Health Director's Weekly COVID Briefing for the Week of September 13, 2021

• • • • • • Pandemic Status: Delta surges on
            • • The current case rate in the US has again risen; it is currently about 180,000/day 7 day rolling average according to the Johns Hopkins Coronavirus Resource Center.
              • Virginia has transiently stabilized in new case rates; currently we have about 3380/day 7 day average, new cases.
              • Three Rivers had 537 new cases last week.
              • The current 7 day average number of people hospitalized in Virginia with COVID 19 is increased at 2201.
              • About 77.5% of the population over 18 in Virginia has received at least one dose of vaccine. In Three Rivers, about 65.6% of our population over age 18 has received at least one dose of vaccine.  Over 84% of our Three Rivers residents aged 65+ have received at least one dose of the vaccine.
              • Across Virginia, the average daily vaccine doses administered has decreased to 13,206.
              • All Three Rivers counties are in high transmission. A VDH map showing indicators of community transmission can be found here:  https://www.vdh.virginia.gov/coronavirus/covid-19-in-virginia/community-transmission/
              • We are experiencing a dramatic increase in outbreaks in schools, especially related to sports teams, long term care facilities, businesses, churches, sports and recreational clubs, and other settings. We are currently tracking about 2000 people in our case investigation and contact tracing system.

              Everyone age 12 and older is now eligible for vaccination in Virginia.  Please visit vaccinate.virginia.gov or call 1-877-VAX-IN-VA to find vaccination opportunities. 

              We have resumed COVID 19 testing in conjunction with our continued vaccination outreach.  COVID-19 Rapid Testing and PCR Testing are available through the Three Rivers Health District COVID-19 Testing Team by appointment.  Please call your local health department or call 804-815-4191 to schedule an appointment for testing. 

              New Federal Mandates

              The White House announced a multi-pronged “Path Out of the Pandemic” last week.  Essential elements of the plan include:

              • Mandatory vaccinations for the following groups:
                • Employers with 100+ Employees Ensure Workers Vaccinated or Tested Weekly
                • All Federal Workers and for Contractors that Do Business with the Federal Government
                • Health Care Workers at Medicare and Medicaid Participating Hospitals and Other Health Care Settings
              • Proof of Vaccination or Testing for Entry to Large Entertainment Venues
              • Requiring Employers to Provide Paid Time Off to Get Vaccinated
              • Booster shots to further protect those who are already vaccinated
              • Protecting Schools and keeping them open through vaccination and testing
              • Increase testing availability, require masking for interstate travel and on federal property
              • Protecting the economy by providing more help to small businesses
              • Improving COVID 19 care
                • Support our COVID 19 burdened hospitals
                • Increasing monoclonal antibody therapy
                • Deploy federal monoclonal antibody strike teams

