Back in April, when the leading doctors made recommendations about how to handle COVID-19, they were sharing their best scientific guesses. By now, nearly every primary care and hospital medicine doctor in America has observed COVID-19 firsthand.

Together with our nurse colleagues, we have seen patients contract the disease, fight it, and recover or, sadly, die. Although there are still some questions that we don’t have answers for, we are now operating on experience.

Public health experts and contact tracers have spoken with hundreds of families right here in Vermont. As we approach what might be the most difficult time of the pandemic so far, we are better prepared regarding how to handle it. What we know now comes, not from far-off experts or from research, but from our own experiences. That is going to help us, as cases increase.

First, we can control this. By following all of the recommendations as best as we can, we can rein in this most recent spike of cases and keep it low. Even though we have all heard them a thousand times, I am going to repeat the complete list of mitigation steps here:

• Socialize outside or in well-ventilated areas.

• Stay 6 feet apart or more.

• Keep in-person visits short, 15 minutes or less, especially if you are visiting inside.

• Wear masks when in proximity to those you don’t live with.

• Avoid contact with others and wash your hands.

• Limit travel to only essential trips. (The dictionary definition of “essential” is “absolutely necessary or extremely important.” This rules out almost everything.)

• Wipe down frequently touched areas.

• Quarantine and get tested if you’ve done something risky.

• Isolate if you have symptoms.

While no one of these efforts will solve the problem entirely, all of them together will provide the best protection we can get. Cases will still happen, even among those who are careful. When they do, health care workers have been working hard to ensure (and continue to improve) the availability of testing and fast and easy results communication. Their goal is to keep isolated cases from turning into clusters and clusters from turning into outbreaks.

Second, it’s not easy. Everything about this pandemic is hard to hear, hard to believe and hard to endure. We are all in situations we could not have imagined before now. It is unsettling and unnerving. I have three pieces of advice that I have been sharing with my colleagues, family, friends:

• Let’s live in the middle ground between paralyzing fear and relaxed complacency. It’s certainly not a comfortable place to be, but it is manageable. If you feel yourself deviating too far to one extreme or the other, come back to that middle place. That middle place is one where you live cautiously. There’s equal emphasis on both words: live and cautiously.

• For me, and for others I have spoken with, it is helpful to look for the joy in everyday life, even in the face of adversity. For me, I find joy taking a run with my dogs. (Maybe it’s because they have no idea there’s a pandemic going on. They are still having just as much fun as ever, and that is so refreshing.)

• Let’s take comfort in the fact that pandemics end. They always have, and this one will end faster than most. Widespread vaccination will allow us to return to traveling and gathering in the ways we always have.

In short, stay with me Vermont. We are going to make it, if we can just hold on a little bit longer.


Trey Dobson, M.D., is chief medical officer at Southwestern Vermont Medical Center.

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