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A shot in the arm: Vaccine distribution begins for local hospital workers

Last Tuesday, UVA hospital’s ICU director Taison Bell became one of the first people in Charlottesville to receive the newly approved coronavirus vaccine. It was a moment of “mixed emotions,” says Bell, who has worked with COVID patients throughout the crisis.

“It was definitely a good feeling to finally have something that can potentially protect you and your family from COVID-19, but also bittersweet,” he says. “In order to get to this point, so many hundreds of thousands of people have died…It was just ironic that the key to getting out of this was in this tiny little vial.”

Nearly one year after the first coronavirus cases were reported in the U.S., the vaccine is finally available. Shortly after the Food and Drug Administration approved the Pfizer vaccine for emergency use on December 11, it was sent to hospitals across the country, including here in Charlottesville.

Last Tuesday, UVA hospital received 3,000 doses of the vaccine. The day before, Sentara, which runs Martha Jefferson, received 11,700 doses to be shared among multiple facilities. Both hospitals immediately began vaccinating doctors, nurses, and other staff who come in direct contact with coronavirus patients in the COVID-19 unit or the emergency department.

Once these high-risk employees are vaccinated—and the two health care systems receive additional shipments—the shot will be available to essential hospital workers, then to the rest of the staff, with priority placed on those who are medically vulnerable.

Local long-term care facilities will be able to receive on-site vaccination services from pharmacies, including Walgreens and CVS.

On Friday, the Moderna vaccine was also approved by the FDA, and shipped to hospitals two days later.

Both vaccines—currently available only to adults—have over 95 percent effective rates, and require two doses in order to be fully effective. Pfizer’s doses must be spaced out by 21 days, while Moderna’s require a 28-day wait.

Bell says he felt fine after receiving the shot, despite the mild discomfort from the needle. However, recipients may experience mild side effects, including fatigue, chills, body aches, or headaches.

While the long-term effects of the vaccine are still unknown, science and safety were not “cut short” in the approval process, explains Bell.

“[It] is based on a platform called messenger RNA technology, which is novel in the sense that it hasn’t been used in a licensed vaccine before—but the actual science and study behind it has been going on for more than a decade,” he says. “I have no doubt [that] it’s safe.”

mRNA ultimately protects recipients from developing symptoms of the virus. It has yet to be determined if either vaccine can completely prevent COVID-19 infections.

The $9 billion government investment into the vaccine also expedited its development and distribution, explains Bell. And as COVID cases continue to spike around the country, researchers had little trouble finding people infected with the virus who were willing to participate in trials, which can be a challenge when developing vaccines for different diseases.

According to the Thomas Jefferson Health District’s Emergency Manager Jessica Coughlin, the next stages of vaccine distribution will likely take several months to get through.

After health care employees, essential workers—including teachers, paramedics, bus drivers, and service workers—will be next in line for the shot, along with high-risk populations. The Centers for Disease Control has released loose guidelines for vaccine distribution priority, but states and hospital systems still have significant control over the specifics of the rollout process.

The vaccine is not expected to be available to the general public until early summer. But with more than 200 coronavirus vaccines still in development across the globe, this timeline may change. Because the development of the vaccine was paid for by the federal government, it will be free to all who decide to get it.

Developing the vaccine is one thing. Convincing people to take it could be a different challenge. America’s long and brutal history of medical racism has left many people in the Black community mistrustful of the coronavirus vaccine, says Bell.

From 1932 to 1972, in the infamous Tuskegee experiment, the U.S. Public Health Service allowed nearly 400 Black men in Alabama with syphilis to go untreated in order to study the full progression of the disease, causing many participants to suffer from blindness, insanity, and other severe health problems. Meanwhile, in Charlottesville, UVA was a hub for eugenic science. Doctors in Virginia sterilized thousands of Black people without their consent from the 1920s to the 1970s.

“The Black community remembers these insults…[They] must be addressed head-on,” says Bell. “It’s not a matter of just saying, ‘Oh, well trust us now.’ Because the same message was given to people back in Tuskegee and the eugenics movement.”

While there is no single solution to this deep-rooted trauma, Bell encourages his colleagues to “recognize these wounds,” and work to heal them by being honest, transparent, and explaining as much as possible. They must also assure concerned patients that Black people have been a part of the research, development, and trials for the vaccine from the very beginning.

Coughlin says primary care physicians will be best-equipped to help people make good choices around the vaccine, and that the health district is encouraging people to “do their research, look at official sources, and speak with their physicians.”

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In the books: Looking back at UVA’s pandemic semester

It’s 11am on Thursday, November 19. The U.S. has reached an all-time high for COVID-19 infections in a single day. Colleges have reported record-high numbers as well, contributing to around 2 percent of national infections, according to the New York Times. 

