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New virus model shows more detail

A new modeling system for recording COVID-19 cases has been developed by the University of Virginia, and the results were rolled out by the state on Monday in the form of various charts on the Virginia Department of Health website.

The charts provide more information about the impact of the illness on localities than was previously available, including the number of people in each health district who have been tested and the number who have been hospitalized. There is also a chart showing outbreaks of the illness. Dr. Richard Williams, director of Three Rivers Health District, said that with a highly contagious pandemic disease such as COVID-19, a single case in a vulnerable facility is a suspected outbreak and two cases represent a confirmed outbreak.

Such an outbreak exists at Haynesville Correctional Center, located in Haynesville near Warsaw, where there are four inmates with confirmed cases, one of whom is in the hospital, and one staff member who has the illness.

The health department’s charts show that 616 people in the Three Rivers Health District have thus far been tested for COVID-19 and 50 have been confirmed to have the illness. Seven of them have been hospitalized, according to Dr. Williams. There has been one death in the district, of a Gloucester resident in her 40s.

More local cases

Locally, 20 people in Gloucester and three people in Mathews had been confirmed to have the disease as of Wednesday morning. These numbers reflect an increase over last Wednesday, when 16 people in Gloucester and two people in Mathews had tested positive.

Statewide, 44,169 people had been tested for the disease as of Wednesday morning, with 6,500 confirmed cases, 1,048 hospitalizations, and 195 deaths. These numbers are cumulative. The hospitalization number reflects only cases that have been investigated by VDH, and so underrepresents the total number of hospitalizations to date, according to the VDH website.

Figures provided by the Virginia Hospital and Healthcare Association, which tracks both the current number of people hospitalized and the number who have been released, show that there were 802 patients across the state who were hospitalized with confirmed cases of COVID-19 as of Wednesday morning, with an additional 496 patients who had pending diagnoses. Of all 1,298 patients currently hospitalized with confirmed or suspected cases, 394 were in intensive care units and 234 were on ventilators. Additionally, 752 patients had been treated for the illness and discharged.

VDDH figures show that there were 2,865 ventilators on-hand in hospitals statewide on Wednesday, with 695 of those, or 24 percent, were in use.

Possible ‘flattening’

Dr. Williams said that the numbers reflect a decrease in the real-time number of cases, and that the rate of new cases appears to be going down across the commonwealth.

“The curve does appear to be flattening,” said Williams, “probably because of social distancing and staying at home.”
Williams said that the UVA model for tracking the disease agrees with other models across the nation that show that if social distancing measures are removed too aggressively and abruptly, the virus will affect vulnerable people and resurge, spreading more rapidly than the first wave of the illness. He explained that this would occur because the virus is already in the population, making a lot more people susceptible than when it was first introduced by travelers coming from Europe, China, and other parts of Asia.

“Probably a vast majority of people have not had it yet, have no immunity, and are still susceptible,” he said. Therefore, if a lot of people begin to interact with each other, it will spread very rapidly. If that were to happen, isolation would once again be needed to flatten the second curve, said Williams, but “a whole lot of people could be affected” first.

“We’re well-advised not to go back too soon,” he said. “It should be done knowing the virus is there and using measures to control it.”

Those measures would again include refraining from gathering in large groups and staying as far away from each other as possible, said Williams. Public health would need to continue to take steps to monitor the spread of the disease by isolating those who have it or are at risk for developing it and by doing contact tracing of those who have possibly been exposed to it. In addition, older people would still be prudent to isolate themselves until a vaccine is available.

“It won’t be normal as in the past, before this virus came into the world,” said Williams. “It will be phased to whatever normal ends up being when we have normal levels of immunity.”

The virus will be brought under control when enough people are immune to it that it has trouble finding a new host, he said. Then it could either just die away or it could return seasonally or annually and be around for a long time.
Williams said that COVID-19 is more deadly than any other virus he has seen in his 40-year career in public health.

“The flu virus can be deadly,” he said, “but it has never killed like this virus. The New York experience tells you it’s a horse of a different color.”

While ideas for reopening the economy are being considered, said Williams, currently no details exist to show exactly what that would look like.

“That takes place at a level higher than me,” he said. “But you don’t flip a switch. You have principles in place … The virus itself will determine what happens, mitigated by our response.”