A mad rush for COVID-19 testing is under way in Vermont as residents scramble to determine whether they should gather with family and friends over the upcoming holiday weekend.
Demand for rapid tests has vastly outstripped supply in recent weeks, emptying pharmacies and leaving workers unsure when they will be restocked. Even Vermont's well-oiled state-run testing machine has been pushed to its limit: Lines are stretching out the door at popular walk-in sites, while the most populous county was booking appointments into next week.
The arrival of the highly contagious Omicron variant has raised the stakes, placing even the fully vaccinated at an increased risk of infections and threatening to send another wave of sick patients into Vermont's strained hospitals. The variant accounted for nearly three-quarters of all U.S. cases over the last week, according to the Centers for Disease Control and Prevention, making it the dominant strain nationally fewer than eight weeks after it was first identified globally.
If Vermont cases were to jump 50 percent after the holidays — which happened last year — the state could wind up averaging 600 new infections a day, and single-day tallies could eclipse 1,000.
At a press briefing on Tuesday, state leaders urged people to take precautions whenever possible heading into the holiday weekend.
"I know many of us are eager to celebrate with loved ones that are exhausted by everything COVID keeps throwing at us, but any way we can lower the risk, the safer we will all be," said Health Commissioner Mark Levine. "We don't want the lasting memory of 2021 to be regret that our holiday gathering could have been done more safely."
Public health officials have been urging people for weeks to get tested prior to holiday gatherings, making rapid COVID-19 tests one of the season's hottest items. These tests, which can be purchased over the counter, aren't as sensitive as PCR tests but can be far more useful when trying to determine whether you are currently contagious, because they provide results within 15 minutes instead of a day or two.
Vermont is requiring certain health insurers to cover the bill; a box of two tests typically runs about $25. But the process has been rife with confusion.
The rule, announced earlier this month, applied only to commercial insurers, leaving out hundreds of thousands of Vermonters. And many pharmacies weren't prepared to immediately begin implementing the change, forcing people to instead purchase the tests themselves and then seek reimbursement after the fact.
While many pharmacies now say they can process the claims upfront, few actually have any in stock.
Calls to a dozen pharmacies across the state on Monday yielded no available tests. A Walgreens in Montpelier had some in stock over the weekend but "they went fast and furious," a worker there said. A CVS in Winooski had turned away nearly 50 people that day alone. Most stores had no idea when the next shipment would arrive but workers doubted it would be before Christmas.
Requests have been so frequent at the CVS on Church Street in Burlington that workers have posted handwritten signs declaring the pharmacy barren. "Every two minutes someone is looking for one," a pharmacist there said.
Walgreens and CVS have said this week that they're experiencing an unprecedented run on tests heading into the holidays. "In the event a local store experiences a temporary shortage, our teams have a process in place to rapidly replenish supply," a CVS spokesperson wrote in an email.
The Scott administration will be offering free at-home rapid tests at various pop-up sites on December 23 and 30 in an attempt to supplement the pharmacy offerings. The state stockpile includes 10,000 LAMP tests — which work similarly to PCR tests but produce results in 30 minutes — for people who make appointments. Another 50,000 antigen tests have been set aside for walk-ins.
It's unclear whether it will be enough to meet the demand: With just 30,000 tests for each of the two days, there will only be enough for about 1 out of every 20 Vermonters.
"We've had to search for a supply chain on these," Human Services Secretary Mike Smith said at Tuesday's press briefing. "I was hoping that the pharmacies would have more of a supply chain — that seems to be a national issue, and something that, hopefully, the federal government will resolve."
There was some movement on that front Tuesday. President Joe Biden announced that the federal government would start delivering 500 million free rapid tests through a website where people can order them directly to their homes.
The feds are also sending medical reinforcements to six states — including Vermont — where hospitals have been hit hard by the latest COVID-19 surge.
The Federal Emergency Management Agency has sent 30 paramedics to Vermont to help transport patients between hospitals and other medical facilities. An additional 20 paramedics and EMTs arrived at the University of Vermont Medical Center on Friday and most are expected to work there for at least two weeks, helping staff areas for COVID-19 patients.
"They will provide support with basic activities of daily living for patients, performing vital signs, helping with patient mobility — such as turning in bed, getting to a chair, or walking — and providing other non-clinical assistance like ensuring supplies are ready for patients," the medical center said in a press release.
"The team will provide much needed support for UVM Medical Center care team members who have been caring for record numbers of patients for months," the press release continued.
The past week has brought some relief to Vermont's health care system. Case counts have dipped slightly, with the seven-day average down to 400 after a high of 485 earlier this month.
The number of available hospital beds had nearly doubled over the last week and was about 100 statewide. A similar trend had played out in intensive care units; after a handful of days in which the state had fewer than a dozen ICU beds free, there were more than 20, according to state data.
There's also hope that Omicron may cause less severe infections than previous strains of the virus. Hospital admissions in South Africa, where the new variant was first located, have so far remained lower than previous waves. The vaccines, meanwhile, seem to be holding up against the worst outcomes, though experts say people who are boosted have far more protection.
Still, there is broad concern that Omicron's remarkable ability to infect people poses a major threat to health care systems. Asked whether Vermont was prepared for the storm headed its way, Scott answered affirmatively, though he quickly added that much depends on the intensity.
"That's the billion-dollar question," he said. "How severe is this going to be?"