COVID Questions Answered

What is the prevalence of COVID right now?
The virus is now nearly ubiquitous in the country, meaning there is a high prevalence of community transmission. We are all going to come across it. Vaccinated, relatively healthy people are unlikely get very sick, especially if they have received their booster. They may feel run down, have sore throat, or experience a fever for day or two. Those who are older or immune compromised may experience worse symptoms. Unvaccinated people are at a significantly greater risk of getting very sick, of being hospitalized, or dying.

COVID case numbers are significantly elevated in Vermont currently and yet the state has some of the highest vaccination rates in the country. This makes it seem as if vaccines don’t work.
That’s an understandable perception, but it is incorrect. Vermont has about 650,000 people. About 500,000 have received at least one dose of vaccine. That leaves 150,000 unvaccinated people. Unvaccinated people are the majority of those hospitalized with COVID. Upwards of 85% of COVID patients using the ICU are unvaccinated. Those who are vaccinated and boosted encounter COVID and may test positive. They do not typically become seriously ill.

It is every individual’s inherent social responsibility to be vaccinated against COVID-19 in order to minimize transmission, protect the vulnerable, and preserve our healthcare system, our economic prosperity, and the education of our children. With the exception of true severe allergic reaction to a component of the vaccine, which is extremely rare, there is no excuse to avoid vaccination. In other words, those that do not receive the vaccine are directly leading to harm and death in friends, family, co-workers, and the population.

How is the hospital doing?
We are at capacity now. Staff are frustrated with the number of patients who are coming in and in need of care but who have chosen not to be vaccinated. We are weary and starting to reach our limits. Hospitals all over the state are in the same situation. It is to the point where we may have to postpone some non-emergent services temporarily. The situation would significantly improve if those who are not yet vaccinated would get vaccinated and everyone would get a booster.

Are there are any reasons not to get the vaccine?
No, with the exception of a severe allergic reaction to a component of the vaccine, which is extremely rare. It is every individual’s inherent social responsibility to be vaccinated against COVID-19 in order to minimize transmission, protect the vulnerable, and preserve our healthcare system, our economic prosperity, and the education of our children. In other words, those that do not receive the vaccine are directly leading to harm and death in friends, family, co-workers, and the population.

Are masks still beneficial?
Yes. When prevalence of virus in the community is high, as it is now, everyone—vaccinated or not—should wear masks in public. Drop your mask only when you are in small groups of people who are both fully vaccinated and not at high risk of a serious case of COVID-19 due to extremes of age, poor health, or immunocompromised state.

What sort of mask should I wear?
Any mask is better than no mask. The most important thing about a mask is how well it fits and how comfortable it is. Any mask that you can wear for the time needed without having to touch it is the best mask. Early in the pandemic, we needed to save the medical-grade masks for medical personnel. Now they are widely available, so everyone can use them.

How should I manage my social life right now?
Mask when indoors in public. Keep gatherings small and among people that you know are vaccinated and, ideally, boosted. Know that large, crowded indoor events are higher risk.

Attention has shifted away from “long COVID.” Is it still happening?
Yes. Physicians, including those at Dartmouth-Hitchcock, are working with patients experiencing ongoing symptoms after COVID. They are conducting studies and beginning to formulate treatments. It is a serious condition that could last for months to many years. 

What are the chances of a vaccinated person getting long COVID?
If you are healthy and vaccinated, and you develop COVID-19, your symptoms will be less severe than those of someone who is unvaccinated. It stands to reason that the chances of suffering from long COVID will be less.

How would you recommend using the different testing options now?
Home test kits are meant to be used either by those who have symptoms or by those who are being tested repeatedly. If you have a symptoms and have a home test that results negative, you still need to get a PCR test. If you are fully vaccinated (and ideally boosted), you can use a home test for added assurance before attending an event, for instance.

PCR tests are the gold standard. They are available at the COVID Resource Center in Bennington. At the start of the pandemic, SVMC invested time and resources on testing equipment. We have one of the best testing systems in New England. One might experience a wait if they arrive right when our site opens, but those who come a few hours into our schedule typically have no wait. Results take about 24 hours.

I went to a large convention. Should I get tested?
If you’re vaccinated, wore a mask, have no symptoms, have no reason to suspect you were exposed, and do not live with an immunocompromised individual, it is not necessary to be tested.

I have cold symptoms. Should I get tested? And how often?
Yes. If the test is negative, you do not need to be tested again during that period of illness unless recommended by your doctor.

Do any of the tests tell you what variant you have?
No. A percentage of positive tests are further tested to monitor for variants in our state.

What treatments are you providing?
For those at high risk, we are providing monoclonal antibody infusions at the hospital. We are looking forward to new oral antiviral drugs within the next 45 days that select patients may get as a prescription.

A new prophylactic treatment intended for those with immune compromises was just approved and should be available in limited supply. Prophylactic means that it is given before the person is exposed to COVID or becomes ill. We expect that it will bolster the immune response for people with cancer, for instance. 

What do you think of Omicron?
Much of the information that has come out so far is limited.  We need to understand how well it spreads (transmissivity), how much harm does it cause (virulence), and whether it can escape immunity. Omicron appears to have a high transmissivity based on case rate doubling times compared with other strains of the virus. Observations in a few locations, including South Africa and the UK, suggest that infected healthy individuals are experiencing less severe symptoms. However, less severe disease among a much larger group of infected people will lead to a greater number of hospitalizations. Finally, in regards to the ability to escape immunity, computer modeling combined with lab studies indicate that omicron possesses some degree of ability to evade antibody immune response. Pfizer reported that antibody response to the presence of omicron in the serum of a small group of vaccinated individuals was diminished. However, the antibody response to omicron in those with a booster were significantly higher. Antibodies are not the only part of the body’s immune response. Thus, the ability of the virus to cause significant disease in those with immunity from vaccine or prior infection in the real world will remain inconclusive for another few weeks.

What can we do to prepare for the arrival of Omicron?
Continuing mitigation efforts is highly advised at this time. Get vaccinated. Get boosted. Wear masks when indoors in public. Stay distanced and maximize appropriate ventilation, including meeting outside. Masks are not necessary outdoors unless crowded very close together. 

What are your recommendations for the holidays?
Get vaccinated and boosted, if you’re eligible. Keep gatherings small and of fully vaccinated people. Those who are much older or immune compromised may want to skip gathering or visit outside on the porch, because the prevalence of the virus is high currently.

What’s the game plan for the next 12 months?
Many people who are currently unvaccinated will eventually decide to vaccinate. It’s the right thing to do. Others will get COVID. Some will need to be hospitalized, and sadly, some will die. COVID will eventually decline, and we will be in a better position. The prevalence will wax and wane. We will continue to monitor case rates and, when they are high, we will wear masks and institute other restrictions.