Vermont’s in an unusual position this month: While COVID-19 case numbers are falling nationally,  they’re still rising in Vermont — a reversal after more than a year of better-than-average outcomes for the Green Mountain State.

Vermont's  seven-day average case rate has increased 27 percent since the start of the Labor Day weekend. Cases have risen more quickly among people who are not fully vaccinated.

At Gov. Phil Scott’s weekly news conference Tuesday, state officials outlined the measures they hope to put in place as part of a long-term response to the pandemic. Officials said that Vermont is one of 26 states that have approved OSHA state plans to expand a federal vaccine mandate for large businesses to include public employees, including school districts.

Updated at 5:06 p.m.

State regulators have granted the University of Vermont Medical Center permission to begin planning its proposed outpatient surgery facility, overriding concerns raised by frontline workers about whether the hospital can adequately staff the expansion.

The hospital was required to seek this initial level of approval, known as a "conceptual" certificate of need, because the proposed facility is expected to cost more than $30 million. The hospital must still return for final approval before it can break ground on the project.

UVM Medical Center leaders have said the new facility would replace the shuttered seven-room outpatient facility at Fanny Allen, address existing surgical backlogs and meet future demand.

Determining that the project appeared to meet an "existing or anticipated need," the Green Mountain Care Board announced Monday that it was approving the hospital's request to spend up to $5 million on planning and designing the proposed facility.

Advocates on Monday called for Vermont to extend a housing program that’s due to end September 23, which would force people in about 540 households  out of motels and hotels.

Vermont Legal Aid and other advocacy organizations want state officials to extend benefits that have housed the homeless since the start of the pandemic. The rooms are available, as is federal funding, said Mairead O’Reilly, a Vermont Legal Aid Attorney who spoke at a news conference in Montpelier.

“We cannot support the termination of benefits for immunocompromised persons whose health is still very much at risk due to the ongoing pandemic, domestic violence survivors who may feel forced to return to abusive homes rather than sleep unsheltered, pregnant women who will become more likely to have less healthy preterm babies as a result of being unsheltered,” O’Reilly said.
Several groups that work to reduce poverty and homelessness signed a September 14 letter to Sean Brown, commissioner of the Department for Children and Families, asking that DCF extend the housing benefits for as long as possible.

The University of Vermont Medical Center’s proposal to build a new outpatient surgery facility is facing opposition from an unlikely source: its own employees.

The Vermont Federation of Nurses & Health Professionals — which represents 2,400 nurses, technicians and technologists at the UVM Medical Center — wrote to state regulators on Monday questioning the wisdom of expanding the hospital’s surgical capacity at a time when its leaders are “unable and unwilling” to safely staff existing operations.

The Green Mountain Care Board must soon decide whether to allow the Burlington hospital to start developing a plan for the new facility, which officials say would help reduce significant surgical backlogs and meet future demands.

But the union says that unless hospital leaders first commit to addressing existing staffing shortages, then the expansion will only exacerbate the current workforce crisis and further jeopardize the quality of care.

In a letter sent September 10, union president Deb Snell requested that the union be granted “interested-party status” so that it could weigh in on the project before regulators determine whether the hospital can proceed.

The Larner College of Medicine at the University of Vermont is offering continuing education credit to doctors, nurses and other medical professionals who attend sessions at an upcoming conference of the Vermont Right to Life Committee.

The workshops that qualify for credit at the October 2 conference include "The Case Against Proposal 5," "The Impact of Abortion on Women’s Mental Health" and "Abortion Survivors: Not a Myth."

A reluctant Green Mountain Care Board on Monday endorsed a $1.5 billion budget for the University of Vermont Medical Center that will allow the Burlington hospital to charge commercial insurers 6 percent more for services.

The budget will allow the hospital to collect an additional 6 percent — or $200 million — in net patient revenue. That's well above the 3.5 percent ceiling that the board had recommended for fiscal year 2022. Even as they approved it, the regulators expressed unease at the steep insurance charge hike, which will likely lead to higher prices for ratepayers.

But the board ultimately decided that the medical center needed the additional revenue to confront its long-standing access problems, which were thrust back into the public eye earlier this month in a Seven Days cover story.

