Virginia now has 890 COVID-19 cases, the Virginia Department of Health reported Sunday in its 9 a.m. website update. Twenty-two people are reported dead from causes related to the virus, and there are 112 people hospitalized with symptoms, and 10,609 people have been tested.
The number of positive cases jumped 151 from Saturday’s update of 739 positive tests. As more tests become available, officials say the number of positives are likely to grow, but Dr. Danny Avula, director of the Richmond and Henrico County health departments, warned Friday that the number of cases in Virginia may jump tenfold in the next week and a half if the state follows trends in Michigan, Illinois and Louisiana, which have seen their numbers explode into the thousands this week.
On Saturday, three health districts announced the first deaths in their regions related to COVID-19:
In Alleghany Health District, a woman in her 80s died from COVID-19 causes. The district includes Alleghany, Botetourt, Craig and Roanoke counties and the cities of Covington and Salem. The city of Roanoke has its own health district.
In Crater Health District reported its first death related to the virus, providing no other information about the patient to protect confidentiality. Crater covers Dinwiddie, Greensville, Prince George, Surry and Sussex counties and the cities of Emporia, Hopewell and Petersburg.
The Western Tidewater Health District reported that a man in his 60s with underlying health issues died in a local hospital of respiratory failure due to COVID-19. The Western Tidewater district covers the cities of Suffolk and Franklin, as well as Isle of Wight and Southampton counties.
Fairfax County continues to have the most positive cases at 187 as of Sunday, although the county health department has announced only two deaths related to the virus since the outbreak. Arlington has 84 confirmed cases, the second highest in the state.
A man in his 60s has died from respiratory failure in a hospital, Western Tidewater Health District announced Saturday in a news release. This is the district’s first COVID-19 fatality and likely the 19th death statewide, pending tests on two cases Friday afternoon.
The patient had several underlying medical conditions, which exacerbated the effects of the virus, according to the news release.
“The staff of the Western Tidewater Health District is deeply saddened by the death of this patient,” Dr. Todd Wagner, district director, said in a statement. “This is another reminder of how important it is for us to protect ourselves and others from the COVID-19 virus.”
Western Tidewater Health District includes Isle of Wight and Southampton counties, as well as the cities of Franklin and Suffolk. The death will be included in the 9 a.m. Sunday update of the Virginia Department of Health COVID-19 webpage. Saturday morning, there were 739 cases confirmed.
Dr. Danny Avula, director of the Henrico County and Richmond health departments, warned Friday, “We need to be prepared that we might have a 10x jump [in the number of COVID-19 cases] in the next week and a half” in the state, which would overwhelm hospitals. Virginia has 604 cases of COVID-19 as of Friday, according to the state health department, so Avula’s estimate could mean as many as 6,000 cases in the state within the next 10 days.
Avula mentioned other states — including Michigan, Illinois and Louisiana — that had positive cases in the 200 range last week and are now seeing thousands of cases. Michigan had 3,657 positive cases Friday; Illinois, 3,026; and Louisiana, 2,746. “The hope is the mitigation efforts that we put into place will slow that, but I also know that those [states] have done similar things,” Avula said during a Friday evening news conference outside the Richmond Health Department building downtown.
Right now, Central Virginia hospitals have about 40% to 50% ICU beds available, a number Avula expects to dwindle. Personal protective equipment (PPE) like N95 masks and gloves also are needed, although he noted that the state government has placed orders for 1 million surgical masks and 500,000 N95 masks that are expected to arrive next week from the Strategic National Stockpile and other sources.
Enforcement of the governor’s order that businesses like restaurants have no more than 10 people inside has also begun, Avula said. Richmond Health Department inspectors teamed up with Richmond police officers Thursday night to warn businesses in violation. So far, unlike governors in many other states, Gov. Ralph Northam has not issued an explicit shelter-at-home order and restaurants are allowed to provide takeout and delivery services, while following a 10-patron limit for pickup orders.
