Tag: virginia department of health

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On a roll: Health department begins vaccinating non-hospital health care workers

Coronavirus case numbers continue to rise in Charlottesville and the surrounding counties. PC: Blue Ridge Health District

The local vaccine rollout process continues. About a month after the first coronavirus vaccines were shipped to hospitals across the country, Charlottesville’s frontline health care employees who work outside of hospitals are now getting vaccinated.

On Monday, the Blue Ridge Health District (formerly known as the Thomas Jefferson Health District) began offering the first dose of the Moderna vaccine to area emergency service providers, dialysis center staff, and Region Ten residential facility staff at its location on Rose Hill Drive.

To expedite the distribution process, on Wednesday the district will begin hosting at least three appointment-only clinics per week for these select health care workers in a new temporary structure set up in the former Kmart parking lot. Red Light Management and the Bama Works Fund contributed funding to set up the facility.

“There are over 1,000 EMS [workers] that we need to vaccinate. There are folks going in and out of the hospital as well. So we want to get them done first,” says Kathryn Goodman, spokesperson for the health district.

The shots will be administered by public health nurses, who received their own vaccinations (and vaccine training) at the end of December. The district is currently working to vaccinate the rest of its staff.

The health district hopes to vaccinate about 500 to 600 people per week at the pop-up clinic.

Because both the Pfizer and Moderna vaccines require two doses to be fully effective, district staff will use a new state Vaccine Administration Management System to properly track appointments and alert patients when they need to return for their second dose.

As more vaccine shipments arrive in the next few weeks, the clinics will open up to other frontline health care workers (hospice employees, primary care providers, dental practice employees, pharmacy workers, Department of Corrections health care personnel, K-12 school nurses, and more) who have had potential contact with COVID or with high-risk patients.

“We’ll have the information sent out to these groups,” says Goodman. “We have quite a long list already of thousands and thousands of individuals who need to get vaccinated as soon as possible.”

UVA and Martha Jefferson hospitals continue to vaccinate their own employees. Other health care entities in Charlottesville and surrounding counties must fill out a BRHD survey indicating how many of their employees need to be vaccinated. The district plans to host additional clinics for health care employees—and eventually other essential workers and high-risk individuals—down the line.

To date, 89,326 people have received the vaccine in Virginia, including 1,542 in Charlottesville, and 1,615 in Albemarle County. However, none have been administered their second dose, according to the Virginia Department of Health vaccine dashboard.

Meanwhile, the health district has seen a record surge in COVID cases and hospitalizations since Thanksgiving, and expects numbers to worsen in the next few weeks following the holiday season. In December alone, there were 2,181 new cases, 86 hospitalizations and 10 deaths—the worst month of the pandemic.

While new cases in the district have remained low since the start of the new year, the district’s positivity rate is currently at 9.4 percent, the highest it has been since April.

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Charlottesville Free Clinic finds a new home

The Virginia Department of Health terminated the Charlottesville Free Clinic’s Rose Hill Drive lease, so the facility is moving to the Wellness Center, eight blocks down the road, on Preston Avenue. PC: Zack Wajsgras

For the past 24 years, the Charlottesville Free Clinic has provided no-cost physicals, prescriptions, mental health services, dental care, and more for the uninsured and underinsured from its Rose Hill Drive facility, which it has long shared with the Thomas Jefferson Health District.

But in May, the Virginia Department of Health announced it was terminating the clinic’s lease, in order to create office space for the additional 25 staff members it planned to hire to do COVID testing, contract tracing, and other pandemic-related jobs. That’s presented a new challenge for the Free Clinic, just as the pandemic accelerates.

While the clinic only had to cover utilities fees—approximately $14,000 a year—at the TJHD office complex, it will now need to pay rent for its new space at the Charlottesville Wellness Center, a medical office complex on Preston Avenue.

“This will be an uptick in our budget significantly. …It’s going to be around $150,000 a year in additional costs,” says Colleen Keller, executive director of the Free Clinic. “And if we can’t get the community to stay behind us and raise the money, it’s going to cost us about $250,000 to move, [since] we have to build a pharmacy and make a few changes to the medical clinic space.”

