BRATTLEBORO — On Nov. 27, Vermont crossed a grim threshold - its 4,000th confirmed case of COVID-19.
While the state still can boast about its low number of cases, its low test-positivity rate, and its low numbers of deaths and hospitalizations, November marked a turning point for Vermont in the pandemic.
According to data from the state Department of Health, more than 45 percent of the 4,172 cases of COVID-19 recorded as of Nov. 30 came in November alone. Nationwide, the United States now reports more than 13 million cases, with more than 265,000 deaths.
After going from July 28 to Nov. 4 without a COVID-19 death, Vermont has recorded 14 deaths - including two in Windham County - since Nov. 5.
One of those deaths occurred in Brattleboro Memorial Hospital, the first to occur there since the start of the pandemic.
“We are deeply saddened that a member of our community has died from COVID-19,” BMH Chief Medical Officer and Chief Information Officer Kathleen McGraw M.D., F.H.M., C.P.E., said in an email to The Commons. “Our thoughts are with the family during this difficult time.”
McGraw wrote that the elderly male patient “suffered from a variety of medical issues, and had been hospitalized for end-of-life comfort measures.”
“Upon his arrival to the hospital, the staff performed routine health examinations, including the nasopharyngeal test for COVID-19, and the results determined the patient was positive for the coronavirus,” she said.
A surge that was expected
State officials anticipated an increase in coronavirus infections in November, knowing that colder weather would likely drive people indoors, to environments more hospitable to the coronavirus.
Gov. Phil Scott's Nov. 13 executive order that banned people from different households from visiting one another and tightened quarantine restrictions on travelers was aimed at heading off a surge.
While state officials say they were heartened by a New York Times survey last week that found 80 percent of Vermonters planned to have smaller Thanksgiving celebrations this year, they had advice for the 20 percent who didn't follow the governor's guidance and traveled to attend family gatherings.
That advice: Quarantine, and get a COVID-19 test.
At a Nov. 27 COVID-19 news briefing, Health Commissioner Dr. Mark Levine urged quarantine for Vermonters who gathered for Thanksgiving with people from outside their homes, or for anyone who traveled to a holiday celebration. They should get tested as soon as possible, then get tested again after seven days, he said.
And Scott asked parents not to send their children to school this week if they attended gatherings with people from outside their household.
“We will learn more in seven to 14 days” about the impact of Thanksgiving gathering, Levine said. “Most of us in state government observed the different feel of the holiday this year - the lack of traffic, the airports reporting lower holiday and pre-holiday activity.”
In his weekly travel advisory on Nov. 24, Department of Financial Regulation Commissioner Michael Pieciak said that it is estimated that 38 percent of Americans intended to travel and gather for Thanksgiving as they did before the pandemic.
Pieciak said if Vermonters behaved similarly, the state should expect between 3,200 and 3,800 new cases in addition to the normal case growth, and an additional 40 to 50 new hospitalizations.
Long-term-care concerns
Levine said he is concerned about the rising number of cases in nursing homes and other long-term-care facilities, so the Health Department plans to increase its surveillance testing there in the coming weeks.
Weekly testing of all staff and residents at such facilities began this week, according to Agency of Human Services Secretary Mike Smith. Some facilities may see daily testing if the state deems them especially vulnerable to infection.
Levine said the best way to protect residents in these settings is to follow the guidance on mask-wearing, distancing, and avoiding crowded places.
As for schools, Education Commissioner Dan French said the first round of surveillance testing has been completed at Vermont schools. Of the 9,400 teachers and staffers tested, 21 tests came back positive for COVID-19.
French said another round will take place in December, with 25 percent of districts testing each week on a rotating basis.
A speedy spread
In the latest illustration of how fast an outbreak can happen, Public Safety Commissioner Michael Schirling said on Nov. 27 that a state trooper at the St. Albans barracks tested positive for COVID-19 last week.
That trooper, whose significant other is a health-care worker, potentially exposed one person during an interview and 15 staff members at the barracks.
Schirling said the employees who were exposed are in isolation pending the results of COVID-19 testing. Troopers and staff from other barracks around the state have been called in to help fill the ranks.
He also offered an update on health and safety assessments that were recently done at 1,200 businesses around the state to make sure they're following the state's guidance to prevent the spread of the virus.
He said no major problems had been found, and the Department of Public Safety will now switch to visiting businesses only if a complaint is made regarding compliance.
Testing and prevention
Brattleboro Memorial Hospital has recently started offering daily COVID-19 testing as part of the state's pop-up testing initiative.
The hospital is staffing the test site in partnership with Cambridge Innovation Center and the Health Department.
“It is going really well,” said McGraw, the hospital's chief medical and information officer. “To date, we have provided 395 tests since the first day of testing on Nov. 18. We have the ability to perform 55 tests each day. In general, all time slots are filled each day.”
The Health Department recommends testing for people who have symptoms of COVID-19, who have had close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with someone who tested positive for COVID-19, or who recently attended an event with people who are not in their usual social circle.
COVID-19 symptoms can include fever (100.4 F or higher), coughing, shortness of breath or difficulty breathing, chills, fatigue, muscle pain or aches, headache, sore throat, new loss of taste or smell, congestion or runny nose, nausea or vomiting, and diarrhea.
The BMH test site is a drive-thru service, but walk-ins are welcome if registered. The free testing is intended for people who are asymptomatic and may have had close contact with someone who tested positive, are looking to end quarantine early (after seven days), or who recently attended a social gathering with people outside of their household. An order from a clinician is not required to get a test.
Testing is also available at the Carlos Otis Stratton Mountain Clinic in Winhall on Mondays, Wednesdays, and Fridays.
To set up a testing appointment at either site, one must create an account at vermont.force.com/events/s/selfregistration to get a patient ID, then log in with those credentials.
For help or technical assistance, call the Vermont Department of Health COVID-19 Call Center at 802-863-7240.
In addition to testing, McGraw noted the critical need for community members to remain aware of their behaviors.
“I continue to urge our community members to be diligent in not only washing their hands, wearing a mask, and practicing social distancing, but also staying home when you're not feeling well, for the sake of family, friends, and neighbors,” she said.