There’s also a shortage of COVID-19 testing kits, Avula said. After two “pop-up” community tests last week that tested more than 100 people, Avula said his department had to cancel an event planned for this week because they didn’t have enough test kits.
After someone has tested positive for the virus, the recommended protocol is to retest them twice after they’ve appeared to recover, Avula said. After a person has had two negative tests in a 24-hour period, they are considered fully recovered. But that’s impossible due to the lack of kits, Avula said, so his departments now consider recovered patients virus-free if at least seven days have passed without symptoms; they haven’t had a fever for 72 hours; and they’re completely free of all respiratory symptoms. So far, “less than five” patients in his region have recovered, Avula said.
Avula also addressed the major health crisis in his district, an outbreak among residents and staff at Canterbury Rehabilitation and Healthcare Center that has claimed six lives. Four people — among them a woman in her 80s and a man in his 70s — were positive for COVID-19, results confirmed by the Virginia Department of Health. Two other deaths, announced Friday afternoon, are “presumed positive” coronavirus cases. One man who died Friday was tested by a private lab, and VDH has not yet verified the test, Avula said. The second man had symptoms that came on more recently, and Avula said he did not know if test results have come back for the patient. One of the men died at a hospital and the other at the center, he said.
The rehabilitation center, where about 800 people live, announced in a news release that 19 residents and six employees have tested positive, although some of the COVID-19 tests have not yet been confirmed by VDH, Avula said.
Canterbury locked down its facility and has not allowed visitors for two weeks, as have other regional long-term care centers, Avula said. The facilities are screening staff members and keeping nursing homes clean and disinfected, following state and federal health guidelines, he added. Many, however, also are forming “informal networks,” sharing advice and questions, Avula noted.
A man in his 70s died Friday in a hospital from respiratory failure, Prince William Health District officials announced Friday evening. It is the first COVID-19 death recorded in the district, which includes Manassas and Woodbridge
Fairfax County Health District reported its second coronavirus death, a man in his 60s who contracted the virus during travel, officials said in a Friday night news release.
These two deaths bring the Virginia Department of Health’s statewide total to 16, although the website will not reflect the two most recent fatalities until its 9 a.m. Saturday update.
Also, on Friday afternoon, Canterbury Rehabilitation & Healthcare Center, a long-term nursing care facility in western Henrico County, announced that two people with “presumed positive” cases of the virus had died, bringing the total number of fatalities connected with the center to six.
Virginia Department of Health personnel are confirming that the two patients were positive for the virus, but Dr. Danny Avula, the Richmond and Henrico Health District director, said that both male patients were showing symptoms and at least one had a positive result in a test conducted in a private lab. The other man showed symptoms more recently, and Avula did not know if he had received test results yet.
If VDH confirms the two Henrico deaths announced Friday, the total coronavirus death toll in the state would stand at 18.
A Henrico County longterm care facility, Canterbury Rehabilitation & Healthcare Center, reported two deaths of “presumed positive” COVID-19 patients in the past 24 hours, in addition to four deaths earlier this week of people whose test results had already come back positive.
One man died at a hospital and the other at the center, according to Dr. Danny Avula, director of the Henrico and Richmond health departments. He estimated Friday night that 53 or 54 residents are showing potential symptoms at the center, having spoken earlier in the day with its medical director.
With the addition of the two most recent fatalities, there are now six deaths connected to the center. According to Canterbury’s Friday update, there are now 19 residents and six workers with positive tests.
The biggest issues currently are staffing and personal protection equipment, although Avula said he hopes there will be more staff to replace those who are sick or quarantined after contacting nursing staffing agencies. The Henrico County Health Department has provided gloves, masks and gowns to the center this week, but Avula said they’re now looking at providing more so staff members who don’t work directly in an isolation unit with COVID-19 patients are protected.