And UVA President Jim Ryan has declared victory. 

In a video posted to the school’s website, Ryan said the university had accomplished “what many said couldn’t be done,” and showed the world “what being a great and good university looks like.”

It’s true that UVA has largely avoided the uncontrolled spread that worried community members in the summer, when the university first announced its plan to welcome students back to Grounds. At the time, Virginia was experiencing a Memorial Day spike in COVID-19 cases and inching out of its initial Phase 1 restrictions. After college students gathered en masse for the traditional Midsummer’s party weekend, some community leaders sounded the alarm. 

“I, for one, don’t understand why the students are coming back into the community, from all over the globe, and why we’re taking that chance,” Charlottesville Mayor Nikuyah Walker said at a virtual press conference over the summer.

Some at the university also pushed back against in-person classes. The United Campus Workers union and Student Council both petitioned for an all-virtual semester. In early September, student and community activists held a die-in demonstration where 50 people protested by feigning dead on the Rotunda steps and the Lawn.

Three months later, the semester is in the books. (Students left Grounds before Thanksgiving, a little earlier than usual.) Since August, the university has identified just under 1,300 COVID-19 infections among students, faculty, and staff, a number the administration has deemed a success. Those cases resulted in zero deaths and zero hospitalizations, reports university spokesman Brian Coy. 

This graph from UVA’s COVID dashboard shows cases detected at the school over the course of the semester.

“There were a lot of people who were skeptical that students, or the rest of our community, would follow those behaviors closely enough to avoid a major outbreak,” says J.J. Davis, UVA’s chief operating officer. “However, as a whole, this community showed that we were capable of coming together and doing the right things to protect each other and keep the semester on track.”

Provost Liz Magill says the university faced “impossible odds” when the coronavirus pandemic halted operations in March. She cited measures such as the high amount of isolation and quarantine beds, increased testing, and restrictions on gatherings when cases spiked. The measures “weren’t easy” but ultimately the university “overcame historic obstacles,” Magill says.

Final exams 

An aggressive testing operation lies at the center of the school’s COVID prevention plan. As the semester wore on, UVA instituted a mandatory testing policy, periodically calling all students living in the area to report to the Central Grounds Parking Garage for a spit test. From November 15-21, as the semester wrapped up, the school conducted 9,453 tests. Virginia has 25,000 undergraduate and graduate students living on Grounds this fall; for comparison, Virginia Tech, a school of 34,000 students, conducted 4,910 tests during that same week in November. This semester, Tech has detected around 1,600 cases. 

At the beginning of the semester, UVA created 1,500 quarantine beds for students who had been exposed to the virus. The ability to shift students into this quarantine housing proved pivotal in the early fall. The University of North Carolina at Chapel Hill  had to send students back home during the first week of in-person classes, when cases shot up and quarantine rooms dwindled to the single digits. UVA experienced a similar spike in cases during its first week of in-person classes (UNC had 130, UVA 199) but the school’s supply of quarantine beds was large enough to weather the storm. 

Additionally, testing allowed UVA to monitor residence halls and identify clusters in places like the Balz-Dobie and Hancock residence halls. Regular dorm wastewater testing combined with mandatory dorm resident testing kept infections from exploding on Grounds.

Dr. Taison Bell, a pulmonary and critical care physician and graduate student who also works in the UVA hospital’s COVID-19 ICU, thinks the university learned its lesson from other colleges across the country.

“A lot of peer institutions were having issues with large-scale COVID outbreaks,” Bell says. “So maybe it was a combination of learning lessons from those institutions and effective messaging at the university.”

Laying down the law 

Even with that containment structure in place, videos periodically surfaced during the semester that showed troubling scenes for those who had hoped to see social distancing.

In October, an anonymous student sent a video to CBS19 of students packing, mask-less, into the first floor of Trinity Irish Pub on the Corner. Weeks before, Ryan signaled out bars specifically in a video message sent to the UVA community, saying “If you can’t stay six feet apart, don’t go in.”

“It seems hypocritical to me that the administration tries to pretend like they’re enforcing these rules when in reality there are these events that are happening,” an anonymous student told CBS19 at the time.

Days later, students were seen waiting in long lines to enter bars on Halloween weekend. 

Davis concedes there were “some issues of noncompliance,” but the school responded by laying down the law, tightening restrictions after the potential super-spreader weekend.

“There were a couple times where more strict messaging had to go out to the university community,” Bell says. “But it seems like, after that happened, the prevalence [of the virus] overall went down and the system wasn’t strained…I think overall they did a really good job.”