Throughout the pandemic, the clinic has had to rely on its reserve fund, along with donations from the community, explains Keller. But to stay afloat at its new location, it will need additional funding.

“The health department doesn’t provide us any support at all…The [City of Charlottesville] and [Albemarle County] support us, most significantly for the dental clinic,” she says.

On the upside, the third floor of the Wellness Center is already a fully outfitted medical clinic. And there are two bus stops nearby, making it more convenient for patients without cars. Still, finding room for the clinic’s 400 volunteers takes some finesse.

As the pandemic rages on, Keller expects the clinic to continue serving an increased number of patients. Approximately 15,000 people in Charlottesville and Albemarle do not have health insurance, according to the latest census stats—and that number has undoubtedly risen, as people have lost their jobs.

“We’re really worried about the newly uninsured, so we’re screening people over the phone. You can send us your income information, and we can get you qualified,” she says.

With thousands of vulnerable residents relying on its services, the clinic will not shut down during the moving process, Keller emphasizes. Staff will continue to safely offer select medical and dental care, as well as curbside pharmacy pickup at its Rose Hill Drive location. Many of its other services, like check-ups and counseling, are currently being offered via telehealth, too.

“For the dental clinic, we come to your car for screening, and bring people in one at a time,” says Keller. “We also just started doing flu shots outside.”

The clinic’s new location will open by early December.

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Phoning it in: Have tracker apps helped Virginia and UVA slow the spread of the virus?

Virginia’s COVIDWISE app uses Bluetooth to anonymously track the spread of the virus.

By Geremia Di Maro

As the community searches for answers to the COVID pandemic, both the Commonwealth of Virginia and UVA have rolled out apps designed to suppress the spread of the virus. While state officials are excited about the state app’s ability to track the disease, UVA’s app—which cost a similar amount to develop—merely encourages users to evaluate their own symptoms.

Almost two months after launching, the Virginia Department of Health’s COVIDWISE app—the nation’s first COVID-19 exposure-notification app for iPhone and Android devices—is slated to reach an important milestone of 600,000 downloads in the commonwealth, as thousands of Virginians continue to download the app each day. Currently, about 13.2 percent of the state’s population has the app on their phones.

COVIDWISE is among a growing list of similar exposure-notification apps in the U.S. The app trades randomly generated IDs between cell phones via Bluetooth connection, without draining battery or accessing location data. Then the app compares the IDs the phone has received to a statewide database of IDs associated with positive COVID-19 test results. If an app user tests positive. and inputs that test in the app, any other app user who has been near the positive case will then be notified.

“There is no GPS or other location data at all, it doesn’t matter where geographically you were,” says Andrew Larimer, an engineer with Spring ML, who helped develop COVIDWISE and is also assisting in the development of a similar app in North Carolina. “The only thing that matters, from the app’s perspective, is whether you were nearby someone else who has gone on to test positive for COVID 19…This framework was designed to take people’s privacy concerns very seriously, and avoid any kind of location tracking.”

As of September 28, 225 positive cases of COVID-19 have been confirmed via COVIDWISE. 

“We don’t collect location data, we don’t collect any sort of personal identifying information,” says Jeff Stover, the executive advisor to the Virginia Department of Health commissioner. “The issue is for any given state, because it’s an anonymous process, it’s very difficult to link back to anything and show any kind of correlation …We understand that this creates data limitations for some people who would like to do more, but we’re serious about protecting patient privacy and just privacy in general.” 

However, Stover cited a recently published study by Oxford University examining the potential for exposure-notification apps to reduce the rate of infection and the subsequent number of deaths caused by COVID-19 in a given area, based on an analysis of app usage and case statistics in Washington state. According to the study’s findings, “a well-staffed manual contact tracing workforce combined with 15 percent uptake of an exposure notification system could reduce infections [from COVID-19] by 15 percent and deaths by 11percent.” 

Stover says that, with more Virginians downloading COVIDWISE each day, the state  expects to reach that 15 percent threshold in the next few weeks. He also emphasizes that there are still few concrete examples and metrics to hold COVIDWISE up to, since Virginia was the first U.S. state to employ exposure-notification technology in earnest. 

