortunately hadn't been vaccinated, even though there were many who are age eligible,” he said. “And many kids that hadn't been infected before now (were) meeting the most infectious variants of the virus that we've encountered at a time when a lot of restrictions were being sort of scaled back.”

He said the low rate of Covid among Vermonters overall could likely be traced to two causes: the high vaccination rate statewide, and Vermonters’ willingness to follow public health guidance on masking, quarantining and social distancing.

About 88% of Vermonters 5 and older have at least one dose of the Covid vaccine, and 59% are up to date on all vaccinations, including any necessary booster doses, according to the health department.

According to Lee, although vaccine-related protection against contracting the virus wanes over time, and the vaccine has gotten less effective against different variants, the vaccine may have played a role in Covid rates remaining low in Vermont in 2021.

Vermonters also mostly followed pre-vaccination guidance to prevent illness, according to a survey from UVM researchers conducted from January to April 2021. The majority of respondents said they always followed guidance about wearing a mask, staying at home and quarantining.

“Our results indicate that Vermonters had a high level of trust in and compliance with public health recommendations from the beginning of the pandemic,” Christine Vatovec, one of the authors of the study, said via email.

Are the 70% of Vermonters who have never gotten infected still destined to get Covid? Levine has often quoted Anthony Fauci, chief medical advisor to President Biden, that the question was “not if, but when.”

Nicolai said Vermonters couldn’t expect to “interact in society and never get exposed,” but said they shouldn’t be disheartened by that news.

“The vaccine is still protecting you from a serious illness,” she said. “It's shortening your duration of illness and most likely shortening the timeframe that you are infectious to others as well.”

Asked if he would have traded Vermont’s low infection rates early in the pandemic and let more Vermonters get infected to prevent the current surge, Levine said he would “never take that away.”

“We had that early success before there was even a hint of a vaccine that would ever be available,” he said. “We were really focused on saving lives and keeping people as well as possible during that time.”

Read the story on VTDigger here: Less than a third of Vermonters have ever gotten Covid, CDC study shows.

Updated at 4:23 p.m.

Every Vermont county besides Essex and Windham has “high” Covid-19 community levels, the U.S. Centers for Disease Control and Prevention reported late Thursday.

The counties in the CDC’s “high” category account for about 92% of the state’s population, including Vermont’s most populous county, Chittenden. This week’s data includes five counties that are newly rated as high: Caledonia, Lamoille, Orange, Rutland and Windsor.

The CDC recommends that people in high-level counties take broad public actions to reduce transmission, including wearing a mask in indoor public spaces. In medium-level counties, high-risk people should consider taking additional precautions. 

The agency also recommends that people in counties at any level get tested when they are symptomatic and stay up to date on their Covid vaccines.

The CDC ratings are based on three metrics: recent Covid case counts, new hospital admissions for Covid and the community’s overall hospital capacity. 

Covid cases in Vermont have risen about 18% in the past two weeks, and state officials have said they believe the recent increase in cases appears to be “leveling off.” 

But at the same time, hospital admissions for Covid-positive patients have increased in the past two weeks, going from about 12 per day to almost 20 per day on average, according to the CDC. State data shows that the number of intensive care patients with Covid has also risen.

Data from the Vermont Department of Financial Regulation shows that, as of Tuesday, the number of hospital beds available in the state had declined from an average of more than 100 beds in early April to about 40 to 50 beds at the beginning of May.

The data released by the Vermont Department of Health on Tuesday showed that among the patients hospitalized with Covid in the week prior, 13 were vaccinated and four were unvaccinated, for a rate of 2.1 hospitalizations per 100,000 unvaccinated Vermonters and 2.9 per 100,000 vaccinated Vermonters.

However, Health Commissioner Mark Levine noted on Tuesday that the department data does not distinguish between people who have gotten the booster and those who have not. The department also doesn't release data on whether patients were admitted because of Covid symptoms, or whether they were admitted for other causes and tested positive while at the hospital.

On Friday, the city of Burlington released the latest week of data on Covid levels in wastewater samples from three treatment plants. The results showed that viral levels were about the same as those reported by the plants about two weeks earlier. 

All three plants continue to report higher Covid levels than they did prior to early March, when the BA.2 subvariant became the dominant Covid strain.

Vermont reported 386 new Covid-19 cases, 64 hospitalizations and no additional deaths Friday.

The state’s seven-day average for new reported infections is 325, down from 332 on Thursday, according to the Vermont Department of Health dashboard. 

Vermont’s seven-day average test positivity rate was 13.4% Friday, up from 13.3% on Thursday. (The test positivity rate includes only PCR tests, not at-home antigen tests.)

The health department reported that 64 people were hospitalized with Covid as of Friday, up from 56 on Thursday. That includes 14 people in intensive care, down from 16 on Thursday.

The health department reported no additional Covid deaths on Friday. In total, 642 people have died since the beginning of the pandemic, including 19 in April and two so far in May.

Read the story on VTDigger here: All but 2 Vermont counties have ‘high’ Covid levels, CDC says.