Health care workers wheel a Covid-19 patient through a hallway at the Southwestern Vermont Medical Center in Bennington on Dec. 13, 2021. Photo by Glenn Russell/VTDiggerThis is the first story in a two-part series that looks back on the impact of Covid-19 in Vermont after five years. The second sto ry, “A visual history of Covid-19’s path through Vermont,” can be found here.Five years ago, Vermont health officials announced the first confirmed case of Covid-19 in the state. Since then, 1,200 Vermonters died from Covid, countless residents were infected and hundreds of thousands of Covid jabs were put in the arms of Vermonters. Last month, the health department announced that it would stop publishing Covid death and case data after years of daily and weekly tracking. The change is the latest shift in how Vermont now views Covid as an “endemic” disease, more like the flu or other seasonal illnesses than a pandemic that stands as the forefront of public health priorities. READ MORE Vermonters have gotten older, but has the state gotten wiser? Are officials better and more prepared to tackle public health crises as they arise? Or is Vermont primed to repeat a cycle of needless suffering and death?The legacy of Covid goes well beyond the impact of the virus itself. Covid has left Vermont with tools that could help address longtime public health challenges along with emerging threats — and with vulnerabilities in public trust and health systems. Officials at the Vermont Department of Health say that Covid was the most daunting challenge they have ever faced, but it left them with new tools and structures that they have implemented in their day-to-day work. They also celebrated the state’s track record with the virus. Vermont has one of the lowest Covid death rates in the nation, behind only Hawaii and Puerto Rico, according to the U.S. Centers for Disease Control and Prevention.But that’s not how Anne Sosin sees it. A lecturer at Dartmouth College and health equity researcher, Sosin reflected on how Covid revealed disparities in Vermont society that continue to today. Sosin said Covid has added to the “burden” of illnesses like flu and RSV on hospitals and health care workers in the winter months. It has also added a “large footprint” of disability, she said. While long Covid is the most well-known aftereffect of contracting Covid, experts are just beginning to understand how a Covid infection can cause long-term health impacts on multiple body systems. Covid has left Vermont — and the nation — with a lasting legacy of mistrust and misinformation, one that appears to be affecting public health response at a federal level, Sosin said. She said the measles outbreak spreading in the U.S. has been fueled by vaccine skepticism that began long before the Covid pandemic, which then amplified it. “We’re gonna see a lot of tragedies over the next few years,” Sosin said. “It’s going to get a lot worse before we, ultimately, recognize we have to rebuild.”Mark Levine, the outgoing commissioner of the health department, echoed that concern in an emailed statement.“While when compared to national data Vermont remains a leader in immunization – even with numbers I would not brag about – it worries me that the uptake on preventative measures like vaccination has declined so shortly after the pandemic reminded us why they are so necessary,” he wrote.Pandemic-era innovationsCovid has left a mark on how the health department is able to respond to other public health challenges, staff said. One of those developments has been Covid wastewater surveillance, which allows state and local governments to measure virus levels in a community by taking samples at wastewater treatment plants. “Wastewater surveillance was done in academic institutions and for research purposes prior to Covid, but it really became a public health tool during Covid,” said Patsy Kelso, the state epidemiologist. The department’s public health lab is now gearing up to use wastewater surveillance to measure mpox, seasonal influenza and Candida auris, a hospital-related illness, she said. The scientific community is also investigating how to utilize mRNA vaccines, developed for Covid, on other infectious diseases like the flu as well. Antigen tests that can detect both Covid and the flu are already on the market. Helen Reid, director of health surveillance, said the pandemic also revealed the need for the state department of health to work more closely with community groups that represent marginalized Vermonters. Covid had a disproportionate impact on Vermonters of color, older residents and people with disabilities. “The very first year of Covid really sort of laid bare what we’ve known for a long time, which is that health disparities have an impact on high-risk populations and underserved populations, and we saw that in Covid time and time again,” she said. Vermont responded by targeting vaccine outreach to those individuals, and some of that effort has changed the way that the health department continues to collaborate with marginalized communities. The health department just had its first “tabletop” exercise — an emergency-preparedness simulation — with community groups like Migrant Justice and Bridges to Health, she said. Sosin also noted the importance of community organizations in responding to Covid in a different way. Early in the pandemic, local efforts like mutual aid groups formed an integral part of helping to reach vulnerable Vermonters. READ MORE “Early in the response that communities would … have a telephone tree, and they would see who was at risk, and they would shop for groceries (for those people),” she said. “We don’t sometimes think of that as public health, but those are the things that enable people to comply with public health.” The pandemic response at a state and federal level included a vast expansion of social programs that directly — and indirectly — affected people’s health. “We saw the unprecedented use of housing policy as a tool for pandemic control” with the housing of unsheltered Vermonters in motels and the moratorium on evictions, Sosin said. The federal government expanded Medicaid eligibility, extended the Child Income Tax Credit and provided several stimulus payments. Those initiatives had a concrete impact on child poverty in the years they occurred. The federal government also lifted restrictions on telehealth, which was beneficial to rural health access, she said. “Unfortunately,” she said, that flexibility is about to end unless the federal government extends it — one of many programs Sosin said was at risk. ‘Emerging threats’In the early months of 2025, President Donald Trump issued executive orders withdrawing the U.S. from the World Health Organization and cutting foreign health aid. His administration announced hundreds of millions of dollars of funding cuts to institutions conducting health research, something that has Sosin worried about the country’s ability to prepare for future health challenges. “We need to be able to generate evidence in real time in response to emerging threats. And research institutions play a critical role in that,” she said. “The existence of research infrastructure was critical to really understanding Covid-19 and to developing tools to respond to it” — from therapeutics to testing to vaccines. Those threats include bird flu or H5N1, which has infected poultry and dairy livestock nationwide and sickened humans, primarily farm workers. The U.S. has also recently seen a surge in measles cases led by an outbreak in western Texas. Experts have linked the rise in measles to a decline in childhood vaccination rates. “There’s been some conversation around (bird flu) and its pandemic threat potential. And to some extent, I think that that’s the wrong question,” she said. “The question is not about just the pathogen and what its trajectory will be, but rather, how prepared we are to respond as a state in the absence of the policy response and federal infrastructure? How are we going to do this without the federal resources coming our way?”She referenced newly confirmed U.S. Secretary of Health and Human Services Robert F. Kennedy, Jr., who has a long track record of anti-vaccine activism. Kennedy has recently recommended unproven health supplements to treat measles while casting doubts on the safety of the measles vaccine amid a growing outbreak. READ MORE “There is a large political economy that’s fueled the rise of RFK and other extreme figures,” she said. Sosin said the “abdication” of health response at the federal level has highlighted how important state leadership will be going forward. “The state needs to prepare for the vacuum of federal leadership.”Levine — who declined to be interviewed by VTDigger on the Covid anniversary, citing travel plans in the days prior to his departure from his role at the health department — shared similar concerns about the federal government to Sosin in an emailed statement. “The turbulence we are seeing in public health at the federal level only underscores the point that here in Vermont, we have to be willing to do what it takes to be good neighbors to each other and protect our communities,” Levine said via email. His top takeaway: Vermont, get vaccinated. Despite the state’s initial progress on the vaccine, uptake for Covid and flu shots have fallen in recent years.“My hope is that what we are seeing in our vaccination rates is a temporary setback, and that it will not take another dire public health emergency to find out if we have learned the right lessons,” he wrote. Read the story on VTDigger here: New technology, and mistrust, is legacy of Covid-19 for Vermont public health. ...read more read less