“Obviously, the more downloads there are, the greater the impact,” Stover says. “But because we were the first state out of the gate, it’s very difficult—it’s as if we’re running a race by ourselves, and we can’t really tell if we’re running fast or slow, or somewhere in between. So there’s no one to compare ourselves to.” 

Although not nearly as complex or as involved as the COVIDWISE app, UVA has also rolled out its own app—Hoos Health Check—for students, faculty, and staff to use to combat the spread of COVID-19 on Grounds and in Charlottesville. 

Designed through a partnership between the university and Charlottesville app developer WillowTree, Hoos Health Check is meant to work alongside and with COVIDWISE. UVA’s app does not share or collect data like an exposure-notification app, but encourages users to also download COVIDWISE, according to university spokesperson Brian Coy. However, Hoos Health Check does require users to sign in to the app via their university-affiliated account. 

Hoos Health Check cost $300,000 to develop, and Coy notes that this figure includes additional features embedded within the app, but did not specify what they were. By comparison, COVIDWISE cost $229,000 in CARES Act funds to develop and has a maintenance budget of $29,000.

“The primary purpose of Hoos Health Check is to prompt users to evaluate their own health and symptoms every day before coming to Grounds,” says Coy, “as a means of helping them make the decision to stay home and away from other members of the community in the event they are feeling ill (and thus, potentially infected with COVID-19).” 

The app reminds users daily to complete the symptom check, although it is only required if a student or employee plans to be physically present on Grounds on a given day. If a user reports no symptoms (cough, shortness of breath, fever, muscle pain, loss of smell or taste, etc.), he is presented with a set of guidelines for preventing the spread of COVID-19, including wearing a mask in the presence of others, maintaining social distancing, and encouraging others to also follow public health guidelines. 

If a user indicates that he’s feeling sick, the app “prompts him to contact student health or his health-care provider for additional screening,” Coy says. It doesn’t enter the symptoms in any database or automatically communicate with any public health authorities. 

Coy says more than 27,000 downloads of Hoos Health Check have taken place since its launch in early August, adding that the app sees greater than 80 percent daily usage across the university community.

COVIDWISE is free to download on Apple’s app store or the Android store. 

 

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Slowing the spread: City and county adopt local COVID-19 restrictions different from state guidelines

Charlottesville City Council recently approved new COVID-19 restrictions, which are stricter than those mandated by Governor Ralph Northam on July 1, when the state moved to Phase 3 of reopening. PC: Eze Amos / Mark Warner Flickr

By Emily Hamilton

On August 1, residents of Charlottesville and Albemarle became subject to a new set of coronavirus restrictions: in-person gatherings of more than 50 people are banned; restaurants and other venues such as wineries, breweries, and distilleries can operate at only 50 percent capacity; and face coverings are required in indoor public spaces. The state’s Phase 3 guidelines, which have been in effect since July 1, allow in-person gatherings of up to 250 people, and stores, restaurants, and bars have no capacity limits, as long as social distancing is enforced.

The new local rules, which were approved July 27 and will last for 60 days, are more strict than the current statewide guidelines, and demonstrate the power localities have been given in crafting policy to contain COVID-19.

As of August 3, the Virginia Department of Health reports 775 cases of coronavirus in Albemarle and 495 cases in Charlottesville. Much of the support for both ordinances comes from concerns surrounding the impending return of UVA students. As the community prepares for the influx, Charlottesville and Albemarle government leaders recognize the potential for a surge.

“Part of…the motivation for this is that nothing would be worse for the economy than for UVA students coming back…to be a super spreader event,” said City Councilor Michael Payne at the July 27 emergency meeting. “And to prevent that, I think, is a decision worth making.”

The Charlottesville and Albemarle County ordinances reflect the difficulty that local governments face as they mitigate the damage the pandemic has wrought upon their communities. Although Virginia entered Phase 3 more than a month ago, recent actions reflect the state’s piecemeal approach to virus control.

In late July, Virginia Beach Mayor Bobby Dyer wrote a letter to Governor Ralph Northam asking the state to impose harsher restrictions after cases surged in that area. Dyer requested that the governor mandate restaurants and bars close early, among other rules. Northam quickly assented, making the rules official the following day.

