Message from the CEO
by Jeff Tieman

As we close the door on 2021 and look to the new year, here’s what I sadly cannot tell you—that COVID will be gone and life will return to how it was in January of 2020. We are never
going back. COVID is here to stay in one form or another. The holiday wave of cases set infection records unimaginable in the early days of the pandemic. With Omicron spreading
rapidly, our hospitals face the possibility of another surge of patients in the coming weeks.

Typically I would not start a new year’s message with such troubling facts. However, these developments continue to distress already worn-out parents, restaurant workers, teachers, state officials, students and so many others. For hospital staff, there are all these factors plus more: the stress of managing health care delivery during a pandemic—both personally and professionally—is significant and growing. Our health care providers have been doing this tiring work for two years. And yet they continue to show up for their patients and stay through the most difficult days.

When 2020 concluded, just about one year ago right now, there was awesome hope that
vaccines would help us beat COVID and get back to our lives—travel, family gatherings,
concerts and events. Well, vaccines did improve our lives because they offered protection and the ability to gather again. We showed the nation how Vermont comes together to achieve an important goal—in this case vaccinating our neighbors and friends in an orderly and fair way. We also kept kids in schools and limited major outbreaks. We tested early and often. Then, when Delta and now Omicron arrived, we adjusted our strategies and kept up the fight.

The new year is a great time for renewal. Social media is full of resolutions touting change: lose weight, save money, buy a Peloton, eat healthier. Nothing wrong there but I think we can keep it even simpler: stick together and keep up the fight. This means taking care of each other mentally, emotionally and physically and continuing to sacrifice sometimes to protect others.

Staying together for the benefit of all means getting vaccinated and boosted; Omicron accounts for the vast majority of new infections, but does not seem to cause serious illness for vaccinated people. We need to limit gatherings and try to avoid meeting with people we know to be unvaccinated. We need to continue masking indoors when in public. These safety measures may seem old and annoying but they still save lives and aren’t that hard to manage.

I won’t say that there is a glimmering light at the end of the COVID tunnel because none of us know when or, really, if ever the virus will be entirely eradicated. And maybe that’s not the point. Instead perhaps the point is how we responded and continue to respond to this adversity. Our health care providers and frontline workers are choosing YOU every day when they go to work. Let’s choose them back and keep up the fight.

Here’s to a happy and healthier 2022!
VAHHS Column
Bracing for Impact
By Devon Green, VP Government Relations
Heading into Omicron, it feels like we’re on an airplane with an unspecified mechanical failure—maybe Omicron will be mild and boosters and therapies will come together for a safe landing… but maybe not. Vermont’s hospitals are expected to have the most critical staffing shortages in the country, according to U.S. Department of Health and Human Services data in Becker’s Hospital Review. Even if Omicron is mild, we can’t afford to have our health care workforce getting sick all at once.
Vermont’s health care workforce shortage is no surprise. Prior to the pandemic, the Rural Health Services Task Force brought forward the issue and advocated for more workforce initiatives. COVID has only accelerated the challenge.

What comes as a surprise to me is how much I take health care for granted. I’ve always assumed that if Vermont were in a critical situation and needed more health care workers, we should be able to pull from the National Guard or FEMA or… somewhere. COVID has laid bare that there is no store of health care workers from which to pull—the clinicians in the National Guard are the clinicians at your local hospital, and with the entire country low on health care workers, there are only so many people FEMA can send.
We can’t keep flying this plane. We need to take immediate action on workforce at the institutional level:
  • As the legislature gathers next week, they must prioritize workforce initiatives from the Health Care Workforce Development Strategic Plan and extend the current regulatory flexibilities under Act 6 of 2021 to maximize workforce capacity.
  • Hospitals need budgetary flexibility from the Green Mountain Care Board to retain and attract health care workers.
There are also small individual actions we can take to strengthen our health care system:
  • Health care workers have been reporting more verbal and physical abuse than ever—it’s heartbreaking. Please realize they are just as frustrated as you and are working under extremely stressful conditions. Let’s keep the health care workers we have!
  • Get vaccinated, get boosted, mask, and gather responsibly during this crucial time. There are new COVID therapies coming out, but they are scarce at the moment Let’s reduce the spread until these therapies are more widely available in the future.
  • We have a severe blood shortage right now. Please sign up to give blood at
Thank you to our health care workforce. When it feels difficult to wake up and go to work in the morning, please know that we value you. It is going to take everything from small gestures of kindness to large short and long term investments, but Vermont can and will avoid a workforce crash.
In the News
Rural hospitals, short of staff, brace for omicron

Hospitals in the U.S. are struggling to stay staffed up. Many were short of workers even before the pandemic caused an exodus of doctors and nurses from the field. 

