COVID-19 Update for Virginia

COVID-19 Update for Virginia

April 7, 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:

  • Importance of Diagnostic and Screening COVID-19 Testing in Virginia
  • SARS-CoV-2 Variants
  • Importance of Reporting COVID-19 Outbreaks
  • Cases of Vaccine Breakthrough

Importance of Diagnostic and Screening SARS-CoV-2 Testing in Virginia

Due to a limited supply early on in the pandemic, most SARS-CoV-2 testing in the Commonwealth to date has been for diagnostic purposes.  We now have a more robust supply, but we face a challenge — a notable decline from 50,000 or more people tested per day to less than 30,000. Despite increasing administration of COVID-19 vaccines, a robust, responsive testing infrastructure is essential to successfully stopping the spread of SARS-CoV-2.  As outlined in CDC’s updated guidance, SARS-CoV-2 testing should be used to (1) diagnose acute COVID-19 infections, (2) screen patients in an effort to reduce asymptomatic and presymptomatic transmission, and (3) monitor trends in infection.

Patients with symptoms and/or signs suggestive of COVID-19 should be tested regardless of their vaccination status.  Prior receipt of a COVID-19 vaccine will not affect the results of a SARS-CoV-2 viral test (nucleic acid amplification or antigen tests). Close contacts to a known or suspected case of COVID-19 who are not fully vaccinated should be tested for SARS-CoV-2, and close contacts with symptoms of COVID-19 should also be tested.

In CDC’s most recent update, they provide additional discussion on expanded availability to, and use of, screening tests to reduce asymptomatic spread. Identifying asymptomatic cases through screening testing and taking prompt public health action can help reduce disease transmission. When ample tests are available, examples of groups in which screening testing would be beneficial include:

If you have patients in these categories, please encourage them to participate in employer-based screening testing if available to them.  If screening testing is not available at their place of work, please encourage them to consider seeking regular testing. Nearby testing locations can be found on VDH’s COVID-19 Testing Sites webpage. Users can search for sites that provide testing at no cost to the patient. VDH has partnered with select Walgreens pharmacies and continues to hold community testing events (CTEs) where all costs for testing are waived. A list of upcoming CTEs can be found by scrolling to the bottom of the COVID-19 Testing Sites webpage.

VDH recently launched a K-12 screening testing pilot program and is currently recruiting schools to participate.  For participating schools, the program will offer voluntary screening and/or diagnostic testing to teachers, staff and students using BinaxNOW COVID-19 rapid antigen tests. Screening testing in K-12 schools is intended to be combined with other key prevention strategies such as physical distancing and masks.  An expanded screening testing program is currently being developed for implementation during the 2021-22 school year.

SARS-CoV-2 Variants

VDH, in collaboration with the Division of Consolidated Laboratory Services (DCLS), the state public health lab, is identifying and reporting variants of concern to the CDC.  VDH recently launched a new informational webpage to describe these variants and why they are concerning.

Four of the five variants of concern have been identified in Virginians. If you have a patient with COVID-19 who is part of an outbreak that seems to spread very quickly, whose illness is more severe than expected, who has a documented previous SARS-CoV-2 infection, or who is fully vaccinated against COVID-19, please consult with your local health department about requesting whole genome sequencing to identify if this patient has a variant of concern.  While this testing is not considered diagnostic, it is critical for public health surveillance.

Importance of Reporting COVID-19 Outbreaks

Per the Virginia Regulations for Disease Reporting and Control, suspected or confirmed outbreaks must be reported immediately to your local health department (LHD) by the most rapid means available, preferably by telephone.  Rapid reporting allows VDH to immediately initiate an outbreak investigation and conduct additional testing, with the ultimate goal of containing the spread of COVID-19.  This is particularly important in congregate settings, including long-term care facilities, even if vaccination events have already occurred. 

Cases of Vaccine Breakthrough

As more Virginians receive the COVID-19 vaccine, we need to better understand how these vaccines work in real-world conditions. This includes identifying vaccine breakthrough cases, which are COVID-19 cases that occur in people who are fully vaccinated. COVID-19 vaccines were found to be highly effective in the vaccine trials; however, it is important to identify why and how COVID-19 vaccine breakthrough cases occur.

If you have a patient who tested positive on a COVID-19 viral test using a specimen that was collected ≥14 days after receiving the second dose of a 2-dose series or ≥14 days after receiving a single-dose vaccine, and it has been at least 45 days since a previous positive test, please report this to your local health department as a possible vaccine breakthrough infection.

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.


M. Norman Oliver, MD, MA
State Health Commissioner