As several states in the United States deal with rising cases of COVID-19, one state, Vermont, has bucked the trend as well as the hardest ravages of the initial pandemic.

Known for its small villages, low population, rolling hills, maple syrup, autumn foliage, skiing and for being the home of the former Democratic presidential contender Senator Bernie Sanders, the Green Mountain State in New England has avoided the coronavirus toll that has hit other states, especially its neighbors New York and Massachusetts.

Massachusetts to the south has had more than 119,000 coronavirus cases and more than 8,830 deaths, and New York to the west, once the epicenter of the virus in the US, has had more than 440,000 cases and more than 32,900 deaths. The US has had more than 6 million confirmed cases of the virus and more than 184,800 deaths.

By Saturday, Vermont had had 1,647 infections and 58 deaths, and 143,088 people had been tested for the virus since mid-March, the state health department said.

Those numbers have put a national spotlight on the state, with media coverage that has asked how it has performed so well compared with others.

The state's motto is "Freedom and Unity", and the latter, health department officials say, is part of the answer. They also give credit to Republican Governor Phil Scott.

"Neighbors are concerned about neighbors," said Tracy Dolan, deputy commissioner of the state health department. "They help each other out, making sure that people can get to the grocery stores. We have a good Meals-on-Wheels program for the elderly, and there is positive peer pressure to wear masks. … We're in good shape."

Residents have "a high level of trust" for public health experts and listen to information on TV and public radio, she said. Many are used to stocking up on supplies to cope with harsh winters. Some grow vegetables and chickens, and this discipline has helped them adapt to quarantining.

Public health science

Dolan also singled out strong leadership from state health officials and from the commissioner of health, Mark Levine, and praised Scott for paying attention to science:"The governor has been really open to understanding and paying attention to public health science and has listened closely to it and has been guided by it."

Preemptive action by Scott and the state health department officials and Vermont being a rural state with a low population aided the success, she said.

It is the second least-populous state, with 623,989 people. Residents are 92.4 percent white, 1.4 percent African American, 1.9 percent Asian, 0.4 percent American Indian and 2 percent Latino.

In May Scott said Vermont was "the envy of the nation" because of how it had handled the pandemic.

"We took a lot of steps early, and we didn't waste a lot of time, and Vermonters accepted that," he said in June, heaping praise on the state's residents. "And they also complied with all the measures."

Scott declared a state of emergency on March 13 and the order was extended on Aug 14 to Sept 15. He has allowed local discretion for size limits on gatherings and sales of alcohol.

Scott said that one of his most important decisions was to shut bars and restaurants before St Patrick's Day. He also shut hotels and put homeless people in motels and camper vans.

At the start of the pandemic in the US there had been fears that Vermont's elderly population would be ravaged by the illness.

At least 1 in 5 residents is elderly, one of the country's highest elderly populations. Months later, half of all of the state's COVID-19 cases have occurred in assisted-living facilities.

Commenting on the state's progress, Dolan said: "Early on we did assessments with the long-term care facilities to determine their infection prevention controls, talk them through any (personal protective equipment) issues and other outbreak protocols, and we did that early. We did that with every single long-term care facility."