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America’s Pandemic Star Loses Some Shine

ls Vermont’s Envy of America no more? The state long lauded for its pandemic response is experiencing one of the most intense COVID-19 spikes in the country. The number of cases is twice as high as at any other point. Hospital admissions have also surged, thwarting hopes that Vermont’s best vaccination coverage would protect its people from the Delta wave.

The coronavirus resurgence — the number of cases is rising again nationally after a continued decline — has demoralized much of the country, but nowhere is that frustration felt more strongly than in the state that seemed to be doing everything right. “What we’re feeling right now is a collective sense of disappointment and sadness,” Rebecca Balint, one of the leading Democrats in Vermont, told me. With strong compliance, patience, and testing, Vermont kept COVID-19 under control throughout most of the pandemic. The number of cases and death rates were lower than anywhere else on the US mainland. Vermonters’ return to normalcy this spring seemed particularly well-deserved: When 80 percent of the eligible population received at least one vaccine dose in mid-June — faster than any other state — Governor Phil Scott lifted all COVID restrictions.

Vermont is not alone in its struggle; other highly vaccinated states in the Northeast, such as New Hampshire and Maine, have seen similar spikes. Even with this latest increase, total cases and deaths per capita in Vermont remain the lowest on the mainland. But the state’s recent downturn has troubling implications. If Vermont has finally lost control of the pandemic, what chance is there for the rest of the country?

With the Delta variant now encroaching on Vermont’s once formidable defenses, state leaders are now debating how to respond — if at all. Vermont’s experience, they admit, could just be a foretaste of the virus’ endemic future, when states can realistically hope they can only contain COVID-19 and not eliminate it altogether. Delta’s sheer contagiousness means it’s likely impossible to achieve herd immunity even if nearly everyone has been vaccinated or previously infected, and while Vermont has a higher percentage of the population vaccinated than any other state, its protection against the virus nowhere near universal . “There are still a lot of people who have not yet been vaccinated for various reasons,” said Jan Carney, a former state health commissioner and now associate dean of public health at the University of Vermont’s Larner College of Medicine. Whether by choice or because of age restrictions, more than a quarter of Vermonters are not fully vaccinated, and like other places in the country, that percentage is higher in counties nationwide. Before the CDC opened vaccinations to children under 12 years of age earlier this month, about 50,000 Vermonters in a population of more than 600,000 had not received a single shot, Mark Levine, the state health commissioner. “That is still a lot of people who find the virus. It’s very effective,” he says.

As it did with spring vaccinations, Vermont is moving faster than other states to provide booster shots for the adult population and vaccinations for younger children who have recently become eligible. And unlike other states experiencing a spike, Vermont hasn’t overwhelmed its hospital system. Cases among the elderly — who are more likely to require hospitalization — have fallen as the booster dose has increased, Levine said.

Vermont has also maintained its primary advantage over other states by mitigating the most severe impacts of a COVID-19 infection. Deaths have increased, but the death rate in Vermont remains quite low compared to some other states experiencing a spike, such as Michigan; for several months this year and last year, hardly anyone in Vermont died from COVID-19. To the extent that hospitals are under pressure, Levine said, it’s because of an increase in other diseases and conditions caused by delayed care over the past two years. “It is not COVID that is causing our hospital stress, although COVID can certainly be the straw that breaks the camel’s back,” Levine said.

Government officials have even put an optimistic spin on the state’s recent struggles. Vermonters, Levine said, are “victims of our own success.” So many people were vaccinated so quickly that their immunity begins to decline earlier than people in other states, Levine said, a dynamic that could be exacerbated by Vermont’s disproportionately older population. And because relatively few people have contracted COVID-19 in other stages of the pandemic, the state has far less natural immunity than in other places. Seroprevalence studies showed that only 3 to 4 percent of the Vermont population had COVID-19 antibodies before the arrival of the Delta variant; by comparison, similar studies indicate that more than 25 percent of the population once had antibodies in New York City, which was hit hard by the virus in the spring of 2020.

Still, the fall storm broke up the era of political goodness that Vermont had earlier this year when, as I reported in May, Democrats couldn’t find anything bad about Scott, a Republican. Now, Democrats like Balint have soured his leadership, saying the third-term governor has reacted too passively to the latest wave. Scott has rejected Democratic calls for tougher restrictions, including an inner mask mandate, arguing that they would be inappropriate at this stage of the pandemic. When Democrats renewed their demands in early October, he hit a note more reminiscent of Florida’s Ron DeSantis — “They want to cancel Christmas,” Scott said — than the moderate genius reelected last year by a landslide in Vermont. “That was a real change of tone,” Balint said. Just as people everywhere have grown tired of the pandemic, so it seems with the governor. “Of course he’s tired,” Balint said. “How can he not be?”

As the case count has continued to climb, Scott has moved in the direction of Democrats. He and his team returned to wearing masks indoors during press conferences, and he offered to sign a bill that would allow cities and towns in Vermont to set their own mandates. “The pandemic isn’t over yet,” Levine warned at a press conference last week. He told me Vermont would reach the endemic stage next year, maybe in March. “We’re not here now,” Levine said.

Still, Levine acknowledged that a significant portion of Vermonters believe that COVID-19 is already endemic. One of the reasons the state’s case curve is no longer exceptional is that its actions are no longer exceptional. A year ago, Vermonters were still living under — and, unlike many other Americans, largely adhering to — a regime of pandemic restrictions. Since then, people there have resumed their lives with the virus in tow, and the state’s leaders are hesitant to pull them back. How Vermont weathers another pandemic winter will show whether the state that managed to drive out COVID-19 can show Americans how to live with it.