              Virus and Vaccine Update

              • The COVID 19 virus continues to genetically drift. The Delta variant is responsible for the vast majority of COVID 19 disease in Virginia, and is highly contagious.
              • Variant B.1.621, also known as the Mu variant, was classified by the World Health Organization as a variant of interest on August 30. According to the WHO, “The Mu variant has a constellation of mutations that indicate potential properties of immune escape.”  The Mu variant may be able to evade antibodies in a manner similar to the Beta variant, which was first detected in South Africa.  The Mu variant is mostly active in South America at this time.  It has been detected in most states in the US, but accounts for less than 1 percent of cases currently.  It is not considered an immediate threat in the United States.
              • The VDH has established a COVID 19 Variants of Concern Dashboard. The dashboard can be accessed here:  https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/variants-of-concern/
              • Our vaccines are highly effective in preventing serious disease, hospitalization, and death from COVID 19 infection. According to VDH data, Over 97% of persons hospitalized with COVID 19 currently are not fully vaccinated.  Fully vaccinated people are highly unlikely to experience severe disease, hospitalization, or death from the Delta variant of COVID 19.
              • The COVID 19 vaccines also help prevent COVID 19 disease.  VDH data show that unvaccinated people developed COVID 19 at much higher rates than partially or fully vaccinated people.   The VDH COVID 19 Cases by Vaccination Status dashboard can be found here:  https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/covid-19-cases-by-vaccination-status/
              • The CDC recommends a third (additional) dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine for people with moderately or severely weakened immune systems. Information from the CDC on COVID 19 vaccination for moderately to severely immunocompromised people can be found here:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html
              • The FDA and the CDC are still evaluating the merits and timing of COVID 19 booster shots.  The booster program is not planned to begin until the FDA conducts an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines.  Also, CDC’s Advisory Committee on Immunization Practices (ACIP) must issue booster dose recommendations based on a thorough review of the evidence.  Individuals who received the Johnson and Johnson vaccine will probably benefit from a booster shot as well; this is being evaluated.
              • All three vaccine types in use in the United States (Moderna, Pfizer, and Johnson and Johnson) are available across the Commonwealth. All of them are very effective in preventing serious and critical COVID 19 disease, and almost eliminate the risk of hospitalization and death.  We recommend COVID 19 vaccination for everyone eligible in the strongest possible terms.
              • Monoclonal antibody therapy is readily available and is increasing in use. Monoclonal antibody therapy is administered in the outpatient setting to COVID 19 positive individuals who are at increased risk for developing serious disease requiring hospitalization.  There are three monoclonal antibody products available for use in the United States at this time:
                • Bam/Ete (Lilly)
                • Regen-COV (Regeneron)
                • Sotrovimab (GSK)

               

              Current COVID 19 precautionary measures

               

              • The US Department of Health and Human Services (DHHS) Declaration of Emergency remains in effect.
              • Individuals who are not yet fully vaccinated should continue wearing a mask, practice physical distancing, and avoid crowds and poorly ventilated spaces in accordance with the CDC’s Guidance for Unvaccinated People, which can be found here: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.  This is especially important with the prevalence of the Delta COVID 19 variant.
              • Fully vaccinated people should wear a mask in public indoor settings in areas of substantial or high transmission. Since every jurisdiction in Three Rivers Health District is now in high transmission, everyone should protect themselves by wearing a mask in public indoor settings.
              • Fully vaccinated people who have a known exposure to someone with suspected or confirmed COVID-19 should be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.
              • The CDC recommendations for fully vaccinated people can be found here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html
              • All individuals in healthcare settings, correctional facilities, and homeless shelters, should mask regardless of vaccination status.

              COVID 19 Vaccine Safety

              The COVID 19 vaccines are among the best and safest vaccines ever developed.  As with all vaccines and medications, there are potential adverse effects.  All the adverse events following vaccination are extremely rare, and the risk of COVID 19 disease far exceeds the risk of any of the adverse events that have been reported.  Health authorities in the Unites States agree that:

               The vaccines are safe and effective, and they prevent COVID-19 illness. They will help protect you and your family and keep your community safe. We strongly encourage everyone age 12 and older who are eligible to receive the vaccine under Emergency Use Authorization to get vaccinated, as the benefits of vaccination far outweigh any harm. Especially with the troubling Delta variant increasingly circulating, and more readily impacting younger people, the risks of being unvaccinated are far greater than any rare side effects from the vaccines. If you get COVID-19, you could get severely ill and be hospitalized or even die. Even if your infection is mild, you or your child could face long-term symptoms following COVID-19 infection such as neurological problems or diminished lung function.

              Testing, pandemic containment efforts

              • Due to increasing case numbers and other reasons, we are experiencing much greater demand for COVID 19 testing. We are receiving reports of difficulty in finding COVID 19 testing opportunities, especially from asymptomatic people looking for testing for travel, post COVID 19 exposure and other reasons.  We are offering COVID 19 testing in conjunction with our Three Rivers vaccination clinics locally.
              • Surging case counts have forced our containment team to prioritize case investigation and contact tracing in accordance with established VDH recommendations. Outbreaks are prioritized for investigation, especially in vulnerable facilities and high risk populations.

