byline: Richard Foster

With an estimated 30,000 medical workers needed in the event of a surge of COVID-19 cases in Virginia, Gov. Ralph Northam has issued an executive order aimed at making it easier for nurse practitioners, fourth-year medical students, residents, interns and out-of-state doctors to assist hospitals and long-term care facilities with providing care for patients.

“While we are seeing promising signs in our ongoing fight against COVID-19, we must continue to prepare for all scenarios, and that includes making sure we have to the necessary staff to confront a potential medical surge,” Northam said of the order, which also allows for expanded telehealth care options. “This pandemic is placing extraordinary demands on our doctors, nurses, and nurse practitioners, and these policies will enable us to expand our health care workforce so more trained medical professionals can step in and help.”

Speaking during an April 17 news briefing, Northam said that Virginia has received $1.6 billion in federal stimulus funds, which will be used for Virginia’s COVID-19 response and to aid local governments. Virginia also received approval from the Federal Emergency Management Agency for hotel accommodations for first responders and essential workers combating the coronavirus pandemic.

Additionally, Virginia has received its first shipment of personal protective equipment (PPE) from the state government’s $27 million contract with Norfolk-based Northfield Medical Manufacturing, receiving more than 24,000 N95 masks as well as protective gloves and gowns. “We expect more shipments from this order in the coming weeks,” Northam said. “The national supply chain issues around PPE remain a problem. We’re trying to work around those by diversifying our sources, so we have multiple different ways to get PPE. I’m proud of the innovative ways our health care providers are coming up with to stretch their PPE supplies, such as decontaminating masks with ultraviolet lights.”

Discussing recent federal guidelines from the Centers for Disease Control and Prevention and FEMA on reopening America, the governor noted that the CDC’s first criteria for a phased return to normal life would include 14 consecutive days of declining COVID-19 cases. However, Virginia has just had two back-to-back record-setting days for new confirmed cases, seeing 602 cases in the last 24 hours, an increase of about 8%.

Virginia’s decisions to ease restrictions will be based on “science and data,” said Northam, noting that planning for reopening the commonwealth also will include developing the capability to screen, test, track and isolate people in order to contain the virus. The state is working to establish and improve processes for that, the governor said, as well as sourcing enough PPE for frontline medical workers and first responders. However, Northam said, “We have no national guidance on testing. … Every governor is having to establish our testing protocols and [procuring] our supplies on our own . … While that improves every day, we’re not there yet.”

Northam also responded to a question about U.S. President Donald J. Trump’s April 17 tweet reading, “LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!” The tweet was one of a few identical messages Trump sent Friday, aimed at fueling protests against Democratic governors in Michigan, Minnesota and Virginia.

Northam replied, “I do not have time to involve myself in Twitter wars. I will continue to do everything I can to keep Virginia safe and save lives.”

LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!

— Donald J. Trump (@realDonaldTrump) April 17, 2020

About 24 protesters assembled at the Virginia State Capitol on Thursday, some of them believing COVID-19 to be a hoax, and called on Northam to reopen businesses and end his shelter-in-place order for Virginia, which is in place until June 10. Virginia Republicans, including state Sen. Amanda Chase of Chesterfield County, have been calling for Northam to end the pandemic shutdown by early May.

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As Virginia remains under a stay-at-home order until June 10, Gov. Ralph Northam said Wednesday that even as restrictions ease, it’s not likely that life will return to the way it was until there is a vaccination or treatment for COVID-19.

“Together we will figure out how to build a new normal,” Northam said during his coronavirus news briefing. “Right now, that new normal will probably look like covering your face, spending more time at home, teleworking if you can, continuing to use social distancing and staying away from large gatherings. … All of these things will continue, I think, as part of the way our society acts on a day-to-day basis.”

