COVID-19 Update for Virginia
August 7, 2020
As the COVID-19 pandemic continues in Virginia, please visit the Virginia Department of Health (VDH) website for current COVID-19 guidance and epidemiologic data. I want to highlight the following updates:
Provider Reimbursement for Counseling Patients to Self-Isolate at Time of COVID-19 Testing
On July 30, the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) announced that payment is available to healthcare providers to counsel patients, at the time of COVID-19 testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms. Reimbursement for providers who are eligible to bill CMS for counseling services will be handled using existing evaluation and management payment codes.
CDC Guidance: Duration of Isolation and Precautions for Adults with COVID-19
Except in rare circumstances, isolation can be discontinued 10 days after symptom onset (or date of first positive PCR test, if asymptomatic) and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms. Until more information is available, VDH recommends the same duration for children with COVID-19. Patients with severe illness may produce replication-competent virus beyond 10 days that may warrant extending the duration of isolation for up to 20 days after symptom onset.
Although persistent or recurrent PCR positive tests continue to be reported, there have been no confirmed reports of COVID-19 reinfection thus far. Retesting persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery is not recommended within 3 months of the date of symptom onset for the initial COVID-19 infection. For persons who develop new symptoms consistent with COVID-19 during the 3 months after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting; consultation with infectious disease or infection control experts is recommended.
On August 5, VDH launched COVIDWISE, a mobile app that can notify people of exposure to someone with laboratory-confirmed COVID-19. Notification is calibrated to people who are considered “close contacts,” defined as being six feet or less from a person with COVID-19 for greater than 15 minutes. The program employs a high degree of privacy protection and relies on people to “opt-in.” For people notified of being exposed to COVID-19 through the app, if they are symptomatic, VDH recommends self-isolation, medical evaluation and testing. If they are asymptomatic, VDH recommends self-quarantine for 14 days from the date of the last exposure and testing. Close contacts within a household might require a longer self-quarantine period if they are unable to separate from the person with COVID-19. For additional information on release from isolation or quarantine, see here.
HHS is launching a campaign to encourage people who have tested positive for and recovered from COVID-19 to donate convalescent plasma. Please consider reaching out to your recovered patients, consistent with HIPAA’s privacy regulations, to encourage them to donate their convalescent plasma. Recovered patients can go to coronavirus.gov to find out where to donate plasma.
School Entry Examination and Vaccination Requirements
Schools are busy preparing to reopen for in-person, virtual, or hybrid learning. Physical examinations and vaccination requirements for the upcoming school year have not been waived because of COVID-19 and all children must be properly vaccinated to be enrolled in school, regardless of the type of learning. Please continue to strongly recommend vaccination to both children and their parents. Your recommendation is critical for ensuring protection from vaccine-preventable diseases. If you are unable to administer vaccines in your practice, please refer your patients to your local health department (a prescription is not required).
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