The Holiday Covid-19 transmission is likely to determine Vermont’s ICU capacity this winter

The number of coronavirus cases caused by holiday gatherings will be a crucial factor in Vermont hospitals’ capacity in intensive care units ahead of the high season for flu, according to government officials.

“We are in a very troubling moment and our hospitals are already as stressed and strained as they have been for several months,” said Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems.

Vermont’s ICUs operate at 85% to 90% capacity, up from 70% to 80% in late spring and summer, according to data from government officials and the Department of Financial Regulation.

The latest increase is primarily driven by pent-up demand from critically ill patients whose strokes, heart attacks or other preventable conditions were exacerbated by a lack of medical care earlier in the pandemic, officials said. At the same time, Covid-19 intensive admissions have increased nearly 30% since early October, according to government data.

Now, a relatively small Covid-19 increase could put significant pressure on the system.

At the same time, holidays – such as Thanksgiving next week, followed by Christmas four weeks later – provide an opportunity for young, unvaccinated children to come into close contact with older adults who did not get their booster shot, Mike Pieciak, commissioner of the Vermont Department of Financial Regulation, said in an interview Wednesday.

The end of the holiday season also typically marks the beginning of the high flu season for intensive care units in the Northeast, according to government officials. Damage to skis and snowmobiles, as well as tourists in need of critical care, can strain the state’s approximately 100 critical care beds in intensive care units, said Gilman Allen, a physician in critical care at the University of Vermont Medical Center.

The state’s ICU capacity strategy has so far relied on helping hospitals cover the cost of staffing additional beds ahead of the holiday season. Earlier in the week, for example, Secretary of the Human Services Agency Mike Smith said his department would pay to staff 10 intensive care units in the coming weeks, increasing the state’s total bed capacity to about 110.

Smith said his agency is also working to ease the pressure on intensive care units indirectly by facilitating the transfer of up to 80 non-ICU patients to long-term care facilities across the state.

The administration took a similar step a few weeks ago when the Smiths agency promised to spend up to $ 1.4 million on staffing 80 long-term care beds over the next few months.

Pieciak says these staffing strategies are likely to see the state through the next four to six weeks.

[Looking for data on breakthrough cases? See our reporting on the latest available statistics.]

“When you get to the other side of January, the elderly population should be really very much covered by the booster,” he said. “And then you get the benefit of the fully vaccinated 5- to 11-year-olds in early January, which should also help with our overall case.”

Carri Chan, who studies hospital surgery at Columbia University in New York City, said crunchy intensive care units are bad for patients and providers. Intensive care units in wards that are approaching capacity tend to develop complications that can make them sick and have them readmitted more often. They are more likely to die prematurely, Chan said.

“There is, of course, a concern that if you get a large increase due to a random incident, it may be that some patients just are not able to access the care they need,” she said. .

During Governor Phil Scott’s weekly press conference on Tuesday, Health Commissioner Mark Levine suggested several steps Vermonters could take to ensure a safer Thanksgiving celebration, including asking other guests in advance if they are vaccinated, keeping the meetings small, getting a combination of PCR and quick test before the meal and another test five to seven days after, and avoid gatherings if anyone feels sick.

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