Five residents are now receiving treatment at a regional hospital, and 10 are now in an isolated unit at the western Henrico center. The number of outstanding tests and “presumed positive” cases is shifting, the center said in its statement.
At a Friday evening news conference, Avula said that one man who died Friday was tested by a private lab, and the Virginia Department of Health has not yet verified the test. The second man had symptoms that came on more recently, and Avula said he did not know if test results have come back for the patient.
“On Wednesday, our medical director personally reached out to each Canterbury family with a COVID-19 positive loved one,” Canterbury Administrator Jeremiah Davis said in a statement Friday. “Members of the Canterbury team reached out to the families of all other residents. Further, we are establishing a dedicated phone line explicitly for families with questions; we have a team in place that will respond as quickly as possible to those calls.”
As Virginia saw its largest 24-hour increase in confirmed COVID-19 cases Friday, Virginia Gov. Ralph Northam called on President Donald Trump and the federal government to implement a “national solution” for supplying front-line medical workers and first responders with much-needed protective gear and medical equipment.
Northam. other state governors and Washington, D.C., Mayor Muriel Bowser held a conference call Thursday with federal officials in which they told Trump and Vice President Mike Pence that the states need federal leadership in marshaling more medical equipment, testing kits and protective gear for health care workers. “We’re all out there bidding literally against each other,” the governor said, noting that Virginia’s state government is competing against its own hospital systems, other states and the federal government to purchase personal protective equipment (PPE) for medical workers and other in-demand medical equipment such as ventilators and COVID-19 test kits.
“The governors on that call repeatedly said that production and distribution of PPE really must be managed at the federal level. We strongly urge the president to use the Defense Production Act to ramp up production of PPE. There is no time to waste,” Northam said. (During that call, Washington Gov. Jay Inslee made headlines for responding to Trump’s comment that the federal government was primed to be a “backup” for states in crisis by saying, “We don’t need a backup. We need a Tom Brady.”)
Northam stated earlier this week that the number of confirmed cases is likely to grow in Virginia as more testing kits become available, as well as from community spread of the virus. Due to the shortage of COVID-19 test kits, it is difficult to ascertain how many people actually have the virus, as some people with COVID-19 only manifest mild to moderate symptoms, which do not meet thresholds for testing.
During Northam’s coronavirus news conference Friday, Virginia Secretary of Finance Aubrey Layne said that Virginia expects to receive $3.3 billion in federal funds from the $2 trillion CARE Act, which was signed by Trump on Friday. Layne said that $1.8 billion of the aid will be directed to the state government to address COVID-19-related public health costs, and $1.5 billion will be allocated to localities. The General Assembly still plans to reconvene April 22 in Richmond, Northam said, and discussions are ongoing about new state spending related to the COVID-19 crisis.
Northam also said he is working with Maryland Gov. Larry Hogan and Bowser to request a federal testing site in the D.C. metro area, especially for federal employees who are considered critical workers, and “need testing in real time” if they show virus symptoms. Currently, Virginia has the capacity to administer 1,800 COVID-19 tests. U.Va. Health and VCU Health have some capacity for in-house tests, and “Sentara is close to up and running,” Northam said. Private labs — including North Carolina’s LabCorp and New Jersey’s Quest Diagnostics — still have about a five- to seven-day turnaround, Northam said. “It’s not a very effective, efficient system,” he said, calling for the federal government to lead the way in providing more tests, especially in densely populated regions like Northern Virginia.
On Saturday, President Trump plans to visit Norfolk to see off the USNS Comfort, a U.S. Navy hospital ship that is being deployed to assist doctors battling the coronavirus in New York City. The ship will provide facilities for emergency surgeries and trauma care not related to the virus, Northam said. “The deployment of the Comfort is a sacrifice for our personnel and their families,” the governor said. “We are proud Virginia can help New York in any way.”
The governor also reemphasized Friday that Virginians need to stay home to prevent further spread of the virus. Unlike many other state governors, however, Northam has not yet issued an explicit remain-at-home order, despite calls from other officials around the state.
