This week, nearly 150 members of the public and health care providers tuned in to a presentation by Dr. Mark Levine, health commissioner for the state of Vermont. Dr. Levine partnered with OneCare for this event to discuss updates about COVID-19, health equity, and chronic lung disease in Vermont. Dr. Levine’s presentation also kicked off a statewide learning collaborative for primary care practices who want to improve care to patients with asthma and chronic obstructive pulmonary disease (COPD) based on best practices. Sixteen practices from across the state joined the learning collaborative, which was developed by OneCare Vermont, the Vermont Department of Health (VDH), the Vermont Blueprint for Health, Support and Services at Home (SASH), Blue Cross and Blue Shield of Vermont (BCBSVT), and Bi-State Primary Care Association. A recording of the presentation is available here.
Number of Vermont Practices Registered for the Asthma and COPD Learning Collaborative 2020
Dr. Levine began by reminding attendees that before the pandemic, the coronavirus that causes COVID-19 had never been seen in humans. A fundamental principle of public health is to contain infectious diseases. Because the coronavirus was new, it took time to develop tests that could track infection and help prevent spread of the virus. Lack of testing and personal protective equipment were compounded by a slow national response, leading to widespread infection, said Dr. Levine. The health emergency is likely to continue for some time. “Until we get the vaccine and until we can really manage this well, we’re stuck in this fragile state, so it would seem,” he said.
According to Dr. Levine, Vermont’s response was swift and effective. He credited Vermonters’ cooperation, our desire to protect the most vulnerable, and a phased and gradual reopening aimed at flattening the curve. At the time of Dr. Levine’s presentation, Vermont had the lowest incidence of coronavirus infection in the US.
Pictured above: A slide excerpt discussing racial disparities among COVID cases from the presentation. The introduction states white Vermonters represent the majority of COVID-19 cases, and African American Vermonters have the highest rate; with the rate being “per 10,000 Vermonters.” A pie chart reflects the percentage of cases by race, and a bar chart reflects the rate of cases by race. To see the presentation in full, click here to download it.
Dr. Levine reviewed COVID-19 data and shared the Vermont Department of Health’s health equity mission: “Health equity exists when all people have a fair and just opportunity to be healthy, especially those who have experienced socioeconomic disadvantage, historical injustice, and other avoidable systemic inequalities that are often associated with social categories of race, gender, ethnicity, social position, sexual orientation and disability.”
Vermonters who are Black or African American have a higher rate of COVID-19 cases when compared to Vermonters from other racial groups. Dr. Levine shared that the state’s Health Equity and Community Engagement Team is taking steps to enhance the state’s educational, prevention, and outbreak response strategies by prioritizing populations disproportionately impacted by COVID-19. This team is also forming partnerships with organizations serving Black Indigenous, and People of Color (BIPOC) communities.
Social determinants of health are connected to specific health conditions, including asthma. Vermont’s asthma rate among adults is the fifth highest in the nation. In Vermont, asthma is more prevalent in people that have lower income and education status, and is also more prevalent among women. Because of the pandemic, people with difficulty breathing due to lung disease may be exposed to cleaning chemicals more frequently and may be wearing masks.
Dr. Levine said that people with asthma might be at higher risk for getting very sick from COVID-19, and those with Chronic Obstructive Pulmonary Disease (COPD) are at risk of serious illness and readmission to the hospital if they do become sick with COVID-19. Best practices for treating people with asthma or COPD including working with patients to successfully quit smoking, avoiding secondhand smoke, developing an asthma and COPD action plan, and reviewing patient triggers.