COVID-19 Update for Virginia
March 4, 2021
Dear Colleague:
Virginia’s response to the COVID-19 pandemic continues to evolve. Please visit the Virginia Department of Health (VDH) website for current clinical guidance, epidemiologic data, and information on Virginia’s vaccination response. The following updates are included here:
- Johnson & Johnson’s Janssen COVID-19 Vaccine
- Patient Outreach about COVID-19 Vaccination
- COVID-19 Vaccination Clinic Best Practices
- Updated Quarantine Recommendations for Fully Vaccinated People
- Work Restrictions for Exposed Healthcare Personnel
- Multisystem Inflammatory Syndrome in Children (MIS-C)
- SARS-CoV-2 Variants in Virginia
- Ebola Virus Disease Outbreaks in the Democratic Republic of Congo and Guinea
Johnson & Johnson’s Janssen COVID-19 Vaccine Update
On February 27, the Food and Drug Administration granted an Emergency Use Authorization (EUA) for Johnson & Johnson’s Janssen COVID-19 Vaccine for individuals 18 years of age and older. On March 2, CDC’s Advisory Committee on Immunization Practices (ACIP) issued interim recommendations for use of this vaccine. This vaccine is a single-dose, viral vector vaccine that can be stored at 2–8ºC. Phase 3 clinical trials found that a single dose of the vaccine was 85% effective at preventing severe disease and provided complete protection from COVID-19 related hospitalizations and death. Virginia expects to receive its first shipments of Johnson & Johnson COVID-19 vaccine this week.
The Pfizer-BioNTech, Moderna, and Johnson & Johnson COVID-19 vaccines are all highly effective at preventing serious illness, hospitalization and death from COVID-19. Please encourage your patients to receive whichever COVID-19 vaccine is available to them.
Patient Outreach about COVID-19 Vaccination
If you have not already done so, please reach out to your patients to inform them about how to access COVID-19 vaccine. Healthcare providers are a critical source of trusted information. Your outreach is particularly important for people who have limited access to vaccine information through the internet and media. Please let your patients know they can pre-register for COVID-19 vaccination at vaccinate.virginia.gov or by calling 1-877-VAX-IN-VA (1-877-829-4682), even if they are not currently eligible to receive a vaccine.
COVID-19 Vaccination Clinic Best Practices
COVID-19 Vaccination Clinic Best Practices offers providers information about vaccination clinic management, pre-vaccination patient intake and education, and post-vaccination procedures and record keeping.
Quarantine Recommendations for Fully-Vaccinated People
Fully-vaccinated healthcare personnel (HCP) who have a higher risk exposure to SARS-CoV-2 should not work onsite until they meet criteria to end quarantine. They are not required to quarantine outside of work. Please note, however, that to mitigate HCP staff shortages, asymptomatic fully-vaccinated HCP may be allowed to work onsite if necessary during quarantine. Please refer to VDH’s Quarantine Recommendations for Exposed Individuals in Healthcare Settings for a summary of these recommendations.
Fully-vaccinated inpatients, residents of a healthcare setting, and residents of a correctional or detention facility should continue to follow quarantine guidance after close contact with a person with COVID-19.
Other people who are fully vaccinated for COVID-19 within the past three months, and are asymptomatic, are not required to quarantine if they are exposed to someone with COVID-19.
Research is still ongoing to understand whether vaccinated people can have an asymptomatic SARS-CoV-2 infection and transmit the virus to others. Because SARS-CoV-2 is still circulating at significant levels, fully-vaccinated people should continue to follow the COVID-19 prevention recommendations, including wearing a mask in public, physically distancing, and washing hands frequently.
Work Restrictions for Exposed Healthcare Personnel Who Have Recovered from COVID-19
On February 16, CDC updated the Interim Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to SARS-CoV-2. Exposed, asymptomatic healthcare personnel (HCP) who have recovered from COVID-19 in the past three months may continue to work but should monitor their symptoms for 14 days after exposure and continue to follow all recommended infection prevention and control practices.
Multisystem Inflammatory Syndrome in Children (MIS-C)
As of March 4, VDH has received reports of 37 cases of Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. The median age of case-patients was 9 years old (range 2–20 years). The mean hospitalization duration was 6 days and 51% required intensive care unit admission. The standardized case definition for suspected MIS-C cases is available here. VDH urges all providers to immediately report any patient who meets these criteria to the local health department by the most rapid means to ensure a timely investigation and to coordinate testing, if needed.
SARS-CoV-2 Variant Update for Virginia
As of March 3, 20 COVID-19 cases caused by the B.1.1.7 variant (first identified in the United Kingdom) and four cases caused by the B.1.351 variant (first identified in South Africa) have been reported to VDH. All cases occurred among people who reported illness onset in December 2020 or after. Of the 23 cases with available travel history, 16 (70%) occurred in people who did not travel during their exposure period, indicating that community transmission is occurring. Because only a subset of positive COVID-19 samples are tested by whole-genome sequencing (WGS), there are likely many other cases caused by variants of concern that have not been detected in Virginia.
The potential spread of these variants threatens our current vaccination efforts and our overall ability to control the pandemic. Public health recommendations for stopping the spread of COVID-19 will work for all COVID-19 variants. This means wearing masks correctly, staying at least six feet from others, avoiding crowds, washing hands often, getting vaccinated for COVID-19 when it is your turn, and staying home if you are infected with COVID-19 or have had close contact with someone with COVID-19.
Virginia’s Division of Consolidated Laboratory Services (DCLS) currently sequences about 150 positive specimens per week and is working to expand WGS capacity across the Commonwealth. Priorities for WGS at DCLS include cases in people who have recently traveled internationally, cases with possible vaccine breakthrough, cases with suspected SARS-CoV-2 reinfection, clusters of more serious illness, and samples with certain diagnostic PCR target failures in combination with strong detection of other SARS-CoV-2 gene targets that are indicative of SARS-CoV-2 mutations. Providers who suspect COVID-19 cases caused by variants of concern should contact their local health department.
Ebola Virus Disease Outbreaks in the Democratic Republic of Congo and Guinea
Two separate but concurrent outbreaks of Ebola Virus Disease (EVD) are occurring in the Democratic Republic of Congo (DRC) and in Guinea. Although the risk of EVD introduction into the United States is considered very low, CDC and VDH are taking steps to prepare. On February 24, CDC issued Level 3 travel warnings to avoid all nonessential travel to DRC and Guinea for EVD. Level 4 travel warnings for COVID-19 were already in effect.
Beginning March 4 at 11:59 p.m., all airline passengers who were in the DRC or Guinea in the previous 21 days will be funneled through six U.S. airports: Washington-Dulles, New York’s John F. Kennedy International, Newark International, Chicago O’Hare, Atlanta Hartsfield-Jackson, and Los Angeles International. About 60 airline passengers from the DRC and Guinea typically arrive in the United States each day. Upon arrival, travelers will be visually inspected for illness and, if indicated, referred for further medical evaluation. VDH will begin daily monitoring of travelers arriving in Virginia from DRC and Guinea on March 5. VDH encourages providers to collect a travel history from all patients who present with fever or other symptoms of acute infection. Providers who identify a Person Under Investigation for EVD should immediately notify their infection control program, laboratory and other appropriate facility staff, and their local health department.
For more information and resources, including VDH’s Ebola Virus Disease Evaluation Algorithm for Hospitals, refer to VDH’s EVD website.
Thank you for all your continued efforts to protect Virginians from COVID-19. Please continue to contact your local health department if you have questions about COVID-19.
Sincerely,
M. Norman Oliver, MD, MA
State Health Commissioner