“We’re talking semantics here. We’re talking enforcement,” he said in response to a question from a reporter about why he hasn’t issued a stay-at-home order.
Northam also has asked the federal government to provide funding through U.S. Code Title 32 to reimburse the state for costs connected to activating more Virginia National Guard members, who are assisting the state with logistics and distribution, along with other virus-related tasks.
After putting out a call for trained medical personnel to volunteer for the Virginia Medical Reserve Corps earlier this week, more than 1,500 people volunteered in the past month, including 650 volunteers in the past two days, Northam said. He also thanked companies including Micron Technologies, The Home Depot Corp. and Dominion Energy Inc. for donating protective wear for Virginia health personnel. For more information on donating protective equipment for medical workers and first responders, visit virginia.gov/covid19supplies.
A VCU Health liver specialist and gastroenterologist is leading clinical trials for a possible drug treatment for COVID-19 patients.
This week, Dr. Arun Sanyal began testing remdesivir, an antiviral medication previously used experimentally to treat the Ebola virus, on several VCU Health System patients with moderate to severe cases of COVID-19. While it’s too early to provide results, Sanyal said Thursday, anecdotally it’s “so far, so good. It looks encouraging so far.”
VCU Health is among a handful of institutions in the United States and in other countries conducting trials on remdesivir, which was developed by Gilead Sciences Inc., a California biotech company. The first trials in this country began in February as part of the U.S. Food and Drug Administration’s fast-tracking of its drug-testing protocol to address the coronavirus.
Remdesivir yielded positive results on COVID-19 patients in China, which led to the FDA’s decision to allow U.S. researchers to jump to Phase 3 testing — i.e., testing on human patients. Normally, trials begin with tests on healthy volunteers and later progress to people with an illness, but the outbreak has prompted a fast-tracking of drug trials that could lead to successful treatment of COVID-19.
This is how the VCU trial works:
A patient must have a certified positive test for COVID-19 and be sick enough to be in the hospital, Sanyal said, with documented fever and pneumonia. If the patient requires additional oxygen, they are designated as having a severe case; if the patient does not need oxygen, they are considered moderate.
At the VCU Health System in Richmond, the patients in the trial are divided into groups: some moderate and severe patients are given remdesivir intravenously for five days and others for 10 days; the other moderate patients are not given the drug, to provide a comparison in the study.
The objectives, Sanyal says, are to see if the five-day and 10-day treatments yield similar results, whether researchers see any improvement among drug-therapy patients, and if the drug reduces a severe patient’s chance of death.
About 10 days from now, Sanyal expects to have a better idea of the effect of the drug, and he will submit his data to Gilead. “These trials are pretty close to being fully enrolled globally,” Sanyal said, and “a month after the last patient is enrolled, then the clock starts ticking.”
Gilead should have a full analysis of the data within two or three months, Sanyal said, which will be sent to the FDA for possible approval of the drug.
Although he specializes in the liver, Sanyal has conducted numerous clinical trials over the years, including some with Gilead. He performs research at the VCU Massey Cancer Center and trains faculty in research at VCU’s C. Kenneth and Dianne Wright Center for Clinical and Translational Research, which oversees VCU’s clinical trials, backed by a $21.5 million National Institutes of Health grant.
Dr. Sanyal in full protective gear. Courtesy VCU Health
Watching the early days of the COVID-19 spread in the U.S., Sanyal said he expected Virginia would not be spared — and he was worried that there were no medications approved to treat the virus.
He contacted Gilead, which designated VCU as one of five locations where clinical trials would be initiated. The tests started at VCU this week — within five or six days after the conversation, Sanyal said. “It was remarkable.” Typically, drug trials take much longer to launch, he noted.
