Virginia could begin to return to some semblance of normal in about two weeks, as long as the state can meet the first set of parameters outlined in a new blueprint for reopening businesses Gov. Ralph Northam announced Friday.
In his first afternoon press briefing since Monday, April 21, Northam shared bits of good news about the status of the coronavirus pandemic in Virginia and detailed what he said must happen for the state to reach phase one of his blueprint, dubbed “Forward Virginia.”
First the good news: According to at least one model, the state may have reached its peak of COVID-19 cases today, Friday, April 24, Northam said.
Earlier Friday, the Virginia Department of Health released the latest data on the pandemic. The state added a 542 confirmed cases Friday for a total of 11,169 confirmed cases and 410 deaths, which include three “probable” deaths. The state has another 425 probable cases of COVID-19, for a total of 10,998 confirmed and probable cases.
Northam said the state’s cases, while continuing on an upward trend, are rising at a slower rate. Also, hospitalizations have flattened, and about 1,600 people who had been hospitalized with the disease have been successfully treated and released, Northam said.
“Together we slowed the spread of this virus. Our hospitals have not been overwhelmed and according to at least one model, we may have seen our case count peak today,” Northam said. “I hope that is true, but we must continue to work to keep counts low. We continue to watch the data.”
Northam said the state would continue watching the daily VDH reports to track the percent of positive tests compared to total tests. The state is also closely tracking the number of hospitalizations due to COVID-19 and the available supply of hospital beds and personal protective equipment for hospital and health care workers.
When the state sees a downward trend for 14 days in the percent of positive tests and hospitalizations -- and is able to boost testing and tracing capabilities -- “then we can move to phase one of easing these restrictions,” Northam said.
What does phase one entail? According Northam, it includes continued social distancing, teleworking wherever possible, limits on travel and public gatherings and continuing to use of face coverings in public.
Any further easing of restrictions will be informed by public health experts, members of the governor’s COVID-19 Business Task Force, who were announced Friday, state and local officials, and other stakeholders.
“We will move forward but in a way that prioritizes public health and creates public confidence. Easing too much too soon could jeopardize public health and consumer confidence. One step forward and two steps back is no way to move ahead,” Northam said. “We will need everyone to continue to take actions to keep themselves and others safe.”
Last week, Northam extended until Friday, May 8, his executive order closing personal care businesses; recreational businesses, such as theaters and bowling alleys; and restricting restaurants to takeout only.
On Friday, Northam said he’d like to begin reopening those businesses after May 8, as long as the stated parameters are met, but likely “not before.”
How long will phase one last? Dr. Norman Oliver, Virginia's health commissioner, said it could take a while, perhaps until there is a vaccine for COVID-19, the Richmond Times-Dispatch reported Friday.
“I, personally, think phase one will be a two-year affair,” Oliver told the Times-Dispatch.
More testing required
Northam and Dr. Karen Remley, former commissioner of health head of a special task force on testing and contact tracing, said the commonwealth will have to “greatly” expand the number of tests performed each day in order to reopen businesses.
About 4,500 tests were administered across the commonwealth in the last 24 hours based on the latest VDH COVID-19 report. The task force is working to ramp up to testing at least 10,000 individuals daily before businesses are reopened, Remley said.
The expanded testing plan includes hiring contact tracers who will support local health departments’ efforts to identify individuals who may be exposed to COVID-19 and advise them to self-isolate.
Remley said testing has so far been slow in Virginia for several reasons. First, she said, the initial guidelines for testing were rigid, allowing only those who were hospitalized or health care workers to be tested.
Testing guidelines were broadened last week to include high-risk individuals, such as those in congregate care centers and nursing homes, as well as pregnant women and the uninsured or under-insured, she said.
The state has now issued a letter to all health care providers to encourage them to test symptomatic patients and to teach them the right way to administer the test, Remley said.
By the time the state reaches the fourth stage of testing – when the capacity reaches at least 10,000 a day – testing will include asymptomatic people so officials can get a better sense of how widespread COVID-19 really is in the state, Remley said.
The governor said widespread testing, contract tracing and the use of self-quarantining by those who are exposed is hoped to create an environment in which people feel safe to venture out of their homes and back into businesses, stores and restaurants, Northam said.
“For business to resume, both customers and employees must feel safe,” he said.
Northam said his business task force will help the state “find the right ways to ease restrictions.” Northam said the state aims to draft overarching rules for businesses as well as separate, industry specific guidelines for entities such as restaurants and non-essential retail.
“This will make sure that everyone knows the rules of how to operate when it is safe to do so,” Northam said.
PPE, hospital capacity
Northam said safely easing restrictions will require an ongoing stable PPE supply chain across all sectors of healthcare, and ensuring that the supply is regularly replenished.
Virginia has ordered 17.4 million N95 masks, 8.3 million surgical masks, 17.1 million gloves, 1.7 million gowns, and 1 million face shields. This includes a contract signed jointly with Maryland and the District of Columbia for 5 million N95 masks, according to a press release issued by the governor’s office.
A second shipment from Northfield Medical Manufacturing was scheduled to arrive Friday and would be “promptly distributed,” the press release promised.
The latest shipment includes 3 million nitrile exam gloves; 100,000 N95 masks; 500,000 three-ply procedure masks; and 40,000 isolation gowns.
Hospitalizations and intensive care unit admissions are largely stable across Virginia, even as case counts continue to rise, the press release said.
To ensure continued capacity as Virginia move towards phase one of easing restrictions, Northam on Thursday extended the ban on elective surgeries through May 1 and expanded the ability of physicians’ assistants and nurse practitioners with two or more years of clinical experience to practice without a collaborative agreement.
The Virginia Medical Reserve Corps continues to recruit and deploy medical and non-medical volunteers to bolster the work of local health departments, hospitals, and healthcare providers. The MRC currently has over 16,500 trained volunteers, more than halfway to Virginia’s goal of 30,000, the press release said.