Are Vermont’s Hospitals Capable of Big Changes?

The Green Mountain Care Board, the entity that oversees and regulates Vermont’s health care system, commissioned a consultant’s report, “Green Mountain Care Board: VT Hospital Quality Review and Capacity Planning in Preparation for Value-Based Care October 27, 2021” to point the way for long-overdue systemic reform. Hospitals do not take kindly to being told what to do. They have become institutions that have been resistant to big change because of the power they wield in local communities. But pressure is mounting for real change. That is what this report points out.

We hear talk about the high cost of health care and about how something needs to be done. The only way this country is ever going to control health care costs is for there to be bold change and bold change in not something hospitals are good at. The consultant’s report calls for bold change.

Don’t Forget The Flu!

Influenza (flu) is a contagious viral infection that can cause mild to severe symptoms and life-threatening complications, including death, even in healthy children and adults.

There was an epidemic of H1N1 Influenza that began in 1918 and petered out in about 1950. At the time, the spread of “The Flu” was blamed by many on the electrification of homes. Another H1N1 pandemic began from 1970 and is still with us today. A more severe flu variant, H3N2, has been running parallel. Electrification has nothing to do with any of it.

Privatizing Medicare A New Threat Beyond Medicare Advantage

Seniors are being bombarded with advertising for Medicare Advantage plans because the open enrollment period for Medicare is from October 15 to December 7. Insurance companies make piles of money if people switch from traditional Medicare to an Advantage plan.

The Advantage plans were created to move Medicare into the private marketplace and provide a financial windfall for the insurance companies.

They are good plans if you never get sick because the initial premiums are low and you get a few extra benefits not available in traditional Medicare.

But if you try to use the insurance in an Advantage plan you are subject to network restrictions and out of pocket expenses. It is not uncommon for a plan to have you pay $6000 out of pocket if you need care.

We Are Pawns In A Deadly Game

The American people have become pawns in a deadly game being played between the pharmaceutical industry and Washington politicians. This should not be news to anyone who has to pay for prescription drugs, especially those who struggle with medications such as insulin and other life-sustaining drugs that they have to ration in order to pay all their other bills.

News of this horrific situation is surfacing again because there are a few legislative initiatives in Washington aimed at lowering U.S. prescription drug prices. Our drug prices are the highest in the world because we do not allow negotiation for prices with the drug manufacturers.

According to the Center for American Progress, “Legislation such as H.R. 3—the Lower Drug Costs Now Act—would allow the U.S. Department of Health and Human Services to negotiate prices directly with drug companies to the cost of drugs. The bill ensures that both Medicare enrollees and privately insured patients will benefit from these prices, and it establishes an upper limit of 120 percent of the drug’s average price in several peer nations if drug companies refuse to come to the negotiating table.”

Town of Brattleboro COVID-19 Response Status – August 11, 2021 – Masks Required in Town Buildings

Update to the Community from Brattleboro Town Manager Peter Elwell: 

The United States Centers for Disease Control and Prevention (the CDC) has reclassified Windham County from an area of “moderate public transmission” of COVID-19 to an area of “substantial public transmission” of the virus. 

All Town of Brattleboro government facilities remain open to the public at this time, but we have reinstituted the requirement that anyone inside Town buildings must be wearing a face covering. This applies equally to employees and to visitors. It applies equally to vaccinated people and to unvaccinated people. The CDC guidance on this matter is clear: all “people [should] wear a mask in public indoor settings in areas of substantial or high transmission.” 

The Delta Variant

I superficially looked at the CDC site, and learned 2 things about delta:

1. CDC sayszz the Delta Variant is one and a half times as contagious as Alpha (which I understand is the first new iteration after original Covid-19. What they mean is that if a person infected with Alpha would (under a particular set of circumstances) infect 2 additional persons; then a person infected with Delta, under the same set of circumstances, would infect 3 people. (Of course a major epidemic management goal would be to get the that number down to .9 or less.).

Only 55.8% In Windham County Are Fully Vaccinated, Says CDC

According to the CDC’s website, 64.4% of the total population of Windham County has had at least one does of a COVID vaccine.  55.8% are fully vaccinated.

Keep this in mind as we crow about Vermont’s high vaccination rates.  We haven’t hit 70% in Windham County yet. We’re much closer to “half way there” than the “almost 100%” people like to assume.

An Open Letter To The Unvaccinated

If you are choosing to not get the COVID vaccine then you need to accept complete responsibility for your behavior. That means acknowledging the fact that you may be responsible for the suffering and death of others. It means that you should make an effort to keep away from other people while you wear a mask. But your selfish behavior has made it clear you will not make the effort to protect others.

