Vermont’s Covid-19 case totals for the past three weeks rose to a level not seen since April, state officials said Tuesday, as they cautioned against growing “pandemic fatigue” as winter weather sets in and people travel for the holidays.

“This is more serious than it might sound at first blush,” said Dr. Mark Levine, commissioner of the Department of Health, at one of Vermont’s twice-weekly press conferences.

“For nearly eight straight months, we've had to really dial back our lives to protect ourselves, to protect each other, adjusting our routines for many of the basic social and family activities that we all enjoy,” he said.

That may lead people to tire of the restrictions, but Vermonters should remember the virus is “very good at finding ways to spread,” he said.

The efforts to stay apart and avoid the virus, he acknowledged, are “exhausting, both physically and mentally.”

Following a surge in local COVID-19 cases, Springfield Hospital is implementing a new “no visitor policy,” according to a news release from the hospital.

The policy, which went into effect Friday night, has some exceptions: Children are allowed to have two parents present, “end of life” care patients may have visitors, and cognitively impaired patients who are coming for outpatient treatments may have a caretaker, according to the news release.

The news comes after the Upper Valley and other parts of Vermont and New Hampshire saw a rise of COVID-19 cases in recent weeks. Vermont reported 13 new cases of the coronavirus on Friday, for a statewide total to date of 1,915. Six of the new cases were in Chittenden County, three in Bennington County, and one each in Windham, Windsor and Washington counties. The total number of deaths has remained at 58 since late July.

As of Friday, a total of 9,514 people had tested positive for the virus in New Hampshire, an increase of 90 from the previous day. Two new deaths were announced, bringing the total to 463.

 Rutland Regional Medical Center unveiled a new medical office building Monday afternoon.

The Thomas W. Huebner Medical Office Building is a 37,000 square-foot building connected to the main hospital. It houses the Vermont Orthopaedic Clinic, Physical Medicine and Rehabilitation, and ENT and Audiology medical practices.

Huebner began working at Rutland Regional in 1990, and was the CEO from 1997 to 2018. He still lives in town and is involved with the hospital.

Claudio Fort, the hospital’s current CEO, says they needed the $24 million project because some of the hospital’s busiest practices had run out of space. “The fact that this is spaced out gives us room for growth. It also being connected to the hospital and right continuous to the hospital, makes it a lot easier for our surgeons to take care of patients and attend to emergencies in the hospital without as much disruption to their practices," Fort said.

Today, the Department of Justice announced an $8.3 billion global resolution of its criminal and civil investigations into the opioid manufacturer Purdue Pharma LP. The resolutions with Purdue are subject to the approval of the bankruptcy court.

The scheme to use medical alert software to boost sales of opioids was uncovered by the US Attorney’s office in Vermont. That part of the case with Practice Fusion from San Francisco was settled last January for $145 million.

“The abuse and diversion of prescription opioids has contributed to a national tragedy of addiction and deaths, in addition to those caused by illicit street opioids,” said Deputy Attorney General Jeffrey A. Rosen. “With criminal convictions, a federal settlement of more than $8 billion, and the dissolution of a company and repurposing its assets entirely for the public’s benefit, the resolution in today’s announcement re-affirms that the Department of Justice will not relent in its multi-pronged efforts to combat the opioids crisis.”

“Purdue’s expansive criminal conduct included paying a kickback in exchange for designing medical software to influence unwitting physicians,” said Christina E. Nolan, United States Attorney for the District of Vermont. “Purdue’s drug marketers paid to invade the sanctity of the physician-patient relationship so that it could influence medical decisions and increase prescriptions of its most potent opioids. As a Purdue entity is now prepared to plead guilty for a second time to conduct involving unlawful marketing of highly addictive opioid pills, this resolution will serve as a reminder that the company put profits before people during the height of the opioid crisis.”

She added that they also corrupted the doctor-patient relationship.

OneCare Vermont has had a challenging fall.

The group, which manages the state’s health care reform efforts, is nearly three years into a five-year effort to shift the way that medical care is funded. OneCare collects money from private insurance companies, Medicaid, and Medicare, and funnels it to hospitals in monthly per-patient payments.

The approach is meant to save money by focusing on primary care and by making it more lucrative for hospitals and doctors to focus on quality, rather than quantity, of care.

In the last several months, the group has faced pushback from doctors, hospitals, the federal government, and the public.

In August, primary care practices threatened to leave OneCare, saying their rates were being cut. The two sides hashed out a deal, but ultimately, some practices did leave.

During budget hearings, several hospital officials criticized the effort as administratively burdensome and too costly. In September, the federal Centers for Medicare & Medicaid Services sent a letter warning the state that it was behind on its targets. Fewer people than expected have participated in the system; OneCare needs the vast majority of the state’s population to opt in for the approach to be successful.

Some groups have protested against the system, saying the administrative costs should be spent to help low-income patients get the care they need.

Nursing homes have been severely impacted by the coronavirus. As the pandemic continues, some residents are feeling more isolated than ever.

Woodridge Rehabilitation and Nursing has managed to stay virus, but has only allowed residents half-hour visits from friends and family.

For many of the residents, this isn’t enough, said psychologist Michael Zacharias, who says he has seen an increase in loneliness among nursing home residents.

“That certainly contributes to a sense of depression,” Zacharias said. “Folks are stressed.”

To help cope, Zacharias encourages residents to get involved in activities. At Woodridge Rehabilitation and Nursing, that means small-group activities, movies and BINGO.

George Gerrish has been a resident at Woodridge Rehabilitation and Nursing since June 2019. Being away from his family has been especially difficult.

“My youngest brother is still alive, and he wants to get up here,” Gerrish said. “Before I came here, he used to come to my apartment every single day.”

Earlier this month, Vermont health officials announced they were getting 21,000 rapid Covid tests from the federal government.

Despite the fanfare with which President Trump sent out the tests, Vermont won’t be using them. At least several nursing home officials said they don’t need them and the state has stockpiled its shipment until further notice, according to Health Commissioner Mark Levine.

“We don’t find that as necessary,” said Alecia Dimario, spokesperson for Birchwood Terrace Rehab and Healthcare in Burlington. Birchwood received a handheld machine to run antigen tests, plus two initial rounds of testing for the roughly 100 residents. But the nursing home doesn’t have the staff or the time to run the tests.

Levine, who has long been hesitant to use the rapid tests, said he would stockpile the tests until at least January when there could be a shortfall. “The reason we've been reluctant to go full-fledged in with antigen tests to date has to do purely with the prevalence of disease in Vermont — it's not as much a matter of is the test good? Is the platform good? It's a matter of is it the appropriate time to use the test,” Levine said in an interview.

At this point, “we don't think it would be as useful,” he said.