VDH Working with Local Long-Term Care Facilities to Protect Vulnerable Populations

October 5, 2020

Media Contact: Christie Wills, Office of Epidemiology, Roanoke City and Alleghany Health Districts (RCAHD),


VDH Working with Local Long-Term Care Facilities to Protect Vulnerable Populations

(ROANOKE, Virginia) — An uptick in the incidence of COVID-19 has resulted in a total of 14 outbreaks at local Long-Term Care Facilities (LTCFs) in the Roanoke Valley and Alleghany Health Districts. This represents a total of approximately 325 cases among staff and patients of LTCFs since March.

“While these numbers are of grave concern to us as managers of public health initiatives, they reflect similar trends in other parts of the state as well as around the country,” said Dr. Molly O’Dell, Director of Communicable Diseases for the RCAHD.

“It is important for our health districts’ citizens to know the public health efforts are continuing to work with the managers of LTCFs to keep some of our most vulnerable population as safe as possible in the face of this extraordinary pandemic.”


Individuals who reside in LTCFs are at higher risk for being exposed to coronavirus because they live in a congregate living facility and because many are older adults, at highest risk for severe illness. This pandemic brought on an entirely new set of circumstances for most facilities, which called for the proactive support of public health expertise.

Early on, our public health team proactively surveyed all of our approximately 20 area LTCFs to analyze their level of preparedness, their access to personal protective equipment (PPE) and other medical supplies, their capacity for fit testing N95 respirators, and their protocols for infection prevention and control.

  • Like the rest of the country, one of our biggest local challenges was the demand for PPE. Our LTCFs reported significant challenges keeping N95 respirators, face shields, eye goggles, and gloves in stock. Our local team joined the Near Southwest Preparedness Alliance (NSPA), a government-funded coalition supporting healthcare organizations through disasters, to distribute more than 116,000 pieces of PPE to LTCFs and other healthcare organizations in Southwestern Virginia.
  • Because N95 respirators are a key tool to decrease the spread of a contagious respiratory illness, our public health nurses and epidemiologists trained key LTCF staff to “fit test” their entire staffs. Proper fit for these products ensures that they function properly, keeping particles from escaping and potentially infecting others.
  • Our epidemiological team reviewed the policies and protocols of LTCFs to ensure they were in alignment with Centers for Disease Control and Prevention (CDC) and the Virginia Department of Health (VDH) guidance. These include facility testing plans, infection prevention and control plans, and respiratory protection programs.

In the initial weeks of mounting our COVID-19 response, public health nurses offered infection control readiness assessment and support as well as fit testing to all the facilities. Our team currently offers the following support:

  • If an outbreak of COVID-19 is identified in an LTCF in our districts, COVID-19 point prevalence testing is offered to the entire facility, staff and residents.
  • We help coordinate the processing of these test results as rapidly as possible through the state lab in Richmond or the lab at Virginia Tech. Testing is always accompanied by case investigations and contact tracing as well as active, ongoing guidance on policy and practices for infection prevention and control.
  • Our team makes unannounced visits to LTCFs to assure the infection prevention plans are properly put into practice, especially during the course of outbreaks.
  • Our team monitors residents’ wellbeing and the prevention/mitigation practices for up to 28 days past the last confirmed case.
  • When our staff confirms an outbreak at an LTCF, our top priorities are the health of the staff and residents as well as the prevention of further spread. Federal rules governing most LTCFs mandate public reporting of LTCF outbreaks. Guidance is posted on the VDH website (vdh.virginia.gov/coronavirus/health-professionals/virginia-long-term-care-task-force/). Local public health staff members maintain confidentiality as they assist LTCF staff to mitigate spread of infection throughout an affected facility.

“While we work tirelessly on the prevention side to protect both staff and residents, our efforts are targeted to respond quickly when outbreaks occur,” said Dr. O’Dell. “As the situation continues to change, the health department will keep working with our LTCF partners and the Near Southwest Preparedness Alliance to ensure they have the resources and education they need to be able to care well for our loved ones.”

RCAHD COVID-19 Case Data (as of October 2, 2020)
Total Cases Related to LTCF= 325
Total Number of Cases RCAHD = 3,445
Percent of RCAHD Cases Related to LTCF= 9.43%
Total Number of COVID-19-Related Deaths LTCF = 26
Total Number of COVID-19-Related Deaths RCAHD = 53
Percent of RCAHD COVID-19 Deaths Related to LTCF= 49.06%