American society is putting a lot of effort and money into trying to convince the unvaccinated to get the shot, but those efforts are resulting in less than adequate outcomes. The time has come to give up on the unvaccinated and start punishing them for putting the rest of us in danger.

Smoke Gets In Your Eyes

It’s an ill wind that blows no good…  Just kidding. As most of us are probably aware, there’s been a lot of smoke in the air recently, although what zephyr it blew in on I have no idea.  We noticed it last night around sunset, and by the time we went to bed, we could see this strange fog enveloping the area, detectable even in the dark.  The trees seemed really distant, we could only see one star, and when a car drove by, there was complete white-out and all the trees disappeared.  Although the National Weather Service forecast was calling it “haze,” it seemed pretty smoky to me.

This morning, it cleared off, but after noon, it rolled back in like gangbusters.  I was surprised to discover that not only can you see the smoke, you can smell and taste it too. I even noticed my eyes burning which is normal if you’re in a smoky environment, but frankly, you just don’t expect to be in a smoky environment as a result of a fire 2500 miles away.  

Cutting to the chase, it’s worth noting that for this afternoon at least, out air quality puts us in an Orange zone as indicated on the EPA air quality web page; this means “Unhealthy for Sensitive Groups.  If you cross the river to NH or drive over to NY, the adjacent areas there are Red zones — which is simply “unheathy air.” You can see the regions highlighted on the map at the link below.

Minority Rules in Government and COVID

It’s bad enough that Senate Minority Leader Mitch McConnell and his band of idol-worshipping Trumpies are controlling much of what goes on in congress, but many of their supporters around the country are also in control of the course of COVID.

Federal politics has always been less than representative of the will of the people and that kind of imbalance has increased over the last few years. Even though Democrats have a slim majority in the Senate they have great difficulty passing any significant legislation because of issues like the filibuster and the need for 60 votes for bill passage. This situation has all but crippled the body politic and it will continue for the foreseeable future.

That future is starting to look at little grimmer when it comes to COVID in this country. A minority of Americans are determining the course of COVID because of their refusal to get vaccinated. The unvaccinated are not a monolithic group but it seems clear that states that lean Republican and places that have bought into the Trump lies have the lowest vaccination rates.

Why Don’t We See More Masks?

Engaging in usual forms of commerce makes one believe that the pandemic is a thing of the past. I find it extremely frightening that more people are not wearing masks in public because the science does tell us that not enough people have been vaccinated to provide the kind of herd immunity that we might need to protect all of us.

Fifty four percent of the U.S. population has received a first dose of vaccine and 47% have received a second dose. That means that as you go about your daily business about half of the people you see should be wearing masks. Of course, the vaccination numbers vary by state. Vermont has a vaccination rate of 82% for a first dose and 75% for a second dose. Massachusetts is at 70% for a first dose and 61% for a second dose.

Even with those numbers we still should see a quarter to a half of the people we engage with on a daily basis wearing masks. It is just not happening. Most places, as well as the CDC, have lifted mask restrictions for vaccinated people and have let the unvaccinated rely on their conscience to do the right thing.
Guess what? It ain’t working. The daily numbers of new COVID cases and deaths are declining but more than 600,000 Americans have died from the disease and it has become clear that most of the recent deaths are in people who have not been vaccinated.

Brattleboro Heat Advisory Notice

 The Town of Brattleboro urges everyone to drink plenty of water, wear light clothing, and stay out of the heat as much as possible during the current heat wave. 

People who need some cool air can visit the Senior Center at the Gibson Aiken Center (207 Main Street), Brooks Memorial Library (224 Main Street), the Central Fire Station (103 Elliot Street), or the West Brattleboro Fire Station (16 South Street). 

Town of Brattleboro COVID Update June 4, 2021


• Effective today, the Selectboard has terminated the Townwide emergency order that required face coverings to be worn inside all facilities (public, private, and non-profit) where the public is invited. Individual organizations and building owners can still require face coverings at their own facilities. 

The Town of Brattleboro thanks everyone for complying with the Townwide “mask order” during the 54 weeks that it was in effect. 

• The public may now enter the Gibson Aiken Center without an appointment. 

The number of spectators is still limited for indoor programs. Masks are still required at all times while in the building. 

• At this time, masks are still required inside all Town of Brattleboro government facilities. “

To Mask Or Not To Mask

Many of us have been wearing masks for over a year and have looked forward to the day when our faces could be on full public display. The Coronavirus is showing signs of receding, at least in this country, and vaccination numbers are increasing.

The CDC has said that fully vaccinated people can do away with masks in most public places and that they do not need to social distance. Exceptions include public transportation such as buses, airplanes and hospitals.

The new CDC guidelines are confusing a lot of people as well as states and municipalities.