Recommended Responses to Record-Breaking Cases

As you may have heard, last week, Vermont broke a record for the number of COVID cases recorded. This week, predictably, hospitalizations increased. These circumstances have put some strain on the hospital system. For the sake of our doctors, nurses, and support staff, we have an interest in discovering the causes of this increase and making recommendations that we hope will bring the situation to a more manageable level.

Factor: Unvaccinated people are most likely to test positive. This includes people who are ages 5 – 11, who are only just recently eligible for vaccination. The highest rates of positivity are among those 20 – 29 and 5 – 11. Unvaccinated adults who are 50 or older are most likely to have a case of COVID requiring hospitalization.
Recommendation: Get vaccinated, and get your children vaccinated. All of the information you need is at https://www.healthvermont.gov/covid-19/vaccine.

Factor: Because most people in Vermont got their vaccines early, they likely kept overall transmission of COVID low. This could translate to lower immunity and increased vulnerability to the Delta variant for those who are not vaccinated. In other words, the pandemic had an opportunity to really gear up before hitting home here in Vermont.
Recommendation: Again, those who are unvaccinated should get vaccinated as soon as possible. Someone who got the Johnson & Johnson vaccine today could be one day short of fully protected by Thanksgiving.

Factor: Many Vermonters got vaccinated as soon as they were eligible, so after many months, the immunity they received from the vaccine is likely waning. Healthy vaccinated people, even those whose immunity has waned, are still mostly protected from serious cases of COVID and those that require hospitalization. 
Recommendation: Get boosted. A booster will renew waning immunity. You are very likely eligible. If you were vaccinated with Pfizer or Moderna 6 months or more ago or with Johnson & Johnson 2 months or more ago and you feel that you have an exposure risk, you are eligible to receive a booster. Visit https://svhealthcare.org/COVID-Resource-Center to schedule.

Factor: We are behaving more normally. People have resumed some of the gatherings and other activities that they had avoided earlier in the pandemic. This leads to increased spread and increased cases.
Recommendation: At this point, it makes sense to use extra care when going about errands or gathering with others. As always, stay home when you get sick and get tested if your symptoms have any similarities with COVID. Otherwise, wear a mask indoors or in crowded outdoor spaces and keep your gatherings small, among vaccinated people, and outdoors, whenever possible.

This is not over. As the weather gets colder and the holidays approach, it could get worse. And no one recommendation will work to solve this problem. As Dr. Mark Levine noted in a press conference on Tuesday, we have to follow all of the recommendations at once. Doing so will relate to a drop in cases, more manageable hospital capacity, and a much happier Thanksgiving for everyone.

Marie George, MD, FIDSA, is an infectious disease specialist at Southwestern Vermont Medical Center in Bennington.