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As the country braces for the unknowns of the new omicron variant, the delta variant is still overwhelming parts of the United States. Some states in the Northeast and Midwest have seen sustained record-breaking case numbers. William Brangham reports on how it's hitting Vermont.
As the United States braces for the unknowns of the new Omicron variant, the Delta variant is still overwhelming parts of the United States.
Some states in the Northeast and Midwest have seen sustained, record-breaking case numbers.
William Brangham has this look on how it's hitting Vermont.
Vermont, with its widespread and early adoption of vaccines and other mitigation measures, was held up as a model for how to handle the pandemic.
But the last month, the state blew past its record case and hospitalization numbers. The surge that hit much of the South earlier this year has arrived in New England.
Dr. Rick Hildebrant is the chief medical information officer and medical director of hospital medicine at Rutland Regional Medical Center in Vermont.
Dr. Hildebrant, great to have you on the "NewsHour."
Help us understand what you're seeing in your hospital right now.
Dr. Rick Hildebrant, Rutland Regional Medical Center:
We're seeing a lot of cases of COVID. We did not see the number of cases, as you mentioned, earlier in the year, and now we are seeing a very large spike. It's in all avenues of care. We're seeing it in the emergency department. We're seeing it in the intensive care unit, and we're seeing it on the inpatient units.
And is your understanding that the bulk of these people are unvaccinated or vaccinated?
Dr. Rick Hildebrant:
The majority of the cases we're seeing are unvaccinated individuals.
There are, of course, individuals who have been vaccinated who are contracting COVID. But the majority of the cases that require hospital level of care, whether it's in the emergency department or the inpatient unit, are those who are unvaccinated.
So, help us understand, because Vermont has — I believe it's the highest vaccination rate, 75-or-something percent, in the country.
We were sort of always led to believe that, if we get to three-quarters of a population, that we wouldn't see what you're seeing. How is that happening?
There's a couple of things that have come into consideration with this.
First of all, when those assumptions were made, that was based on the native virus, not on the Delta variant of the virus. The Delta variant is just far more contagious. And that 75 percent number is not nearly enough to have herd immunity for a community. It's way higher than that, 90-plus percent.
We did have a very robust adoption of the vaccine. But that was almost a year ago. A year ago, people are rushing to get vaccinated. That immunity has waned. And after 10 months, the immunity is waned to the point at which people can contract COVID.
Now, the people who are getting COVID who have been vaccinated are generally not that sick. They're having mild illness. But they're acting as vectors. They're spreading the illness to other individuals who are unvaccinated and are getting very sick and are landing in the emergency department.
So it's a couple of different things that are playing into that.
How's the booster campaign going where you are?
Unfortunately, not nearly as well as the initial vaccination efforts went.
The booster uptake in Vermont has not been very good. And that has contributed significantly to the spike that we're seeing right now.
What we have seen elsewhere with these other recent surges, like in the South, cases went up and cases went down.
Are you seeing any trend line that looks good to you? Or do things seem to be progressing in the wrong direction?
Unfortunately, we're not.
We definitely saw a big peak a few weeks after the Halloween holiday. And we're seeing another peak now on the coattails of that related likely to Thanksgiving and small indoor group gatherings. We have seen nothing, however, other than increased number of cases for the last several weeks.
And, unfortunately, there doesn't seem to be an end in sight.
Vermont is an incredibly rural state, and people live far apart from each other. There's not that many hospital systems to begin with.
And I have been hearing a lot of interviews with different medical staff around the state, and they're describing a sense of burnout, that it's — that they're feeling that this has been going on for a really long time, and they feel taxed.
Are you guys experiencing that? What are you hearing from staff in your own facility?
There's definitely a level of exhaustion amongst staff.
I think we are better poised than other places, in that we have had relatively good staffing through most of this. The last several months have been really challenging with both nursing staff and physician staff. There is definitely a feeling of fatigue. The numbers have been high for a while. Even before we were seeing this most recent COVID surge, the amount of delayed care that has required inpatient hospitalization was very high.
And to add a COVID surge on top of that, we have seen volumes at our hospital that we have really never seen before, both in the acute care space in the medical surgical beds, but also in the ICU. And that can be really challenging when the ICU beds are completely filled in a hospital such as ours.
Unfortunately, it's not just our hospital. It's also the hospitals around us. It's our tertiary partners that are also taxed by this. And our ability to transfer patients has been limited. So it's been very hard on staff, for sure.
We have a very positive attitude in this hospital. It's an upbeat, can-do attitude, but it has been very taxing on many people.
Given the trends that you're describing, I know it's cold and getting colder. The holidays are coming. Omicron, with its unknowns, are coming.
How concerned are you about what's down the road?
If we did not have a robust surge plan in place, I'd be very concerned.
It's all about having the appropriate plans in place. So we have been working for a very long time. We know in the South that hospital systems were overwhelmed. And we never wanted to find ourselves in that type of scenario. So we developed a very robust surge plan that includes the ability to care for a large number of patients.
This has been more challenging, for sure, in this time. And the critical care capacity not only here, but on the rest of the state, has really made it challenging. However, I'm reassured, in that we have a good surge plan in place to deal with those types of volumes.
All right, Dr. Rick Hildebrant of Rutland Regional Medical Center, thank you very much.
And best of luck to you up there.
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William Brangham is a correspondent and producer for PBS NewsHour in Washington, D.C. He joined the flagship PBS program in 2015, after spending two years with PBS NewsHour Weekend in New York City.
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