Historically, Virginia is no stranger to friction between state and local jurisdictions. Localities in Virginia generally do not have much power, thanks to the Dillon Rule, which limits the powers of local governments only to those expressed by the state government. Localities aren’t allowed to do things like ban firearms or (until this year) remove monuments.

In times of crisis, localities have a little more say. Although Charlottesville and Albemarle’s new guidelines depart from those set by the state, the ordinances are in line with the expectation for local governments to protect their citizens during a crisis. The city’s ordinance cites the continued state of emergency along with the fact that the COVID-19 pandemic remains a “disaster” under Virginia Code. In Northam’s executive order declaring the state of emergency, he stated that local governments have the power “to implement recovery and mitigation operations” to fight the virus.

At the July 27 Albemarle County Board of Supervisors meeting, Bea LaPisto Kirtley, who represents the Rivanna District, expressed her confidence in the board’s decision to move forward with the local ordinance. “I would hope that the public, our county, our citizens, our community, would look at this as what I call a Phase 2.5,” she said. “I think we’ve made a lot of adjustments that fit our community, that fit us, and then will help us help our businesses help keep our citizens safe.”

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Don’t get complacent : The virus is still with us, says local health department

It’s been nearly three weeks since most of Virginia moved into Phase 2 of the state’s coronavirus reopening plan. Some restrictions were loosened on businesses and social gatherings, but the pandemic is far from over, warns Ryan McKay, deputy incident coordinator for the Thomas Jefferson Health District. PC: Robert Llewellyn

Nearly three weeks ago, most of Virginia moved into Phase 2 of the state’s coronavirus reopening plan, loosening restrictions on a range of businesses. As the percentage of positive COVID-19 tests continues to trend downward, Virginians can now sit down to eat inside in a restaurant, work out at the gym, or hit the pool. And with places like Great Wolf Lodge planning to reopen soon (and Virginia Beach already open), you can even take a summer vacation.

But the pandemic is not over, warns Ryan McKay, deputy incident coordinator for the Thomas Jefferson Health District. Due to increased testing and availability, especially in black and Latino communities (which have been disproportionately impacted by the virus), new cases are still being reported in the Charlottesville area every day. And since the start of Phase 2, four people in the district have been hospitalized with the disease.

Fortunately, “case counts are relatively small compared to other localities in the state,” McKay says. “We continue to climb a little bit, and here and there we may have a day with more cases than we’ve seen previously, [depending] on what sort of testing is going on. But we’re not overwhelmed locally with cases in terms of contract tracing or investigation. Our hospitals have not been overwhelmed…we feel like we’re in really good shape, and we have been all along.”

“But that can change because we’re opening up more,” he stresses. “More people are going to be together in larger groups, and we just want to make sure we’re adhering to the guidance for Phase 2…[They’re] the safety measures that got us to this point in the first place.”

When going out, everyone should take Governor Ralph Northam’s order seriously, and always wear a face mask indoors.

“The asymptomatic individuals who have COVID can spread the disease,” says McKay. “You might feel great. You want to go out, and don’t want the face covering because it’s constrictive, or you don’t like the way it feels or think it’s unnecessary—[but] you still can actually spread the disease.” 

“The best way to prevent that spread is [to] wear the face covering,” he adds. “That’s really what it’s meant for, to limit spread. It’s not necessarily a safety measure for the individual wearing it, but we’re helping to protect the community.”

People should also stay at least a six feet away from others, excluding household members, and comply with the established guidelines for each place they visit or activity they participate in, even with close family and friends. At a picnic or cookout, for example, they should avoid sharing food or utensils, says McKay.

While it’s generally fine for people who adhere to these rules to go out, it’s still safest to stay home, when possible. Those with underlying health conditions should especially “be mindful of where they’re going,” and “stay inside as much as they can,” adds McKay.

Though the recent protests against police brutality and systemic racism held in Charlottesville have attracted hundreds of people (many wearing face masks), the area has not seen a dramatic rise in cases. “Phase 2 and some of the protests here have coincided, so we’re not at a point where we can definitely say that one thing or the other has led to a huge increase in cases,” McKay says. “But we haven’t really had big spikes in our cases.”