The Balz-Dobie and Hancock clusters prompted new gathering restrictions early in the semester, barring students from gathering in groups of more than five people. The university’s ambassadors, a school-run safety force that patrols areas on and off Grounds, enforced the rules strictly, and violations could result in academic punishments. 

In a September video, Ryan alluded to several interim suspensions of students failing to adhere to social distancing policies. The university’s policy directory states that students cannot hold an event, indoors or out, that includes multiple groups from different households. The policy also outlines the face mask and social distancing requirements.

Fourth-year Hallie Griffiths says the stricter penalties had a real effect. “I know friends that would have gathered in bigger groups regardless of safety because they felt that if they got sick, they would be fine,” but they didn’t want to get expelled, she says.  

The looming terror of the virus made it a strange time to be a student, Griffiths adds. In addition to the interruption of extracurricular activities, classes, and Greek life, students had to cope with ever-changing rules, the complexities of online classes, and fears of infection.

Constant safety adjustments were a whirlwind as well. The university has updated and added information to its Return to Grounds plan at least 24 times since August 4, an experience Griffiths says was “confusing and frustrating.”

“Every week there was a new email and a lot of people’s lives were turned to chaos,” she says. “And then we would adjust and then there’d be a new email.” 

“It was scary in the sense that all of us came into it not really knowing what to expect and then it very quickly became very real,” Griffiths says. “All the traditions are gone. Time is stopped in one place but also going very fast. …Especially with classes ending this week, I’ve realized that time is gone and I’ll never get it back.”

Community containment 

A central concern for observers in town was the possibility of community spread, especially for vulnerable communities surrounding the university. Although cases spiked at UVA in September and October, the numbers don’t suggest that on-Grounds cases resulted in large numbers of city and county residents getting sick.

But while UVA was cracking down on restrictions, the city was as well.

“Coronavirus ordinances in Albemarle and Charlottesville that were passed were aimed at being in conjunction with UVA returning,” says City Councilor Michael Payne. 

In the summer, Charlottesville imposed more severe gathering restrictions than the rest of the state, in part to mitigate the effect of students returning. In Charlottesville, restaurants were unable to operate at more than 50 percent capacity and people weren’t allowed to gather in groups of more than 50.

“I think UVA was taking a huge risk in terms of having all these students come back,” Payne says. 

“They have been able to prevent a massive community spread in a worst-case scenario. So in that sense it’s definitely been successful,” the city councilor continues. “But there’s no way around it: When you have that many people coming into the community, you’re going to see a big spike in cases, and that’s what we did see.”

And of course, the story is far from over. Students will return for the spring semester in February. As cold weather drives groups inside and students travel back to Charlottesville from COVID hot spots, the university could once again become dicey terrain. Referencing the cold weather and spring semester, Magill said that “vigilance will be more important than ever.”

“I’m never going to say that I feel comfortable with where things are, because there’s always the possibility that things can break loose,” says Bell. “But what I will say is that, in general, our area has done fairly well with controlling the pandemic compared to a lot of areas of the country…I think this means that, going forward, we have to keep that same diligence up.”

 

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‘A good deal of trust’: UVA wants students to come back to Charlottesville. What will happen once they get here?

By Sydney Halleman

Amy has a lot of school spirit. A third-year at the University of Virginia, she’s been active in the UVA community since her first year. She holds leadership positions in multiple clubs. “I go to all the football games,” Amy says. “And I love wearing my UVA gear.”

But her sentiment toward her university started to shift as the novel coronavirus swept through Virginia. Amy, who is immunocompromised due to asthma and chronic sinusitis, is concerned for her club members and her own health as the University of Virginia moves closer to opening Grounds to students on August 25. She has been given no specific guidelines on how to hold meetings or host club activities safely. 

“This is not a time for self-governance,” Amy says.

Students like Amy—and Charlottesville residents—have become increasingly concerned with the university’s guidelines for reopening, and its lack of enforcement of mask wearing and social distancing, which are crucial to preventing the spread of COVID-19.

“This is the first time I’ve felt disappointed with UVA,” she says. “I love UVA, I truly love it. And this is the first time where I feel like I’ve been cheated…The lack of communication and lack of transparency is very, very frustrating.”

 

Preventative measures

The coronavirus has killed 141,000 people in the United States since March. Charlottesville, thus far, has been relatively spared in comparison to other cities, due to non-essential businesses closing early and limits on gatherings.

However, as national COVID-19 rates spike for a second time, Charlottesville’s rate of infections has been steadily rising. City leaders and community members are concerned that the return of students could mark a deadly rise in coronavirus cases. In a July 13 virtual press conference, Charlottesville Mayor Nikuyah Walker called UVA’s plans to reopen Grounds to students a “recipe for disaster.”

