COVID-19 Update for Virginia

COVID-19 Update for Virginia

December 7, 2020

Dear Colleague:

COVID-19 cases, hospitalizations, and deaths in Virginia are rising rapidly across the Commonwealth.  Please visit the Virginia Department of Health (VDH) website for current epidemiologic data and guidance.  The following updates are included in this document:

  1. Prioritizing Case Investigation and Contact Tracing in Virginia
  2. Updated Guidance on the Duration of Quarantine
  3. COVID-19 Vaccination Phase 1a Vaccine Allocation
  4. COVID-19 Vaccination Resources
  5. COVID-19 Vaccine Safety Monitoring
  6. National Influenza Vaccination Week
  7. Upcoming Holidays Guidance for Social Gatherings

Prioritizing Case Investigation and Contact Tracing in Virginia

Today, VDH announced that the current substantial levels of COVID-19 community transmission have forced many local health departments to prioritize contact tracing efforts for key elements of the population.  Effective today and in accordance with CDC’s Prioritizing Case Investigations and Contact Tracing for COVID-19 in High Burden Jurisdictions, VDH may prioritize follow-up of cases and tracing of close contacts for the following groups:

  • People diagnosed with COVID-19 in the past 6 days and their household contacts
  • People living or working in or visiting congregate living facilities
  • People involved in known clusters or outbreaks
  • People at increased risk of severe illness.

By prioritizing these investigations, VDH can target available resources to the investigations most likely to slow the spread of COVID-19.  This means that the local health department may not be contacting everyone with COVID-19 infection or close contact to someone with COVID-19 infection.  Instead, VDH urges people to take proactive responsibility to isolate at home if they are infected and to identify and notify their close contacts.  Please help us in this effort by counseling patients on the need to isolate and quarantine when indicated and promoting VDH and CDC resources.

Updated Guidance on the Duration of Quarantine

 On December 2, 2020, CDC released Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing.  CDC continues to recommend a 14-day quarantine period after the last close contact to a person with COVID-19 and all close contacts should monitor for symptoms, wear a mask, keep distance, avoid crowds, and wash hands often for 14 days after exposure.  However, there are two alternatives if people are not able to quarantine for the recommended 14-day period and if ample testing is available:

  • Quarantine can end after Day 10 without testing and if no symptoms have developed; OR
  • Quarantine can end after Day 7 if a viral test (e.g., PCR or antigen test) performed on or after Day 5 is negative and if no symptoms have developed.

These shorter duration quarantine alternatives aim to reduce the burden of quarantine and increase overall compliance.  CDC based the guidance on information from household transmission studies and modeling the residual post-quarantine transmission risk.  The estimated risk at day 10 with symptom monitoring without testing is 1%, with an upper limit of 10%.  Estimated risk at day 7 with symptom monitoring with testing is 5%, with an upper limit of 12%.

Today, VDH is adopting this revised quarantine guidance for everyone except healthcare workers or healthcare facilities.  CDC’s healthcare-associated infection prevention and control experts are currently reviewing the revised guidance; in the meantime, VDH recommends that healthcare personnel and residents and staff in healthcare facilities continue to use a 14-day quarantine.  VDH materials are being updated as quickly as possible to reflect these changes.

COVID-19 Vaccination Phase 1a Vaccine Allocation

On December 1, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted to allocate the initial doses (phase 1a) of the national COVID-19 vaccination program to both healthcare personnel (HCP) and long-term care facilities residents (LTCF). Virginia announced it will adopt the ACIP recommendations.  VDH was notified December 3 by the federal government to prepare to receive an estimated total of 480,000 doses of vaccine from two manufacturers (Pfizer and Moderna) by the end of December 2020. VDH estimates that there are up to 500,000 HCP and LTCF residents in Virginia. VDH is partnering with the Virginia Hospital and Healthcare Association to vaccinate healthcare personnel and with the CDC to vaccinate LTCF staff and residents through the Federal LTCF Pharmacy Partnership with CVS and Walgreens. Information on vaccination opportunities will be provided to HCP by health systems and local health districts in the upcoming weeks.

COVID-19 Vaccination Resources

The best source of information about COVID-19 vaccine and the vaccination efforts in Virginia is our website (www.vdh.virginia.gov/covid-19-vaccine).  I encourage you to bookmark this website and visit it often.  You can use this website to complete COVID-19 Vaccination Program Provider Enrollment, learn more about the Virginia Immunization Information System (VIIS), review resources from VDH or CDC, and access meeting minutes from the Virginia COVID-19 Vaccine Advisory Workgroup.

On-line training to learn more about the COVID-19 vaccine include:

VDH will host a general COVID-19 vaccine educational webinar for Virginia healthcare workers on December 9, 2020 at 11:00 AM

COVID-19 vaccine-specific training will be available once vaccines receive Emergency Use Authorization.

COVID-19 Vaccine Safety Monitoring

Vaccine safety has been and will continue to be a top priority for VDH and CDC.  Once COVID-19 vaccines are available in the United States, existing systems, such as the Vaccine Adverse Event Reporting System (VAERS), and new systems, such as V-SAFE, will be used to monitor vaccine safety.  V-SAFE is a new smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines.  V-SAFE will use text messaging and web surveys from CDC to check in with vaccine recipients for health problems following COVID-19 vaccination.  The system also will provide telephone follow-up to anyone who reports medically significant adverse events.  V-SAFE information sheets and posters are available on our website. Vaccination providers are asked to recommend the use of V-SAFE to all COVID-19 vaccine recipients.

National Influenza Vaccination Week

 COVID-19 vaccine is in the news so much now it can be easy to forget the importance of influenza vaccination. National Influenza Vaccination Week (NIVW) is December 6–12, 2020. During NIVW, we are reminded that everyone 6 months of age and older is recommended to get a flu vaccine to protect themselves and others during the upcoming winter and holiday months.  Please encourage those who have not already received their flu vaccine to roll their #SleeveUp today, especially those with underlying medical conditions.  Visit CDC’s NIVW Digital Media Toolkit page for more resources and information on how to participate in NIVW.

Upcoming Holidays Guidance for Social Gatherings

 VDH guidance for social gatherings and holiday celebrations emphasizes the importance of keeping gatherings small in size and short in duration and not mixing people from different households.  People should avoid travel; if they choose to travel, they should do it as safely as possible by getting a flu shot before travel, considering COVID-19 testing 1–3 days before and 3–5 days after travel, staying home after travel, and taking everyday precautions (e.g., wear a mask, stay at least 6 feet away from others, and washing hands often).

On behalf of the entire VDH team, thank you all for your heroic efforts since early 2020.  We are grateful for your dedication and partnership.  Please continue to contact your local health department if you have questions about COVID-19.

Sincerely,

M. Norman Oliver, MD, MA
State Health Commissioner