He says the health department’s main concern is people disregarding safety guidelines on a larger scale. Phase 3 of reopening could be delayed again, or—in dire circumstances—Virginia could go back to Phase 1.

“Wearing the masks, if we do that as a community, down to the individual level, that’ll help us move forward into Phase 3 and continue to be able to do things that we want, with some mitigation strategies in place,” McKay adds.

But until there is a vaccine and widespread immunity to COVID-19, we should remain “concerned” about the possibility of a second wave of coronavirus cases, according to McKay. With local schools and the University of Virginia reopening in the fall, there will be even more opportunity for the virus to spread if the proper precautions aren’t taken.

Right now, “the best thing we can do is stress education about those strategies to minimize risk,” he says. “Making sure we’re protecting ourselves, but also each other, is going to be hugely important.”

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In brief: Church amidst coronavirus, feeding the frontlines, and more

A congregant reacts during an Easter Sunday mass at Covenant Church on Sunday, April 12, 2020. Churches have adapted to allow patrons to listen to the services from their car radios and over loud speakers in order to continue congregating. PC: Zack Wajsgras

Creative worship in the age of corona

Pastor Harold Bare was met with an unusual scene when he stood in front of his congregation on Easter Sunday—a barrage of car horns during a Facebook-streamed drive-in service, which welcomed congregants to decorate their vehicles and watch Bare’s sermon from a parking lot. 

Like every other institution in town, religious organizations have had to get creative as the novel coronavirus has radically reshaped our world. On Good Friday, Bare’s Covenant Church convened its choir over Zoom, with singers crooning into laptop microphones in rough, tinny unison.   

“Fear not, God is in control,” read a sticker on the side of one car at Covenant’s Easter service. Additional stickers thanked more earthly leaders, like nurses and doctors.

Other religious groups have had to adjust in similar ways. Zoe Ziff, a UVA student, organized a Zoom Passover Seder for her friends who have been scattered across the world by the university’s closure.

“We spoke over each other and lagged, but it was beautiful to see my friends, hear their voices, and share the story of Passover together,” Ziff says. “It’s a reminder that everywhere in the world, Jewish people are retelling this story—though this year, over a webcam.”

“We’re being as careful as we know how to be,” Bare said at the beginning of his holiday sermon. Religious traditions might stretch back thousands of years, but these days, they’re Zooming along just like the rest of us. 

A congregant’s car is seen decorated during an Easter Sunday mass at Covenant Church on Sunday, April 12, 2020. PC: Zack Wajsgras

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Signing day

The Virginia legislature turned in a historic session earlier this year, and as the deadline approached this week, Governor Northam put his signature on dozens of new bills. The new laws will tighten gun safety regulations, decriminalize marijuana, allow easier access to abortion, make election day a national holiday, repeal voter ID laws, allow racist monuments to be removed, and more. Northam didn’t sign everything, though—he used his power to delay the legislature’s proposed minimum wage increase by one year, citing the effects of the COVID-19 pandemic. 

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Local COVID-19 case update

53 confirmed cases in Albemarle

34 confirmed cases in Charlottesville

4 deaths

Data as of 4/13/20, courtesy of Thomas Jefferson Health District

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Quote of the Week

“In Virginia, the capital of the Confederacy… in Charlottesville, the home of Thomas Jefferson… We led the charge to change the state. It’s all been worth it.” ­

—Former vice mayor Wes Bellamy, on the new law allowing localities to remove Confederate monuments

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In Brief

Statue status

Governor Ralph Northam has finally made it official: Charlottesville will soon be able to legally take down its Confederate monuments. The bill, which Northam signed on April 11, will go into effect July 1. The end is in sight, but the city will have to wait 60 days and hold one public hearing before the statues can be removed. 

Foy joy?

Last week, state Delegate Jennifer Carroll Foy (D-Prince William) filed paperwork to run for Virginia governor in 2021. Foy is a 38-year-old former public defender who sponsored the legislation that led to Virginia’s ratification of the Equal Rights Amendment. If elected, she would become the first black female governor in United States history. Her likely Democratic primary opponents include Lieutenant Governor Justin Fairfax, an accused sex offender, and Attorney General Mark Herring, who has admitted to appearing in blackface.    

