A Message from the CEO
By Jeff Tieman
VAHHS President and CEO

A reporter recently asked me if I was proud of Vermont’s hospitals and their planning and preparation during the COVID-19 pandemic. My answer was an unequivocal “yes.” I am also proud of Vermonters, who have stepped up to help one another and the health care system by following guidance and staying at home. These steps assisted in avoiding a surge that could have overwhelmed our hospitals.

Together, it appears, we have passed through at least the first wave of infection. Hospitals and other health care providers can begin to return to a sense of normal and offer the services they put on hold in case all of their resources would be necessary to care for COVID-19 patients. It is important for people to get the care they need as soon as possible, and providers are ready to schedule procedures and other postponed visits.

Legislative Update
by Devon Green
Vice President of Government Relations

Last Week
Resuming Non-Urgent Care:  On Monday, Governor Scott announced that non-urgent out-patient care and procedures can resume if facilities take environmental precautions, have a reliable supply of PPE, and perform patient and staff screening and testing. For the administration’s guidelines, go  here .

Telehealth and Extending COVID-19 Regulatory Flexibilities:  The health care association coalition  advocated  for an extension of the flexibilities provided in Act 91 through FY 21. This would give providers the tools they need to manage COVID-19 care through a long-term pandemic regardless of the state of emergency. The coalition also advocated to allow for audio-only telemedicine on a permanent basis.

Next Week
The Senate Workgroup on Transition Challenges:  This group of senators will begin working on recommendations on transitioning towards reopening the economy. Recommendations will focus on four areas: economic development, education, governance, and health care. The group is expected to share findings and recommendations with the greater Senate later this month.

Interstate Nurse Licensure Compact:  The health care committees will be taking up  S.125 , the bill on the Interstate Nurse Licensure Compact. The Rural Health Services Task Force recommended passage of this bill. VAHHS fully supports passage of the bill as a means of strengthening our health care provider workforce.

Physicians’ Assistant Licensure:  The health care committees will be taking up  S.128 , a bill which eliminates the physician supervision requirement for PA licensure. As with the Interstate Nurse Licensure Compact, the Rural Health Services Task Force recommended passage of this bill. VAHHS fully supports passage of the bill as a means of strengthening our health care provider workforce.
In the News
Vermont Department of Health to Open Additional COVID-19 Testing Sites
Press Release

A pop-up site in Colchester will be open on Saturday, May 9 to offer COVID-19 virus testing for workers on the frontlines of Vermont’s pandemic response. The specimen collection site is one of several to be opened around the state in the coming days for health care workers, first responders (EMS, fire, and law enforcement), and child care providers currently serving essential workers.

Last week, Governor Phil Scott announced the state will significantly increase and strengthen its testing and contact tracing programs in order to quickly identify, contain and suppress cases and outbreaks of COVID-19.
South Burlington Aircraft Firm Turns Attention to Ventilators
Seven Days

Ordinarily, when the engineers and software designers at Beta Technologies measure and design for air flow, they’re concerned with the aerodynamics of an aircraft, not whether a patient in respiratory distress is getting enough oxygen to stay alive.

But in March, as COVID-19 created a worldwide shortage of mechanical ventilators, Steve Arms, a sensor engineer with the South Burlington electric aircraft developer, decided to take on the problem. With help from company cofounder Kyle Clark, design engineer Cody Spiegel and other Beta staffers, as well as physicians at the University of Vermont Medical Center, Arms designed, built and tested an emergency ventilator in about three weeks.

The AutoVENT is designed to be small, portable, easy to use and inexpensive — about $500 to $600, compared to a typical mechanical ventilator used in an intensive care unit, which costs $40,000 to $60,000. The AutoVENT, one of several mechanical ventilators invented by Vermonters in recent months, is now undergoing emergency review by the U.S. Food and Drug Administration.
Dr Joshua White: A new normal
Vermont Business Magazine

At 3 pm Wednesday, April 29, the Vermont Department of Health was reporting no new COVID cases in Vermont for a 24-hour period. This is a stunning accomplishment, and one that I would not have imagined possible. On the same day, New York reported more than 4,500 new cases and Massachusetts just under 2,000 new cases. And here we were at zero. This is particularly incredible given that a number of Midwestern states are now in the unfortunate position of realizing that a rural environment is not a guaranteed defense against widespread disease. Vermonters should be proud.

Lest we celebrate early, it’s worth considering that we’ve painted ourselves into a bit of a corner. We did it, but we’re not done. Suppressing COVID to this degree means that almost none of us has immunity, and so the risk of a surge hasn’t really changed. It won’t change until there is a significant alteration of the environment. The best-case scenario would be a vaccine, but that’s not likely for a year or more. Alternatively, if social distancing stops, the surge would occur and soon enough we would be done. Although rapid, that route would be a horror show.

Soldiers’ Home, a nursing home in Holyoke, Mass., has reported 83 COVID dead – one nursing home with nearly as many dead as all of Vermont for the entire pandemic. It’s obvious that we must stop that from occurring here. That one nursing home should highlight that this is not the flu. The United States has not seen an infectious disease outbreak like this for 100 years.

Yet, living in a bunker is also not an option.

The Bright Side: A sewing machine mechanic supports DIY mask makers

While businesses and industries across the state have shuttered in the face of the coronavirus pandemic, for one repairman in Johnson, business is booming.

Steve Engel fixes sewing machines. And in the world of sewing machines, the past few weeks have been nothing short of a renaissance.

In the face of a global shortage of medical masks and increasing public health recommendations to wear cloth masks, thousands of Vermonters are digging out old sewing machines to make their own at home.

But, Engel said, when people retrieve their old machines from cabinets and closets and wipe off the cobwebs, they’re often finding the machines don’t work as well as they used to. Sometimes they don’t work at all.

“People are pulling them out of basements and attics and garages,” Engel said. “They haven’t been used for years, they’re stiff and need to be oiled and cleaned. Some of them were broken when they were put away, but people have forgotten all about it.”

That’s where Engel comes in.
Vermont taps local ambulance crews to help with Covid-19 testing
St. Albans Messenger

The state Department of Health has deployed local ambulance crews in the far reaches of the state to help ramp up Covid-19 testing.

Ten EMS squads will be trained and sent out as needed to help the state reach its goal of 1,000 Covid-19 tests a day, Health Department officials announced Wednesday.

In the parking lot of the Newport Ambulance Services, about two dozen Newport and Caledonia-Essex County EMTs donned masks, gowns and gloves to try out the procedure. Department of Health nurses demonstrated the tests to the crews before letting the EMTs take their turns.

Albert Stringer, an advanced emergency medical technician with the Newport services, winced at the procedure — a six-inch Q-tip-like swab inserted up the nose to the back of the mouth. He nevertheless volunteered to let a second EMT try the test on him.