Three Rivers Pandemic Update 03/15/2021

Pandemic status:  New case rates across the US have plateaued

  • Case numbers across the states have plateaued; the current case rate in the US is about 58,000/day 7 day rolling average.  Almost all states report stable trends.  Case rates across Europe are increasing.
  • Virginia has improved, our new case rate is about 1300/day 7 day average. 
  • Three Rivers has dropped to about 30 new cases/day, 7 day average.
  • In Virginia, about 21% of us have received at least one dose of the vaccine

Vaccination Program Update:  Supply is increasing

    • All health districts remain in phase 1b.  For details of vaccination phases, please visit this website:  https://www.vdh.virginia.gov/covid-19-vaccine/#phase1b
    • The national vaccine shortage is improving.  This is expected to continue to improve over the next several weeks and months, as Pfizer and Moderna enhance their manufacturing throughput and the Johnson & Johnson vaccine becomes more available.  Our pace of vaccination is picking up.
    • We now have over 20 partners in Three Rivers Health District administering vaccinations:  these include three health care systems with their medical group practices, large retail and independent pharmacies, free clinics, federally qualified health centers, private practices, and the health department.  We are working with our health care system partners to set up larger scale vaccination centers in the Middle Peninsula and the Northern Neck to increase our capability when vaccine supplies increase.  We are also working with our EMS providers in almost every jurisdiction to offer collaborative vaccination events at the local levels.
    • The Virginia Department of Emergency Management and the Virginia Department of Health are setting up Community Vaccination Centers as more vaccine becomes available.  These staffed by commercial vendors; the first three will stand up this week in Petersburg, Danville, and Portsmouth.  They are prioritized be an equity formula developed by the Deloitte Corporation, driven by age, elevated health risk, income levels, and demonstrated risk to communities of color.  We are not at present scheduled to be considered for a Community Vaccination Center in Three Rivers.
    • Our nursing staff is forging ahead with first doses to essential frontline workers and vulnerable populations, and our Point of Dispensing teams (PODs) are following up with second doses.  We are piloting an EMS/HD collaborative vaccination model in Essex and Westmoreland over the next 2 weeks; we intend to establish this capability at the jurisdictional level as we are able to do so.   
    • Second doses are allocated based on the first dose; if you get your first dose of vaccine, we will call you when it is time for your second dose.
    • Three Rivers Health District jurisdictions compare very favorably with surrounding counties in vaccine doses delivered per 100,000 population. We are focusing more vaccination efforts in King William and King and Queen Counties; these jurisdictions are our least vaccinated areas.  These data can be reviewed here:  https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/  
    • The Federal Retail Pharmacy Partnership phase 2 has started in Virginia.  CVS, Albertsons (Safeway), Food City Giant Corporation, Kroger Corporation, Walmart, Walgreens and a Network of multiple independent community pharmacies are receiving vaccine this week and starting vaccination operations.  Retail pharmacies in Three Rivers will begin delivering vaccinations using the federal retail partnership in the next two weeks.

How to sign up for a vaccination appointment

    • People eligible for COVID 19 vaccination in phase 1b seeking a vaccination appointment can contact their health care providers for initial consultation. 
    • Preregistration for a vaccination appointment and maintenance of our waiting lists are now maintained centrally.  The preregistration lists are designed to communicate with the Virginia Immunization Information System when someone on our waiting list receives a vaccination, a vaccination date is assigned to them in the preregistration database.  We are finding that many people who have already received their vaccination have not been identified in the database; this is causing a lot of duplication of effort as we are reaching out to people to offer vaccination appointments.  As we move through the list of 65+ year old people qualified in phase 1b and on into more 16-64 year olds with underlying medical conditions, we hope the quality and accuracy of the database improves.  As of 3/14, the database contains 45,500 people signed up for vaccination, and 31,500 vaccinations delivered in Three Rivers.  The call center is open from 8AM – 8PM 7 days a week to answer questions and offer preregistration help at 1-877-VAX-IN-VA.  Preregistration on line is available 24/7 at vaccinate.virginia.gov. 
    • We are working through our waiting lists as fast as we can; our pace is accelerating as we receive more vaccine and bring more partners on line.
    • IF YOU ARE WAITING OR A VACCINATION OPPORTUNITY, PLEASE MAKE SURE YOU ANSWER YOUR PHONE AND CHECK YOUR EMAIL (INCLUDING SPAM FOLDER) VERY FREQUENTLY.