“I, for one, don’t understand why the students are coming back into the community, from all over the globe, and why we’re taking that chance,” she said.

During a recent city schools school board meeting, Chairwoman Jennifer McKeever said, “In any given moment, after the students come back into our town, the local numbers are going to be really different than they are right now.”

Early in March, the university outlined plans to reopen, and opted to hold classes, excluding large lecture hall courses, in person. In this hybrid model, most students can choose to attend classes online, if they wish, with the exception of some practicum courses. Classes will be held through fall break, and in-person teaching will end by Thanksgiving. The university will quarantine those who test positive for coronavirus, and provide personal protective equipment. Additionally, students are required to submit a negative COVID-19 test before returning to school.

In a May 28 email, the university wrote that “In some ways, it would be easier simply to be online all fall,” but mentioned the “obvious financial risks” to that course of action. Like many schools around the country, UVA has been clear about its fears that an all-virtual semester would destroy tuition revenue.

 So UVA’s administration has decided to forge ahead. “There inevitably will be greater risk in having students return,” the email reads, “and we will be placing a good deal of trust in our students to look out for the safety and well-being not just of each other, but of our faculty, staff, and community members.”

 

Party on

Mounting evidence suggests that these steps—and this trust—won’t be enough to prevent students from spreading the virus among themselves and to the rest of the city. Although 92 percent of undergrads responded in a university survey that they would practice social distancing, mask wearing, and hand-washing, flocks of maskless students crowded corner bars and fraternity houses to celebrate during the weekend of July 11-12, the traditional party weekend called Midsummers. 

Tyler Lee, a rising second-year, was one of those who took part in the Midsummers festivities. Over Instagram direct message, Lee recognized that “partying in the midst of a pandemic is not the best idea,” but said he expects students to continue partying once classes resume. 

“I do not expect to see bars empty or a lack of people at parties in the fall,” Lee said. “I had my fun, even if it was for a short weekend.”

Following Midsummers, Dean of Students Allen Groves sent a scathing email to students, calling the partying “selfish and ignorant,” but failing to explain how the school would enforce safety at future large, student-held gatherings. 

Ryan McKay, a senior policy analyst for the Thomas Jefferson Health District, says the state health apparatus is scaling up contact tracing and educational messaging, but noted that, ultimately, “there’s a concern if students aren’t wearing face coverings and not social distancing.”

“Even if we did say that restaurants needed to close,” McKay says, “we need to be concerned about social gatherings where we don’t have authority.”

Around 40 percent of UVA upperclassmen live in off-campus housing, which further complicates the picture because the university has very little control over what happens in those houses and apartments. Harvard University made headlines recently for its COVID prevention plan, which allows only 40 percent of students to return to campus, something it can more easily do because 97 percent of its undergraduates live in university housing. At UVA, students can decide to return to Charlottesville even if classes are held completely virtually. 

UVA English professor Herbert Tucker recognizes that students behave much differently outside the classroom than in it.

“I’ve been in the business long enough to know that no matter how much homework-doing students are on the ball…they behave very differently with each other when they’re out of class,” he says. “The students infect each other…these are not fantasies, these things are certainly going to happen more frequently. This isn’t rocket science here.” 

“The extreme that everyone should imagine is a fraternity party,” Tucker says. “Those events are going to happen.”

And while Tucker says the faculty can “take care of themselves,” citing UVA’s flexibility in allowing faculty to teach remotely, he worries about the staff and community members that students could infect with COVID-19. 

“They won’t enter the students’ minds,” he says.

 

Risk factor

Residents in neighborhoods surrounding UVA, like 10th and Page, are particularly at risk of serious health complications stemming from coronavirus. The virus disproportionately affects Black Americans and those with underlying health conditions.

Dr. Taison Bell, an infectious disease, critical care physician, and the director of UVA’s medical intensive care unit, recognizes that risk, and says Charlottesville has to develop a safety plan that “has to be, more so than we’ve done in the past, integrated into the whole plan for the city and the region.”

As for making students practice social distancing, Bell says it’s “a little unclear” what can and cannot be enforced. 

“One variable, or a big part that the community is concerned about, is how younger people will behave during their free time,” Bell says. “Will they behave in a responsible way…Or will they be potential drivers of infection?”

For decades, area residents have watched UVA students party their way across town. Now, the university has put forward a coronavirus containment plan that relies in large part on students choosing to act conscientiously. 

“If we’re going to have a substantial amount of students,” Bell says, “then there needs to be a collective understanding that [they] have to behave differently than they have before.”