Northam is extending his March 24 executive order banning gatherings of 10 people or more; restricting restaurants to offering takeout and delivery; and closing recreation, entertainment and personal care businesses such as  gyms, movie theaters and hair salons until May 8, he said, and the state will continue to monitor and assess the need for the order. The governor also announced Wednesday that the state is receiving $70 million from the federal CARES (Coronavirus Aid, Relief, and Economic Security) Act to provide child care options during the pandemic, particularly for essential workers.

“I know this has been a frustrating time for us — people are out of work, businesses are closed. Our entire sense of normal life is out the window,” Northam said.  “I want everyone to know that these sacrifices that you have made are necessary and they are helping. They are slowing the spread [and] they are giving us time to plan and to prepare.”

The governor said that his administration has been discussing with peers in Maryland, North Carolina and Washington, D.C., about what lifting protections might look like. The Virginia business community will also be included in those conversations, he added, so that consumers will feel “safe and comfortable” patronizing businesses. “The way forward will be deliberate and it will be careful but we will move forward and we will do this together,” Northam said.

“Virginia started off strong before this virus and we will continue to be strong moving forward. This is a great state to do business. …. Prior to COVID-19, our economy was literally on fire,” the governor said, noting that state General Fund revenues were 10.8% higher in March than during the same period in 2019. “But that has changed, unfortunately, and we must work together to rebound. … This is going to be a business- and consumer-driven recovery.”

University of Virginia data modeling predicting the spread of COVID-19 in the commonwealth shows that if social distancing continues until June 10, cases will continue at a steady rate of a few hundred cases a day on average. Absent of any protective measures, however, the state would have seen the pandemic spiral out of control by now, spawning more than 5,000 cases per day.

“It shows that our social distancing measures are working. We are slowing the spread of this virus,” Virginia Gov. Ralph Northam said during a Monday coronavirus news briefing. “It also shows right now that Virginia hospitals have sufficient capacity to handle the surge in patients that we expect, but this model also demonstrates if we lift the stay-at-home order on social distancing too soon — if we try to rush to get our lives back to normal — the number of cases will spike higher and earlier and we can’t afford that.”

The U.Va. Biocomplexity Institute, which has also performed modeling on Zika and Ebola viral epidemics in the last decade, has developed five “what if scenarios” following the progression of COVID-19 in Virginia, said Bryan Lewis, research associate professor in the institute’s network systems science and advanced computing division, during a  Monday webinar. The scenarios reflected in the modeling look at options ranging from no social distancing response to lifting restrictions at the end of April to sticking with Northam’s current stay-at-home orders, which are in place through June 10.

Worst-case scenarios, in which no intervention was put into place, show that Virginia cases would have surged to more than 5,000 per day by now, with more than 1,000 Virginians hospitalized and 200 requiring ventilators daily. Under this scenarios, cases would peak at 30,000 daily confirmed cases by early May.

If restrictions were lifted at the end of April, Virginia daily confirmed cases would peak at between 15,000 to 20,000 cases between June and July, according to the U.Va. model.

And if Virginia stays with the June 10 date for lifting the stay-at-home order, the model forecasts that cases will begin surging upward in early July and peak at around 12,500 daily confirmed cases in mid-August.

Continuing the state government’s current plan to lift restrictions on June 10, the U.Va. modeling shows that hospital bed capacity would be exceeded in July in Northern Virginia and in August in Central Virginia, Hampton Roads, Roanoke and Shenandoah. Hospital capacity would be exceeded in far Southwest Virginia in September.

“Under these current conditions, we do have sufficient medical resources for the next couple months,” Lewis said, noting that “it is dangerous to consider lifting social distancing too soon.”

Virginia Secretary of Health and Human Resources Daniel Carey said during the webinar that the state government is “optimistic about our hospital capacity,” and is continuing to coordinate with hospital systems to share data and information and provide resources and equipment.

Most importantly, Carey said, the U.Va. modeling shows that “our actions now will affect our outcomes. … We are in it for the long haul and we need Virginians to keep working with us on this.” The modeling demonstrates that the state needs “to be responsible about when we ease these restrictions … in a way not to trigger a second or third surge.”

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