“Our goal is to keep enrolling patients,” Sanyal said. He encourages anyone who may have COVID-19 to talk to their doctor, who can then fill in the patient’s information in an online portal. There are several hurdles any patient included in the trial must pass.
“We have to take into consideration whether the patient has COVID-19, whether they’re likely to benefit from the drug,” Sanyal says. If a patient has significant kidney disease or high liver enzymes, he can’t include the person in the trial. Also, Sanyal must consider whether a patient can be safely transported to VCU and if there is an isolated bed available at the hospital, which is often 90% to 100% full in normal times.
“That requires coordination and effort,” he says. “We understand their anxiety, and we sympathize. We really encourage patients to talk to their doctor.”
Meanwhile, Sanyal is staying busy with his regular duties, which don’t stop because of the pandemic. “I still have my day job, to take care of my liver patients here.”
The Loudoun County Health Department reported its first COVID-19 death Thursday afternoon, bringing the total fatalities in Virginia to 14.
The patient was a woman in her 70s who died from respiratory failure caused by the virus. She was hospitalized, according to a press release from the county.
“We are saddened by the first confirmed death of a Loudoun County resident due to COVID-19. Our hearts go out to her loved ones,” Dr. David Goodfriend, director of the Loudoun County Health Department, said in a statement. “The health of our residents is our top priority, and we ask that everyone do their part to slow the spread of the virus in our community: practice social distancing, wash your hands and cover coughs and sneezes.
According to the most recent update by the Virginia Department of Health, Loudoun has 28 recorded COVID-19 cases, and there are 460 recorded statewide.
More than half of Virginia’s 460 confirmed COVID-19 cases are among men and people older than age 50, according to demographic information released Thursday by the Virginia Department of Health about the Virginians who are known to have contracted the novel coronavirus so far.
Men have contracted the virus at a slightly higher rate, making up more than 52% of the known cases in Virginia. And 52.3% of the cases, or 240, are among people ages 50 and above.
VDH has not released similar demographic information about the 14 Virginians who have been killed by the virus, but according to the information released by local health districts, these have occurred among patients ages 60 and older, reflecting worldwide trends that show that elderly people are more vulnerable to the virus.
Due to a dearth of available COVID-19 test kits, state health officials and medical professionals have limited much of the testing to those in respiratory distress or showing more severe symptoms of the disease, so the data may not provide a clear picture of the extent of the spread of the virus in Virginia, as many people may only exhibit mild or moderate symptoms that don’t meet the threshold for testing.
Racial data is missing for more than 60% of Virginia’s confirmed cases, but according to data provided to VDH, 121 cases have occurred among white Virginians, 32 among black or African American Virginians and 27 among other racial groups.
Children ages 0 to 19 make up 2.4%, or 13, of Virginia’s COVID-19 cases, while 15.9%, or 73 cases, have occurred among people in their 20s. People in their 30s account for 14.6% of cases, or 67, and 15%, or 69 cases, are among those in their 40s. Cases among people in their 50s and 60s accounted for 18.3% for each age group, or a total of 168 cases. People ages 70 to 79 made up 10.9%, or 50 cases, and people ages 80 and older account for 4.8%, or 22 cases.
VDH also released statewide statistics Thursday reporting the number of cases by the day patients began exhibiting symptoms or were reported to state health officials. The peak occurred on March 16-17, when 113 people became ill over a two-day period. The numbers are lower from March 18-24, but VDH cautions that more recent cases may not yet have been reported, so the numbers may change.
The Virginia localities with the highest number of COVID-19 cases have remained the same in recent days, although the numbers have grown: Fairfax County has 79 patients, Arlington County with 54 and James City County with 49.
Also, Thursday afternoon, the Richmond Police Department announced that two officers have tested positive. The first case, announced Monday, was a female officer in her 40s, and today’s case is a man in his 40s from the same precinct. Other officers are now in self-quarantine as a precaution, the police said.
