Three Rivers Pandemic Update 04/12/2021

Pandemic status:  The US is in plateau, but there are hot spots

  • Case numbers across the United States are fluctuating; the current case rate in the US is about 70,000/day 7 day rolling average.  25 states now report increasing case rates.  There are hot spots in the upper Midwest, New England, some southern and some western states.  Case rates across many European countries are fluctuating as well.
  • Virginia is relatively stable, our case rate is about 1480/day 7 day average. 
  • Three Rivers has improved; our new case rate is averaging about 20 new cases/day, 7 day average.
  • In Virginia, about 36.6% of us have received at least one dose of the vaccine.   In Three Rivers, about 41.7% of our population has received at least one dose.

Vaccination Program Update:  Virginia is preparing to move to Phase 2 of the vaccination campaign

    • Virginia is making excellent progress through the vaccination campaign.  Some health districts progressed to phase 2 of the vaccination campaign last week.  Virginia will go to phase 2 on April 18.  For details of vaccination phases, please visit this website:  https://www.vdh.virginia.gov/covid-19-vaccine/#phase1b
    • Three Rivers Health District is advancing to phase 2 on Monday, 12 April.
    • Three Rivers vaccinating partners will continue to reach out by phone or email to anyone eligible in phase 1 who preregistered in Three Rivers for a vaccination opportunity.
    • Our Three Rivers vaccination system is currently delivering over 4,700 COVID 19 vaccinations per week, combined first and second doses.  At our current pace, we are on track to vaccinate 75% of the eligible adult population of Three Rivers by late May, assuming we get the population uptake we need.
    • The Virginia Department of Emergency Management and the Virginia Department of Health are setting up Community Vaccination Centers (CVC) as more vaccine becomes available.  These centers are staffed by commercial vendors, and are prioritized by an equity formula driven by age, elevated health risk, income levels, and demonstrated risk to communities of color.  In general, they have a scalable 3,000 person per day capability.  We are not at present scheduled to be considered for a commercially staffed Community Vaccination Center in Three Rivers.
    • Our nursing staff is providing first doses to essential frontline workers and vulnerable populations, and our Point of Dispensing teams (PODs) are following up with second dose and doing some first dose events.  We have EMS/Health Department collaborative vaccination model in Essex and Westmoreland counties operating at 100 first dose/day capacity; we intend to establish this capability at the jurisdictional level going forward, with multiple opportunities for vaccination appointments weekly.   
    • We are doing very well in Three Rivers; about 41.7% of our district population has received at least one vaccine dose and every jurisdiction has a first dose vaccination rate greater than 30,000/100,000 population.  We are still focusing more vaccination efforts towards King William, King and Queen, Richmond and Westmoreland Counties; these jurisdictions remain our least vaccinated areas.  The jurisdictional vaccination data can be reviewed here:  https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/  
    • The Federal Retail Pharmacy Partnership phase 2 is proceeding in Virginia.  WalMart, Rite Aid, Walgreens, CVS, Kroger, Main Street, Mathews, and Tappahannock pharmacies in or near Three Rivers are delivering vaccinations through the federal retail partnership, including Johnson and Johnson doses.

Details of Phase 2 Transition

    • People eligible for COVID 19 vaccination seeking a vaccination appointment can contact their health care providers for initial consultation.  The vaccine is now available in many clinical practice settings.
    • Preregistration for a vaccination appointment and maintenance of our waiting lists continue to be maintained centrally.  The preregistration lists are designed to communicate with the Virginia Immunization Information System (VIIS).  When someone on our waiting list receives a vaccination, a vaccination date is assigned to them in the preregistration database.  We continue to find that many people who have already received a 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.   Most districts, including Three Rivers, will discontinue preregistration during phase 2.
    • As we go to phase 2, we will continue working through the preregistration list for another week and then shift to establishing standing vaccination clinics for several weeks in advance.  We will publish links to these clinics that can be accessed through vaccinate.virginia.gov.  We will use the new VASE (Vaccine Appointment Scheduling Engine) system developed by the VDH in recent weeks to establish and manage appointments.  A link to Vaccine Finder will be on the website, and people will be able to search for vaccination clinics near them.  They can also call 1-877-VAX-IN-VA to get help finding an appointment and registering for one.  The call center will prioritize all people eligible in phase 1 and refer them to the districts for appointments as soon as possible.  The call center will remain open from 8AM – 8PM 7 days a week to answer questions and offer appointment assistance.  Appointments will be available on line hrough vaccinate.virginia.gov 24/7. 
    • Pharmacies are already using Vaccine Finder; Health Care Systems and medical practices will initially concentrate on their remaining patients eligible in phase 2, and may participate in Vaccine Finder as phase 2 progresses to completion.
    • IF YOU ARE ON OUR WAITING LIST FOR A VACCINATION OPPORTUNITY, PLEASE MAKE SURE YOU ANSWER YOUR PHONE AND CHECK YOUR EMAIL (INCLUDING SPAM FOLDERS) VERY FREQUENTLY.  EITHER THE HEALTH DEPARTMENT OR ONE OF OUR VACCINATING PARTNERS WILL BE REACHING OUT TO YOU TO OFFER AN APPOINTMENT.  IF YOU DO NOT RESPOND, WE WILL ASSUME YOU HAVE ALREADY RECEIVED A VACCINATION OPPORTUNITY.

Vaccine development and virus update

    • All three available vaccine types are being delivered across the Commonwealth.  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, although evidence is growing that they effectively do so in many people.  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; both have been detected in the Eastern Region.  The UK strain is now dominant in the US.
      • Comparable variants with similar mutations have also emerged in California, New York, and other areas of the United States.
      • These strains are more contagious; hospitalization rates are rising and the hospitalized people are younger.  Local hospitals also report an uptick in COVID 19 cases. 
      • Vaccine effectiveness against these strains continues to be evaluated; it appears our existing vaccine is very effective against the UK strain.  Proceeding with vaccination is strongly recommended for all of us.
      • Wearing more efficient masks, such as the KN-95 mask, 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.
      • Moderna and Pfizer are conducting pediatric clinical trials, and Janssen is conducting a clinical trial in adolescents.  Pfizer requested Emergency Use Authorization from the FDA on Friday, March 9, to extend use of its vaccine to 12-15 year olds.  We anticipate vaccine availability for school age children by this fall or sooner; we will need to conduct another vaccination campaign to make the fall school terms safer.
      • 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. 
    • 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; this capability is completely intact.
    • Our Executive Order Compliance team continues with full capability and activity.

K-12 School Status:  More students have returned for in-person learning

    • 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 3 feet of physical distancing, handwashing and respiratory etiquette, cleaning and maintaining healthy facilities, and maintaining effective case investigation/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.  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, at all levels of community transmission.
    • The VDH is piloting a COVID 19 school testing program this spring, to enhance safety and confidence for in-person school attendance.  This program may expand in the fall.
    • Sports teams are an area of interest and higher risk; since high school sports began in the spring term, several outbreaks involving sports teams have occurred. We will cooperate with schools in case identification, contact tracing and quarantine activities to help mitigate the effects of sports related outbreaks.
    • Schools are bringing more students into the classroom setting with mitigations in place.  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 also continue to help with all school based COVID 19 infections and outbreaks.
    • As of last week, we have experienced COVID 19 cases among students in 8 of our jurisdictions in Three Rivers.  Evidence is emerging that children are playing a larger role in transmission of the COVID 19 variants.  We are watching this carefully.

Useful links

 

 

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