(No) walk in the park

To the disappointment of Old Rag enthusiasts, the National Park Service completely shut down Shenandoah National Park April 8, per recommendation from the Virginia Department of Health. All trails—including our stretch of the famed Appalachian Trail—are now closed. Still want to explore the park? Visit its website for photo galleries, videos, webcams, and interactive features, or follow it on social media. 

Win-win

Under the name Frontline Foods Charlottesville, local organizations are working with chef José Andrés’ World Central Kitchen to deliver food to health care workers, with meals supplied by area restaurants like Pearl Island Catering, Champion Hospitality Group, and Mochiko Cville. In the coming weeks, FFC plans to add more restaurants, which will be reimbursed for 100 percent of the cost of food and labor, and expand to serve other area community members.

Demanding justice

As reports of intimate partner violence increase due to coronavirus lockdowns, UVA Survivors, a student advocacy and support group, has created a petition calling for the “immediate, structural, and transformative change” of the university’s sexual violence prevention and support services. The petition demands UVA fund an external review of the Title IX office; provide survivor-created and informed education on sexual violence and consent; create a stand-alone medical unit for sexual, domestic, and interpersonal violence survivors; and move the Title IX office from O’Neill Hall (located in the middle of UVA’s ‘Frat Row’), among other demands. It has been signed by more than 100 students and student organizations.

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Sick leave: At least 25 get ill from pop-up dinner

Now & Zen owner/chef Toshi Sato said he believes the bean sprouts or spinach were to blame for pop-up dinner customers getting sick. Photo by Elli William

A crucial part of learning to be a sushi chef is food safety. So imagine Now & Zen owner/chef Toshi Sato’s horror when he learned that people who attended a special pop-up ramen dinner February 16 at his restaurant got sick.

“All my good customers,” he says. “I was terrorized. I didn’t know what caused it. It’s a scary thing.”

Comments started appearing the next day on the restaurant’s Facebook page. “There was something wrong with the ramen last night,” says one. “Four out of five people in my dinner party got sick. I had to skip classes today because I was feeling so terrible and haven’t been able to keep anything more than half a bottle of water down.”

“My wife and I both got sick after eating these ramen last night,” says another.

Reports of “gastro-intestinal complaints” started coming into the local Virginia Department of Health office as well, says Thomas Jefferson Health District epidemiologist Kerry Morrison. No one went to the hospital, and although she can’t provide specific numbers, she says, “We believe at least 25 people became sick.”

So far, the health department doesn’t know what caused the outbreak, and it can take several weeks to investigate, says Morrison. She calls it a “single, isolated event.”

She also says it’s health department policy to not identify the business unless it’s an immediate threat to public health.

Sato has his own theory. “I think it was the vegetables,” he says, naming the bean sprouts or spinach.

He emphasizes that the dinner was a special event and sushi was not served that evening.

Morrison contacted people who became ill to understand their symptoms, when they began, what they ate and whether they’d had other contacts that could have made them sick, for example, with an unwell animal.

“The owner sent an online survey to customers,” she says, noting he was “very cooperative.”

She also collected food samples from the restaurant and requested stool samples from the stricken.

Such foodborne illness outbreaks are relatively rare in the area. The Thomas Jefferson Health District had one last year and two in 2014 that were caused by norovirus and salmonella, says Morrison.

Eric Myers is the environmental health supervisor with the department of health, and he, too, investigates outbreaks within 24 hours to make sure best practices are followed in the kitchen of a restaurant, school or anywhere else food is being served to the public.

He says risk factors include personal hygiene of food preparers, improper holding of hot and cold foods or not cooking at proper temperatures. He also checks employees’ health to make sure no one has been ill in the past week and that contaminated equipment has been properly sanitized.

And with the popularity of pop-up dining and food trucks, Myers says, “Anytime food is served to the public, it’s required a permit be posted.”

Myers says, “The owner has been very cooperative. We feel good about the control measures put in place.”

Sato canceled a second ramen pop-up on February 17, and a week after the outbreak, he still sounds shaken. He doesn’t see any more ramen nights in Now & Zen’s future. “Mentally,” he says, “I don’t think I can take it.”