Vaccine development and virus update

    • We have received and are administering the Johnson & Johnson vaccine across the Commonwealth, including Three Rivers. The J&J vaccine lends itself well to mass vaccination venues, and current plans at the state level call for it to be used primarily in this setting.  Public health authorities recommend taking the first vaccination opportunity afforded to us regardless of manufacturer; there is no guarantee any of the available vaccines will prevent infection.  They are all very effective in preventing serious and critical COVID 19 disease, and can turn a life threatening infection into a much less serious health threat.  All available vaccines are probably effective in reducing viral transmission potential in the event of infection as well.
    • The COVID 19 virus continues to genetically drift.
      • The United Kingdom, South African, and Brazilian variants are all in the United States now.  The UK and South African strains have been detected in Virginia.  The UK strain and South African strain has been detected in the Eastern Region.
      • Comparable variants with similar mutations have also emerged in California New York.
      • These strains are more contagious and the UK strain is expected to become dominant across the United States in the relatively near future.
      • Vaccine effectiveness against these new strains is being evaluated; it appears our existing vaccine is very effective against the UK strain.  Proceeding with vaccination is recommended for all of us.
      • Wearing more efficient masks, or double masking, has emerged as a recommendation to protect against these more contagious strains.
      • We are in a race to vaccinate people as fast as we can to drive case levels down if possible. The higher the case levels in the population, the more opportunity exists for the virus to continue to drift.  Protective measures such as masking and social distancing remain very important.
      • Persons who have had COVID 19 disease can seek vaccination after their isolation period ends, and after their symptoms, including fever, have resolved.  While the vaccine remains in short supply, people recovered from recent COVID 19 infections may elect to temporarily postpone vaccination with the understanding that immunity from natural infection may decrease over time.
    • After receiving COVID 19 vaccination, public health authorities are recommending we all continue masking, maintaining social distancing and avoiding crowded areas after being vaccinated.  
      • The vaccine may not prevent all COVID 19 infections
      • Public health authorities will let us know when it is safe to relax protective measures.  This will occur when case numbers in the population fall to very low levels.
      • The CDC has published new Interim Public Health Recommendations for Fully Vaccinated People; those recommendations can be found here:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

How to volunteer with the Three Rivers Health District

    • The Medical Reserve Corps (MRC), our volunteers, are absolutely critical to our efforts at all times
    •  We will need additional volunteers during the vaccine campaign, which will last for many months. 
    • If you are interested in becoming an MRC volunteer, or have family or friends that are interested, please visit www.vamrc.org to learn more.
    • If you have questions about the process, please reach out to Johanna Hardesty, Three Rivers Medical Reserve Corps Coordinator at 804-758-2381 x 14. We welcome your help and participation in the fight against COVID 19.

Testing, pandemic containment efforts

    • Community testing and testing in response to vulnerable facility outbreaks can be requested by facilities and jurisdictions by using commercial firms on contract with the Commonwealth of Virginia or the Virginia National Guard. 
    • Our containment team has resumed investigation of all new cases with contact tracing of all high risk exposures.
    • Our Executive Order Compliance team continues with full capability and activity.

K-12 School Status:  The CDC published new school guidance

    • The CDC published comprehensive K-12 school guidance based on latest evidence concerning viral transmission in children and adolescents and on the experience base gained during school operations over the past year.  The guidance, which facilitates return to in-person learning, leverages the protective measures we have had in place all year and is tied to levels of community transmission.  The guidance stipulates universal and correct use of masks, maintaining at least 6 feet of physical distancing, handwashing and respiratory etiquette, cleaning and maintaining health facilities, and maintaining effective contact tracing in cooperation with local health departments.  The detailed CDC school guidance can be found here:  https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html
    • The VDH and VDOE have also revised guidance concerning school operations.  A major difference between the CDC and VDOE/VDH guidance is liberalization of social distancing at substantial and high community transmission levels.  The CDC language requires 6 feet of social distancing with masking at these levels.  The VDH/VDOE language emphasizes the benefit of 6 feet as standard practice, but accepts 3-6 feet of social distancing with masking if 6 feet cannot be maintained with a full return to in person learning.
    • Our Three Rivers Nursing staff and our community partners have finished first dose vaccinations for school faculty and staff, and our POD team is following up with second doses.
    • Schools have been able to continue offering in-person education under a hybrid model, with mitigations in place.  As community transmission levels decline, it will be feasible to bring more students into the congregate environment.
      • Three Rivers staff will continue to work closely with schools and school boards to help make the best decisions going forward.
      • Three Rivers staff will continue to help with all school based COVID 19 infections and outbreaks.

Useful links

 

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