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Virginia’s COVID-19 decline is officially over

Infections are rising in regions with low vaccination rates

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COVID-19 vaccine syringes in a basket Virginia Mercury

A basket of syringes containing the Moderna COVID-19 vaccine ready to be used at Richmond Raceway in Richmond on Feb. 2, 2021. 

Courtesy Virginia Mercury

After six months of sharp decline, COVID-19 cases in Virginia are again on the rise, spurred by the spread of more infectious variants and a plateau in new vaccinations.

With just over 53% of the population fully vaccinated (and more than 64% of adults), the case burden is still far below states like Arkansas and Missouri, where low vaccination rates, especially in rural areas, have allowed the Delta variant to overwhelm local hospitals. But the slow growth in infections have worried public health experts, who warn that communities in Virginia with similarly low immunization rates could begin to see similar trends — particularly as students return to the classroom

“I’m very, very concerned about the fall and winter,” Dr. Taison Bell, an infectious disease specialist at the University of Virginia, told the Mercury last week. “I can’t express it any better. The difference is that it’s truly preventable at this point.”

There are a variety of different metrics experts can use to track the spread of the virus. Last week, researchers at the University of Virginia’s Biocomplexity Institute reported that cases are increasing in 13 of the state’s 35 local health districts. The reproduction rate, used to model how many new cases could result from an individual infection, is also climbing in five of the commonwealth’s six regions, putting unvaccinated people at particular risk of contracting the disease in areas seeing more community spread.

Statewide, the positivity rate — or percentage of COVID-19 tests that come back positive — has also risen from below 2 percent to 3.4% as of Wednesday. Some of the largest increases in infections have been scattered throughout Eastern and Southwestern Virginia, where some counties are still reporting far lower vaccination rates than the rest of the commonwealth, according to data from the Virginia Department of Health. 

Southwest Virginia is also seeing the greatest number of cases caused by “variants of concern,” VDH reports. Nearly 95% of infections in the region are linked to the Alpha variant (once better known as the U.K. variant), which was one of the first to be detected in the state. Close to 2% have been caused by the Delta variant, which Virginia Health Commissioner Dr. Norman Oliver said is estimated to be 40 to 60% more transmissible. 

Statewide, 4.7% of cases are attributed to the Delta variant, with the highest proportion — 9.5% — in the Central region. But not all COVID samples are tested, according to VDH spokeswoman Melissa Gordon, making it likely that the numbers reported by the agency are “fewer than those that actually occur in Virginia.” 

UVA researchers reported that the share of cases linked to Delta are growing and the variant “has become dominant in Virginia in the last couple of weeks,” worrying health officials in regions with low vaccination rates.

Earlier this month, VDH announced that nearly 100% of new COVID cases from December 29 to June 25 have occurred among unvaccinated or partially residents. Those Virginians made up 99.3% of hospitalizations and 99.6% of deaths over the same time period.

But raising the daily number of shots has been a growing challenge for state and local leaders. Virginia has invested more than $20 million in outreach and focused efforts specifically on reaching vulnerable populations, including large community vaccination sites in communities that bore a disproportionate burden of disease. But a July report from VDH found that Virginia still has a higher unvaccinated rate among Black and Latino residents than the national average. Boosting support for the shots has also been a challenge in some rural communities.

Many of the biggest reasons for vaccine hesitancy have declined, including concern over side effects and overall effectiveness, according to polling by Virginia Commonwealth University. Local health departments are also working to prioritize convenience, pushing more vaccines to primary care offices and offering shots at a wider variety of smaller events.

Still, “although more Virginians have received vaccinations, the pace of vaccinations has slowed,” VDH reported. On Wednesday, more than two dozen professional medical organizations issued a joint statement urging residents to get immunized as restrictions are lifted and more states begin to see a rise in hospitalizations.

“COVID-19 continues to pose the greatest health risks to people who have not been vaccinated,” the statement reads, “with officials at the U.S. Centers for Disease Control and Prevention now describing it as a ‘pandemic of the unvaccinated.’” 

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