UPDATE, 5 p.m. Wednesday: A third resident of Canterbury Rehabilitation & Healthcare Center has died, according to a news release from the long-term care facility in Henrico County. Fourteen residents and four staff members have tested positive for COVID-19 over the past 11 days, according to a statement by Dr. James Wright, the center’s medical director.
Two residents died Tuesday, the Virginia Department of Health reported Tuesday afternoon. With today’s death, the number of COVID-19 fatalities statewide is at 13.
Meanwhile, two of the 14 sick residents continue to receive treatment at a hospital, and nine residents are being treated on-site in an isolated unit by nurses and nursing assistants whose “status is being monitored closely,” according to the release. Employees are being screened daily, and those with respiratory symptoms or fever are prohibited from entering, Wright said in the statement.
Dr. Danny Avula, director of the Richmond and Henrico health departments, confirmed the third death after speaking with Wright earlier Wednesday on a conference call.
He anticipates the number of positive cases to rise at Canterbury, while noting that the “biggest challenge is staffing,” because some of the staff have been exposed and are now quarantined. Avula added that his health department dropped off personal protection equipment for staff members Monday and will provide more as needed.
As for finding replacement staff, Avula said his department wants to make sure no one works at more than one facility at a time, which could lead to further spread of the virus. “We’re learning more and more that this virus can spread even if you don’t have symptoms,” he said.
According to the center’s news release, the center has hired an industrial cleaning service to “provide full and ongoing decontamination of the facility. This includes both daily deep cleaning and the incorporation of six hydroxyl generators, which create airborne hydroxyl radicals that treat pathogens in both the air and on surfaces.”
Earlier:
As the number of confirmed COVID-19 cases in Virginia jumped to 391, Gov. Ralph Northam announced Wednesday that he is ordering health care providers to delay elective surgical procedures during the crisis so that resources such as hospital beds and ventilators can be kept on reserve to respond to the growing pandemic. Northam is also ordering all campgrounds, cabins and bathhouses closed as of Friday morning.
Virginia cases surged by 101 cases in 24 hours, according to State Epidemiologist Dr. Lilian Peake, adding that 12 Virginians are now dead from the illness. Two adults died Wednesday morning in the Peninsula region and another died in the Pittsylvania County/Danville area, she said.
The resident of the Pittsylvania-Danville Health District, the first fatality recorded there, died in an out-of-state hospital, according to a news release Wednesday afternoon. The two Peninsula residents — a woman in her 80s and a woman in her 60s — died from respiratory failure in a local hospital, VDH reported. The cause of the illness is unknown, the news release said.
“Hospitals and medical facilities in Virginia and around the country are in desperate need of additional masks, gowns, gloves, and other personal protective equipment,” Northam said in a statement issued later Wednesday. “While we work to increase our supply, it makes sense to decrease the demand on that equipment where we can. Postponing elective surgeries allows us to divert more PPE to the medical staff who are dealing with the COVID-19 outbreak so we can better protect the men and men on the front lines of this public health emergency, fighting to keep us all safe.”
The public health emergency order does not apply to any procedure if the delay would cause harm to a patient, the governor added. The order also does not apply to outpatient visits at hospital-based clinics, family planning services or emergency procedures. Additionally, licensed inpatient and outpatient surgical hospitals, free-standing endoscopy centers, physicians’ offices and dental, orthodontic and endodontic offices may perform any procedure or surgery that if postponed or canceled would result in the patient’s condition worsening.
Speaking about the need for medical volunteers, Gov. Northam urged Virginians with medical training to join the Virginia Medical Reserve Corps, a citizen volunteer group comprised of medical and public health professionals. Northam also talked again about the commonwealth’s urgent need to source personal protective equipment such as masks and gowns for front-line health care providers and first responders such as police and fire fighters.
Fifty-nine people are hospitalized with coronavirus symptoms, according to VDH. Fairfax County has the most cases at 76, followed by Arlington County with 46 and James City County with 41.
This story will be updated.
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