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Masking Returns to Health Centers as Winter Viruses Surge

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As the United States experiences its second largest COVID-19 surge ever, health services in Vermont are coming under strain, according to a recent notice from the state’s Department of Health. 

Multiple respiratory illnesses, including respiratory syncytial virus (RSV), influenza (flu), and COVID-19 (caused by the SARS-CoV-2 virus), mean the state is experiencing bed and staff shortages and longer waits for care, including in emergency departments, the notice said.

Some health centers have reinstituted masking requirements, such as the Northeast Washington County Community Health, Inc. (also known as The Health Center), in Plainfield. The clinic announced Jan. 8 that staff members, patients, and people accompanying patients must wear masks. 

“We’re small and we’re vulnerable,” said John Matthew, MD, CEO and medical director of The Health Center. “If a couple of us are down, we can’t take care of people.”

As of Jan. 11 at the University of Vermont Medical Center, masking had once more become mandatory for staff members providing direct patient care. In a press release, the hospital also encouraged others to “consider” wearing a mask while in its facilities. 

Evidence in the Water

Wastewater data, which track how much virus people in an area collectively shed into their toilets, show levels of SARS-CoV-2 rose sharply in early January in Washington and Chittenden counties. 

As for RSV, Montpelier saw a huge spike in wastewater levels around the turn of the year, while flu levels peaked soon after. Norovirus, which causes vomiting and diarrhea, also burgeoned here around the turn of the year. 

Vermont is not alone. Flu, SARS-CoV-2, and RSV all hit highs across the United States shortly before or around the turn of the year, according to nationwide wastewater data. 

A Surge in Deaths and Long COVID

The current SARS-CoV-2 surge is the second highest ever, rivaled only by the first Omicron wave two years ago. Some 1,697 people in the U.S. lost their lives to COVID during the week of Jan. 6.

A Jan. 15 report from the Pandemic Mitigation Collaborative estimated that 10.2 million people are now being infected weekly, meaning about one out of every 33 people is now infectious with SARS-CoV-2. In a room of 10 people, chances are better than one in four that someone is infectious; in a room of 25 people, there is an over 50% chance someone is infectious, according to the report.

The report also estimated that at least one-half million new Long COVID cases are occurring every week. 

Anyone can develop Long COVID, including those who are healthy and fully vaccinated and those who have previously recovered from COVID. Its symptoms, which often include fatigue and trouble concentrating, can range from mild to disabling. 

“When you’re in clinical practice and see the accumulating number of people with long COVID, this is genuinely scary …. It can take your career away,” Matthew said. COVID is not only underreported and underestimated, he said, but also undertreated. 

The physician cited a recent pre-print study estimating 48,000 deaths could have been prevented if just half of all people eligible for the antiviral drug Paxlovid had taken it between December 2021 and February 2023. 

Protecting Yourself and Others

It isn’t only lifesaving drugs that are sitting on shelves. Vaccines, too, are gathering dust. As of the end of 2023, only one in five eligible adults and fewer than one in 10 children were up to date on COVID-19 vaccinations, according to the CDC. 

But vaccines against COVID, flu, and RSV remain available, and the Vermont Department of Health advises eligible Vermonters to stay up to date on them. 

Everyone over six months of age is eligible for flu and COVID-19 shots; information about where to find them is at vaccines.gov. The RSV vaccination is for people aged 60 or older and for those in late pregnancy, while the protective antibody nirsevimab is available for certain young children. 

The department advises people to stay home if they are sick, to mask in the event of symptoms or when around young children or medically vulnerable people, and to limit close contact with infants vulnerable to RSV. 

(Norovirus, a gastrointestinal infection, is transmitted through food, drink, or contact with an infected person, and alcohol hand sanitizer does not deactivate it. Instead, remove it by washing your hands thoroughly with soap and hot water.)

At-home COVID tests can be ordered in limited quantities at Covid.gov. People are encouraged by the National Institutes of Health to report their results, whether positive or negative, at MakeMyTestCount.org. Those who test positive may be eligible for Paxlovid. TestToTreat.org offers information and free medication for some.

Because respiratory viruses spread through the air, filtering indoor air or ensuring it is well ventilated reduces the risk. Instructions for building an inexpensive air purifier out of a box fan and HEPA filters can be found at CleanAirCrew.org. Well-sealed, high-quality masks such as N95s that are worn consistently also reduce the risk of getting infected. 

“Immunizations are imperfect. Masks are imperfect. But we’re in every case trying to increase the protection of our staff, our clientele, our families,” Matthew said.

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