“What's kept me up at night is that approving a 6 percent commercial rate is really tough to swallow,” said board member Jessica Holmes. “But what’s tougher for me to swallow is thinking that if we reduce it below that, we as a board will be ... limiting the resources necessary for the medical center to address what I think we all see now as a patient access crisis.”

Vermont will require anyone who works for the governor’s office or state agencies to attest that they are vaccinated starting on September 15, Gov. Phil Scott said Wednesday.

Workers who don’t will be required to wear masks on the job, and will have to undergo a COVID-19 test every week, Scott said at his regular weekly press conference. The order covers about 8,000 state government employees, excluding those who work for the legislature and the judiciary.

There are signs that Vermont’s COVID case rate, which started rising in July, may have hit a peak. The rate among vaccinated people rose just 1 percent in the last seven days, officials said. The case rate among unvaccinated people rose 11 percent, according to the state Department of Health.

“We feel it’s the best way to put this pandemic behind us,” Scott said of requiring vaccinations. “I continue to urge other employers to follow suit.”

The move was expected, said Steve Howard, the executive director of the Vermont State Employees' Association. Scott in mid-August issued a similar mandate for people who work in Vermont’s prisons, psychiatric hospitals and in the state veterans' home. But Howard said in order to keep state employees safe, members of the public who enter state office buildings should be required to wear masks and show they’re vaccinated.

“It’s not just the employees who are in these buildings,” he said.
COVID has killed 282 Vermonters since March 2020. Thirty-two people were hospitalized with the virus Wednesday, seven of them in intensive care.

Officials announced Wednesday that they are amending guidance for schools. To encourage students to get vaccinated, the state initially issued a recommendation that all students remain masked until 80 percent of eligible students were fully vaccinated. After that, only students under the age of 12 — who are not yet eligible for vaccines — would have to wear masks.

That guidance is voluntary, yet only one school district has chosen not to follow it, according to state officials. The town of Canaan voted in late August against a mask mandate.

Some parents and administrators have been pushing Scott  to require masks in school. He has stayed firm on a refusal to renew the state of emergency needed for that requirement. But on Wednesday, he announced the state will now advise schools to require masks of all students and staff, regardless of their vaccination status, until October 4.

“We will continue to adjust our recommendations based on conditions for the virus in our schools and our communities,” said Education Secretary Dan French. He noted that 80,000 students started school in September; 81 cases of COVID-19 have been reported among students.

“I can’t help but reflect and draw a comparison from where we were last year,” he said. “It’s important to acknowledge we have 80,000 students in person right now in schools.”
About 77 percent Vermonters eligible for vaccinations — 440,000 people — have completed the shots, a rate that puts the state near the top nationwide. On Wednesday, the administration announced it will set aside $2 million in grant money for schools with higher vaccination rates.

Schools can apply, with student input, when they reach certain benchmarks. Grants will focus on priority areas such as academic, social and emotional support and recovery, said French.

The proposal was immediately lambasted on social media as a giveaway for more affluent, liberal schools.

“Wouldn’t schools with the lowest rates require more assistance?” tweeted one critic.

Next up are booster shots, which could be available as early as this month. They’ll be administered to Vermonters on the same schedule the first shots were, starting last December: Health care workers will get them first, followed by people at long-term care facilities. After that, older Vermonters will get in line. The booster shots are available already for people who have health conditions that compromise their immunity.

There are still many details to be worked out with the booster shots, cautioned Vermont Health Commissioner Mark Levine. It’s not yet clear what shots will be recommended for people who got the Johnson & Johnson vaccine, for example.

“I encourage your patience for the next 10 days,” he said. “By then we’ll have answers for some of these questions.”

The People’s United Bank Vermont City Marathon & Relay will be scaled down to a half-marathon this year, organizers announced Tuesday, citing a desire to limit the number of medical professionals needed at the popular event.

Peter Delaney, executive director of RunVermont, said race organizers felt it would be insensitive to ask for volunteers from the health care professions at a time when the pandemic continues to strain hospital resources.

The compressed race will allow RunVermont to staff the event with EMTs from the Burlington Fire Department and only a handful of volunteers, Delaney said, instead of the up to 125 frontline workers who have helped in years past.

"It’s probably not the best use of their time to support a public event that is of a recreational nature," Delaney said. "Their skills and talents are probably better utilized in supporting the needs of the hospital and the medical community."

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