“It ain’t over till it’s over.” —Yogi Berra

Vermont has found some powerful new tools to make Covid disappear. Since the very beginning of this pandemic, our health department and other leaders and authorities took bold steps to “slow the spread” of the virus.

First we were told to stay home, stay safe, wash our hands, and keep our distance from others in public. Then we were told to mask up and limit travel and large gatherings.

As testing and vaccination became available, these tools were pushed out across the state, with a strong emphasis on protecting the most vulnerable Vermonters — the elderly or disabled and those with underlying conditions, such as immune compromise.

The success of these measures was impressive. Our health care resources were strained but never overwhelmed, as they were in other states and countries. Deep gratitude and appreciation is due to our leaders, health care workers, and all the other frontline workers who kept us moving forward under the threat of infection, serious disease and death.

Now we have entered a new era in our response to Covid. Covid still causes death or long-term disability for many Vermonters. It has caused many more to leave the workforce permanently. Businesses struggle to remain open in the face of supply chain disruptions, customer wariness, manpower shortages and burnout.

For the foreseeable future, the “new normal” seems to involve rolling surges in Covid cases due to new variants of the virus, confusing public policy, changes in the weather, and even the kitchen sink. While the numbers of hospitalizations and deaths due to Covid have remained relatively low since the Omicron surge, they continue nonetheless as the elusive virus remains uncontained in the community.

To combat the chronic stress and impairment this situation has caused, Vermont has pulled out some powerful new tools to make Covid disappear:

• We have stopped calling Covid a pandemic. Now it is endemic, or end-emic as some say. This makes it seem like a virus we can live with.

• We are closing state-run vaccination and testing sites. This may make access to these important tools more difficult for disadvantaged citizens or those who live in remote areas. But the upside to these closures is the implication that things are now really getting better. It will also save money for the state, making it a real win-win for Vermont.

• We have stopped those depressing daily reports of new cases, hospitalizations and deaths. No one wants daily reminders of how devastating this disease continues to be. And we have stopped those dreary weekly Covid press conferences with Gov. Scott and the administration. Those good folks always tried to put a positive spin on the situation in Vermont, but that could only go on for so long.
• We have loosened or removed Covid restrictions in our public schools. This restores freedom of choice for students and their families. Hopefully, it will also allow face-to-face (rather than mask-to-mask) engagement in the classroom, just like old times.

Indeed, these are powerful new tools. If they work, maybe things will finally be all right again. And if they don’t work, we can just continue our slow, spiraling descent into the maelstrom.

All of us are searching for some endpoint to all of this. And we continue to seek guidance and support from our experts and leaders to get us to our goal. Unfortunately, it is still unclear what that goal might be, and unclear how we might be able to achieve it.

In that context, health policy decisions have been made that resulted in unintended consequences. Let’s focus on just one: the impact on Vermonters most vulnerable to serious disease and death from Covid, namely immune-compromised citizens and the elderly or disabled.

In the early days of the pandemic, protecting these vulnerable Vermonters was the top priority in implementing public health policies and procedures by the administration. Not so much anymore. In fact, it feels to many that Vermont has turned her back on them.

And in fact, the clear message now is that they must fend for themselves. Right now, the distressing reality faced by these vulnerable Vermonters is that public policy no longer has their backs — instead, public policy has pushed them further into the shadows where they cannot be seen or heard.

Not only must they continue to cope with all the old safety precautions imposed by Covid — masking, washing, distancing and avoiding — but now they must guard against the increased risk of exposure due to “opening up.”

They need to take extra precautions. They need to ask family visitors if and when they have been tested for Covid, and, better, ask them to stay masked and/or outside in any case. They need to double-mask when they go grocery shopping (one mask for themselves, one for those other shoppers who are not adequately masked). For those with disabilities who are unable to mask themselves, all public spaces must remain off limits.

They need to keep a personal stock of rapid antigen tests. These tests are not for their own use — if they test positive, it is already too late — but to make it a little more possible to engage directly with family and other potential visitors.

And for these vulnerable Vermonters, this situation has engendered a regrettable new level of distrust. Distrust of the experts and leaders and policy-makers who no longer have their backs. But also a new distrust of friends and family and even ordinary passersby who now unwittingly pose an increased risk for infecting them.

Maybe we are doing the right thing. Maybe these powerful new tools will take us in the right direction. Maybe unintended consequences are unavoidable.

Whatever the case, maybe a bit more fine-tuning of public health policy could be helpful. The recent changes in policy, especially those changes that place responsibility for Covid precautions on the individual, have led to considerable confusion and multiple interpretations.

Given that state of confusion for the general public, it could be very useful to vulnerable Vermonters if the Department of Health could provide clear and thoughtful guidelines both for vulnerable individuals and the general population to help protect vulnerable Vermonters and perhaps even allow them to participate in the community again.

Note: Dr. David McKay is a retired physician from Middlebury and past president of both the Vermont Medical Society and the Vermont Psychiatric Association.