From the CEO
Thanks for our caregivers and journalists who illuminate their
hard work and struggles
Through the pandemic, there has been some great and crucial journalism. A worldwide public health threat naturally inspires curious journalists to explain the unexplainable and shine a light on what’s really happening. This kind of careful and thorough reporting is important, especially when misinformation is rampant like it is now.
This month, Vermont Public Radio provided an example of stellar journalism in its series featuring caregivers at Northeastern Vermont Regional Hospital in St. Johnsbury. Speaking about the difficulty of seeing COVID patients give up hope, one nurse says, “We cry. We cry together as a group, especially night staff, you know. We have a lot of moments where we feel overwhelmed.”

That sense of being inundated and exhausted is not unique to NVRH, or to Vermont hospitals. Caregivers from coast to coast and around the world have been doing this mentally and physically taxing work for two years now. The days are long and the frustration and grief only grow when so many unvaccinated patients occupy precious ICU beds.

The VPR pieces illustrate well how the continuing clinical challenge and workforce shortage—coupled with raw emotion and pure exhaustion—has deeply affected doctors and nurses.

“The day that I really got angry was the day I was one-on-one with an ICU-level patient and there was no beds in New England for him,” NVRH nurse Kara Lawrence told VPR. “He'd had a stroke, and his brain was bleeding and there was nowhere for him to go. And I was with him one-on-one for hours, trying to make sure that he was OK. That's the day I was mad.”

Firsthand accounts of treating and managing COVID patients offers so much vital insight. For those people who don’t work in a hospital, it is impossible to fully understand what has been taking place there for the past 18 months. The VPR stories deliver that perspective. They are difficult to hear but also illuminating and inspiring.

Caregivers are amazing people who have been through a long war with no clear end in sight. They earned our gratitude and support way before the pandemic, and now they prove their devotion and resiliency day in and day out, even as the challenges grow once again.

I want to thank the caregivers who have stepped up and keep doing so. And I want to thank the journalists at VPR and so many other outlets who have worked hard during the pandemic to tell the truth, cut through the clutter and paint a clear and informative picture of what is happening in our distressed world.
In the News
COVID spikes in highly vaccinated Vermont amid booster lag

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.
How hospitals are preparing for omicron variant

Concern has risen during the past week over a rising number of COVID-19 infections in Vermont before the omicron variant was detected in the United States.

Health officials reported a record-high number of COVID-19 hospitalizations at the end of November, with 84 people receiving treatment. That includes 22 patients who were being held in an intensive care unit.

Federal health officials said they don't yet know how serious the omicron variant might be and won't for several more days.
One St. Johnsbury hospitalist, tired of risking her life at work, pleads with Vermonters to get vaccinated

Vermont has struggled to contain the delta surge for months now, and COVID-19 cases and hospitalizations have reached all-time highs. It comes at a time when hospital workers say they are exhausted from nearly two years of the pandemic, and frustrated by people who refuse to get vaccinated.

Northeastern Vermont Regional Hospital in St. Johnsbury has 25 beds, and it covers southern Essex and Caledonia counties. And as far as I can tell, there's only one registration desk. Nobody gets lost at NVRH.
Perras to Chair AHA Committee on Rural Health Services 
The American Hospital Association (AHA) has named Dr. Joseph Perras chair elect of its Committee on Rural Health Services. His term begins January 1, 2022. 
The American Hospital Association represents and serves all types of hospitals and health care networks across the country. The Committee on Rural Health Services plays an important role in advising the AHA on advocacy positions, public policy issues and rural member service strategies. 
“Dr. Perras will bring his valuable perspective as a physician, critical access hospital administrator and rural Vermonter to leading this important committee,” said Jeff Tieman, CEO of VAHHS. “The AHA and VAHHS—and their respective members—are fortunate to have Joe heading up this group at a crucial time for health care.” 
Dr. Perras joined Mt. Ascutney Hospital in 2013 as Director of Hospital Medicine and became Chief Medical Officer in February of 2015. Dr. Perras completed his internship and internal medicine residency at the Beth Israel-Deaconess Medical Center in Boston, MA. He served 12 months as a chief medical resident and was an Instructor in Medicine at Harvard Medical School. Dr. Perras continues to hold the academic appointment assistant professor of Medicine at the Geisel School of Medicine at Dartmouth. He received his undergraduate and medical degrees at The George Washington University in Washington, DC. 
Dr. Perras lives with his wife Laura, a school nurse in Hanover, and their two children in Norwich, VT. 
Calling for help: Rural hospitals struggle with overwhelmed ICUs, finding beds

Calling more than 20 larger hospitals trying to find an open bed.