Now, the more transmissible omicron variant is sending some of the remaining workers home, and hospitals are running out of backup plans — particularly in rural areas. 

Vermont was already in dire need of health care workers, even before the pandemic drove many into early retirement and other careers, according to Jeff Tieman with the Vermont Association of Hospitals. 

“Our workforce is shrinking and stressed, you know, at a time when we need it to be growing and resilient,” he said.
The Deeper Dig: How Vermont hospitals are handling the Covid-19 surge

Vermont hospitals are feeling the strain from the recent surge of Covid-19 cases — and so are patients. 

The state’s Covid hospitalization rates have been climbing throughout the fall, peaking about two weeks after Thanksgiving. But they’re expected to start climbing again after the New Year, when the more contagious Omicron variant spreads further.

Doctors and nurses are caring for an overwhelming number of people — many of whom are sick with severe Covid, while even more are crowding facilities after delaying care earlier in the pandemic. 

The Biden administration has sent federal reinforcements to several Vermont hospitals, and the surge has forced some patients to delay procedures they see as essential.

‘Tough’ times for health care workers
Valley News

Dr. Marvin Malek, a hospitalist at Springfield Hospital, tries not to smile.

“Usually I try to put patients at ease by saying something funny,” he said in a recent interview. “Now I have to make sure I don’t laugh.”

He tries to keep a flat expression so as not to disturb the fit of his N95 mask, which filters most, but not all, airborne particles. Protecting himself from COVID-19 is one of the many things on Malek’s mind as the 69-year-old physician cares for patients amid the largest surge of COVID-19 the Upper Valley has seen since the pandemic began two years ago.

Health officials in both Vermont and New Hampshire expect that cases and hospitalizations are likely to increase even more in the coming weeks following holiday gatherings and due to the increasing presence of omicron, a more infectious variant of the virus that causes COVID-19. Deaths also continue to mount, with the highest rate of death among those who are not vaccinated. Last week, New Hampshire announced its first pediatric death due to COVID-19.
Delayed surgeries during Covid-19 surge leave patients in limbo, sometimes with severe pain

Ed Striebe, 59, was diagnosed with moderately aggressive prostate cancer in September. After talking with his surgeon, they decided Striebe’s treatment plan would start with surgery. The hospital would call Striebe to schedule the procedure. 

Striebe waited. And waited some more. Then he called the hospital — which Striebe did not want to name — only to be told that because they were cutting back their number of scheduled surgeries, they could not give him a date yet. He called again last week and received a similar response: The hospital would get back to him soon. 

“When you have a doctor in front of you saying, ‘Yeah, you have cancer,’ the big C-word, whether it’s small, big or different, you get a little bit wigged out,” Striebe said. “Then you kind of just keep going along. But I just — I want it done.”
Vermont hospitals receive new therapeutic treatments for COVID-19

New therapeutic treatments for COVID-19 are giving hospitals more tools to combat the virus.

“Vermont has received an extremely limited supply of all the current COVID-19 therapeutics," said Dr. Mark Levine, Vermont's health commissioner. "The federal government will continue to allocate supply based on hospitalization and case data.”

There is one drug, sotrovimab, that is effective against the omicron variant. Rutland Regional Medical Center has only received 12 doses and hasn’t yet administered any.

“Right now we’re going by the National Institute of Health guidelines. They recommend to reserve sotrovimab until omicron cases reach 80% or more," said Saisha Branchaud, director of pharmacy services at Rutland Regional Medical Center.
Vermont, and the nation, face a critical blood shortage

Vermont, like the rest of the nation, is facing a critical blood shortage.

Blood supplies have been declining since the pandemic began in March 2020, exacerbated by surging Covid-19 cases and a lack of donations.

Blood shortages can have disastrous impacts on hospitals’ ability to treat patients with serious health problems. For instance, blood is a crucial part of most surgeries.

When the pandemic began, donations quickly declined, said Mary Brandt, spokesperson for Red Cross of Northern New England. People were worried about getting Covid-19, and blood-donation centers seemed like a risky place to visit.
Hospitals in the News