              K-12 Update     

              • The Virginia Department of Health (VDH) and Virginia Department of Education (VDOE) have partnered to launch a new vendor provided COVID-19 testing program for the 2021 - 2022 school year, Virginia School Screening Testing for Assurance (ViSSTA).  The ViSSTA program will be initiated in schools choosing to participate in the next month.  More details are available at the VDH K-12 testing website here:  https://www.vdh.virginia.gov/coronavirus/k-12-testing/
              • The CDC published revised guidance for COVID 19 prevention in Child Care and K-12 settings, which can be found here: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html
              • The VDH and VDOE have published Interim Guidance to COVID 19 Prevention in Virginia PreK-12 Schools, which can be found here: https://www.vdh.virginia.gov/content/uploads/sites/182/2021/03/Interim-Guidance-to-K-12-School-Reopening.pdf
              • On August 12, 2021, State Health Commissioner Dr. M. Norman Oliver reissued a Public

              Health Order requiring all students, teachers, staff, and visitors in public and private K-12 schools to wear masks indoors, regardless of vaccination status.

              • This Order reinforces current state law, which requires Virginia schools to adhere to

              mitigation strategies outlined by the Centers for Disease Control and Prevention.

              • The public health order can be found here: https://www.vdh.virginia.gov/content/uploads/sites/134/2021/08/PHE-Order_K-12_8-12-2021.pdf
              • All Three Rivers school systems are open. We have seen COVID 19 cases among the faculty, staff and students of most of the school systems that have opened thus far, making quarantine of exposed individuals necessary.  We are seeing a sharp increase of cases among children and adolescents.  Athletic teams are proving to be a challenge regarding outbreak potential.  We will follow each school system closely and be ready to support them in any way we can as the school year proceeds.

               

              Additional useful links

              • The FDA fact sheets for recipients and caregivers for the Pfizer vaccine can be found here: https://www.fda.gov/media/144414/download
              • The FDA fact sheet for recipients and caregivers for the Moderna vaccine can be found here: https://www.fda.gov/media/144638/download
              • The FDA fact sheet for recipients and caregivers for the Johnson and Johnson vaccine can be found here: https://www.fda.gov/media/146305/download
              • The Virginia Department of Health is maintaining COVID-19 Vaccination Dashboards, which are available here: https://www.vdh.virginia.gov/coronavirus/covid-19-vaccines-received/ and here: https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/
              • The VDH COVID 19 outbreak dashboard can be found here: https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/
              • Links to useful information about COVID 19 myths and facts:
                1. American Academy of Family Physicians: https://www.aafp.org/dam/AAFP/documents/patient_care/public_health/COVID19-Vaccine-Myths.pdf
                2. CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
              • American Association of Medical Colleges: https://www.aamc.org/news-insights/transcript-vaccinevoices-covid-19-vaccine-myths-debunked

               

           

         

         

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•  If you have an appointment at the Health Department:

Please stay in your vehicle and call us at 804.758.2381

We will arrange to meet you via appointment or to provide service by telephone or email.

If you have a fever or cough, please return home and visit us when you are well.

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THREE RIVERS HEALTH DISTRICT is a 10 county Virginia Department of Health district for Virginia’s beautiful Northern Neck and Middle Peninsula regions. This 2,000 square mile area is located between the waters of the Potomac, Rappahannock, and York Rivers and borders the Chesapeake Bay on the east. Our public health professionals serve a population of approximately 140,000, including 2 Native American reservations, 9 incorporated towns, and a large number of visitors.

Whether you are a resident here, just visiting the area, or thinking of relocating your family or business, I hope that you will take time to explore our website and Annual Report to see the many ways our health professionals keep our communities and shorelines healthy and safe. Building healthy communities is our mission.