Transferring patients as far away as Connecticut or Pennsylvania.

Families grappling with whether to send their loved ones hours away or to choose palliative care.

As Vermont’s intensive care units become overwhelmed, including a record-setting 31 Covid patients reported in ICUs on Tuesday, medical staff at the state’s smaller hospitals say they’ve faced an escalating crisis in recent weeks. Strained capacity affects what kinds of care they can offer, they say, in part because it’s become increasingly difficult to transfer patients to larger hospitals. 
Vermont hospitals hit new post-Thanksgiving COVID peak

A post-Thanksgiving COVID surge continues to stress Vermont hospitals and state officials say they expect to see continued elevated case counts for the remainder of the month.

The post-Thanksgiving delta spike in Vermont continues to fill up the state’s hospitals. There are currently 90 people in hospitals, with 31 of them in the ICU -- a 24 percent increase in ICU patients since last week.

Officials Tuesday reported a 31 percent increase in COVID cases over the last two weeks, with the highest number of infections in those under 49. They say the high numbers are driven by Thanksgiving gatherings and some of the highest per capita testing in the U.S. “Make no mistake about it, this is a true post-Thanksgiving surge,” said Vt. Health Commissioner Dr. Mark Levine.
Federal vaccine rules are up in the air, but some Vermont hospitals keep mandates on the books

As the first deadline for the federal vaccine mandate passes, some Vermont hospitals said they will continue to require coronavirus vaccinations of their employees. At least one hospital opted to alter its policy, however. 

The Biden administration’s policy would have required some 17 million health care workers — thousands of them in Vermont — to get their first dose by Dec. 6 and be fully vaccinated the following month. But with multiple federal courts temporarily blocking the policy late last month, the future of the mandate is uncertain for now.
Vt. health officials now see rapid tests as key tool in COVID fight

Vermont health officials are now encouraging the use of at-home rapid COVID tests, a sharp departure from messaging at the start of the pandemic, when officials disparaged the accuracy of the tests.

So why are antigen tests considered more reliable now than they were before? It all comes down to cost-efficiency and improved quality. Last fall, some of the antigen tests on the market didn’t work very well. Due to that wide range in quality, health officials couldn’t count on the tests as a safe, reliable option. Now, officials say the science has improved significantly.

The antigen tests do have a higher chance of missing an infection than a PCR test during the early stages. That’s why experts say it’s imperative to take at least two tests in a 24 to 48 hour period. Most at-home tests come two to a package.
Can Vt. solve ER waits for kids seeking mental health care?

Vermont lawmakers are searching for solutions to ease the perennial problem of long ER wait times for children seeking acute mental health care.

Health care professionals from across Vermont pleaded with lawmakers Thursday to help alleviate the longstanding problem of Vermonters -- often teens and children -- left waiting in hospital ERs, sometimes for days.

“We have 10 beds. Five of those beds -- 50% of our emergency department dedicated to prolonged psychiatric treatment. One patient waiting six days for transfer,” said Dr. Ryan Sexton with Northeastern Vermont Regional Hospital.
Hospital workers ask state for help, as UVM Medical Center negotiates wage increases

Hospital workers from across Vermont met with lawmakers Thursday morning to tell them how stressed the health care system is right now and why they desperately need the state to step up.

"To be clear, it has never been this bad," said Dr. Ryan Sexton, the emergency department medical director at Northeastern Vermont Regional Hospital in St. Johnsbury.
Hospitals in the News