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Health Professionals and Healthcare Workers

Virginia Department of Health’s (VDH)’s up-to-date resources relevant to health professionals and their responses to COVID-19 in Virginia. This page includes information on vaccination, treatment, testing, and other COVID-19 topics. 

Thank you for your continued work to protect the health and well-being of all Virginians.

VDH COVID-19 Resources

Hot Topics for Health Professionals

The Omicron XBB.1.5 subvariant continues its dominance

March 27, 2023 – According to the CDC NowCast model’s projected data for the week ending March 25, the XBB.1.5 omicron subvariant of SARS-CoV-2 continues to be widespread in the United States (projected to cause 90.2% of infections nationally in this week) and even more so in HSS Region 3 that includes Virginia (94.1% of all infections in this week). Other XBB subvariants are estimated at 4.9% and 4.8% in the U.S. and in Region 3, respectively. As with various BQ and earlier XBB sub-variants, XBB.1.5 is highly resistant to neutralizing COVID-19 antibodies and to all available monoclonal antibodies. Its persistence may also be due in part to its stronger adherence to the ACE-2 receptors that help bind SARS-CoV-2 to human cells. However, XBB.1.5 does not seem to cause more severe COVID-19 illness than earlier omicron strains. Ensuring that patients stay up-to-date with COVID-19 vaccines, Paxlovid treatment of high-risk patients with COVID-19, and non-pharmaceutical interventions such as masking can still help prevent infection and severe illness.   

Metformin may reduce Long COVID risk if taken early in illness onset

March 9, 2023An earlier study found that compared to placebo, neither metformin, ivermectin, nor fluvoxamine started in the first 7 days of mild-to-moderate COVID-19 illness prevented death or severe illness (hospitalization, etc.). However, long-term follow-up data from that same study, just published as a Lancet preprint, indicate that compared to placebo, metformin appears to be highly effective (42%) in preventing Long COVID. The effectiveness was even greater (63%) in people who had started metformin within 4 days of COVID-19 illness onset. These Long COVID prevention effects were NOT observed in patients who took either ivermectin or fluvoxamine. Although metformin is not yet recommended as an acute treatment of COVID-19, providers should be aware that Paxlovid is already available and, does appear to reduce longer-term risk of Long COVID if given early in the course of COVID-19 illness. 

New program from the American Public Health Association (APHA) helps educate patients about COVID-19 risks and treatment options

March 3, 2023 - In partnership with the U.S. Department of Health and Human Services, the APHA has developed downloadable handouts, talking points, posters, and other resources in both English and Spanish to help educate patients about the risks of severe COVID-19 illness and the availability and importance of early treatment. Healthcare providers should consider making some of these available to their patients who are at higher risk from COVID-19.  

The timing and magnitude of U.S. government investments in mRNA vaccine research well before the 2020 arrival of COVID-19

March 1, 2023 – A recurring theme in the reluctance of some people to accept mRNA-based COVID-19 vaccines has been a concern that because these vaccines were developed so quickly, there was not enough experience with this “new” mRNA technology to know whether it was safe and effective. Generic responses that vaccine-related mRNA technology has been studied extensively well before these current vaccines were developed have not been sufficient to overcome that reluctance. However, a recent detailed review found that since 2003, >$330 million of U.S. government funding had been invested in dozens of mRNA vaccine-related research studies well before the late 2019 advent of COVID-19. Healthcare practitioners should be prepared to describe the duration and extensive magnitude of this earlier mRNA vaccine-related research if it could help convince some of those reluctant people to accept these current mRNA vaccines.  

Yet another careful study finds ivermectin to have no benefit over placebo in treating mild-to-moderate COVID-19

February 28, 2023 – Multiple controlled trials have found ivermectin to be no better than placebo for treating mild-to-moderate COVID-19. Some people have argued that the ivermectin doses used in those prior studies were too low. In a recent randomized controlled study published in JAMA, a much higher ivermectin dose (600 mcg/kg) was given for a longer (6 day) period to 602 randomized patients with lab-confirmed COVID-19; placebo was given to 604 controls. The median time to sustained recovery was 11 days in patients receiving ivermectin and 11 days in people receiving placebo. Deaths occurred in one ivermectin patient and no placebo patients. Adverse effects were uncommon in both groups. 

Although ivermectin was well-tolerated at this higher dose, its continued promotion in the absence of any documented benefit constitutes misinformation (or sometimes disinformation) that is an obstacle to the use of other antiviral agents with well-documented benefits such as Paxlovid. An accompanying editorial note provides additional perspective on ivermectin use, including the need to address ongoing misinformation.  

New healthcare appointment checklist available for Long COVID patients and caregivers

February 27, 2023 – A newly available Post-COVID Conditions (Long COVID) patient checklist provides detailed suggestions for things that patients with suspected or confirmed Long COVID should do before, during, and after their appointments with healthcare providers. The checklist is also available in Spanish. Healthcare providers and their staff should ask that patients calling in for appointments related to Long COVID take the recommended pre-appointment steps in this checklist before coming in for their appointment. 

High rates of persistent symptoms two years after COVID-19 hospitalizations

February 27, 2023 – A new research study describes in detail the extremely high rates of persistent symptoms among 165 patients who had been hospitalized with COVID-19 in 2020. Forty-seven (28%) of these patients had spent time in an intensive care unit. Twenty-four months after their COVID-19 admission, 139/165 (84%) still had symptoms affecting everyday life. The most common persisting symptoms “were related to cognition, sensorimotor function, and mental fatigue.” Of those 165, 35 (21%) had been re-admitted during that period, with cardiovascular disease as the most common re-admission reason.  

Healthcare providers should consider advising patients hospitalized with COVID-19 about the possibility of long-term persistence of some COVID-19-related symptoms. 


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 Last Updated: March 27, 2023

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