Dr. Richard Williams, director of the Three Rivers Health District, discussed the COVID-19 crisis during an electronic meeting of the Mathews County Board of Supervisors on Tuesday. He said that, while the pandemic curve has flattened in Virginia and has been declining in most places for several weeks, the U.S. as a whole has nearly 100,000 deaths from the disease and has confirmed approximately 1.7 million cases.
In Virginia, he said, more than 39,000 cases have been confirmed, with nearly 500 cases in the Three Rivers Health District. A large portion of those are in Richmond County, where there have been two outbreaks, he said.
Williams said that the daily count of community-spread cases in the district runs from two or three up to 10 or 11, which is “fairly stable” and “not jumping up.”
Virginia’s key measures for determining the pathway to reopening are “trending favorably,” he said, but community transmission is still widespread, and the majority of people are still subject to infection.
“This is a disease like we haven’t seen before,” said Williams. “People without symptoms outnumber people with symptoms by five or 10 to one.”
In addition, the disease is causing cases of Multisystem Inflammatory Syndrome in children, two of which have occurred in Virginia thus far. He said the illness is deadly for older people with pre-existing conditions, with a three- to five-percent fatality rate.
“The virus still has five times the case fatality rate of seasonal flu,” said Williams.
The fact that there is asymptomatic spread of the disease makes it even more problematic, he said, and makes it even more important that people protect each other by using face coverings, practicing social distancing, washing hands, and following other recommended practices.
The only drug that has proved to be effective in treating the illness is Remdesivir, said Williams, and that is in short supply.
But supplies of such things as personal protective equipment and swabs for testing are now adequate, he said, and no shortages are being reported.
Williams explained the two types of tests available for COVID-19. One is the PCR test, which tests for current or recent infection and is performed by swabbing the naso-pharyngeal area for live viral material. The other is a blood test for antibodies that determines whether someone has already had the illness and possibly has some immunity to it in the future.
The Three Rivers Health District is conducting a drive-thru testing event on June 4 at the Middlesex County Health Department (see separate article in this week’s paper for details). In addition, he said that former director of the Virginia Department of Health, Dr. David H. Trump will oversee the testing of 5,000 people around the state for antibodies. These tests will probably be aimed at higher risk people in a health care setting, he said.
The primary defense the community has against the pandemic is case identification and contact tracing, said Williams.
The state is hiring more than 1,000 contact tracers to try to identify every single case, trace the people they have been in contact with, and thereby prevent further spread of the disease.
Williams said that the health department has been charged with enforcing Gov. Ralph Northam’s new requirement for all employees and customers to wear face coverings while inside places of business. He said it’s going to require developing relationships with businesses that the health department never dealt with in the past in order to be able to respond to non-compliance issues.
“There’s a lot of passion about masks and personal freedom,” he said. “We’ll approach that with caution and safety in mind.”
While it’s necessary to reopen businesses and reboot the economy, he said, “those of us who are vulnerable should still stay home, protect ourselves, wash our hands, and practice social distancing”
Wearing face coverings is a vital part of that, said Williams. He said that from a biologic perspective, wearing even a cloth mask can prevent spread of the disease if both parties are wearing them.
“We have to maintain vigilance to reduce the spread,” he said. “We need to take it seriously.”
Current numbers
As of Wednesday morning, there were 30 cases of COVID-19 in Gloucester, up by one from last week, while the Mathews count remained the same, at five.
Middlesex cases increased by two, from 12 last week to 14, on Wednesday morning.
Across the Three Rivers Health District, there were 494 confirmed cases as of Wednesday morning, up from 429 last week, with 34 patients having been hospitalized and six deaths.
The largest number of cases in the district was in Richmond County, which had 275 as of Wednesday, up from 263 last week. Most of these were at the Haynesville Correctional Center, where 246 inmates and nine employees have been confirmed positive for the illness.
Throughout the state, 275,074 tests had been conducted as of Wednesday, with a 13.9 percent positive rate. The statewide goal is a positivity rate of 10 percent, which will mean that enough tests are being conducted.
The total number of people that had been hospitalized in Virginia as of this week was 4,385, up from 3,979 last week. Thirty-four of those hospitalized were determined probable for COVID-19 rather than confirmed.
The total number of deaths from the illness in Virginia as of this week was 1,281, up from 1,074 last week. Of those deaths, 1,202 were confirmed as positive for COVID-19, while 79 were probable.
The Virginia Hospital and Healthcare Association reported on Wednesday that there were currently 1,459 people in state hospitals with current or pending diagnoses of COVID-19. Of those 390 were hospitalized in the ICU and 203 were on ventilators. The total number of ventilators available in the state were 2,994 on Wednesday, with 610 of those in use, and there were 4,300 regular hospital beds available, with 3,695 additional beds that could be occupied under the governor’s Emergency Order 52.