Holsworth: May 4, 2020, Virginia Covid-19 Update

Editor’s note: Bearing Drift is grateful to Dr. Bob Holsworth for permission to share his daily Virginia coronavirus updates. For more, follow him on Facebook.

 

MAY 4, COVID-19 UPDATE: VIRGINIA

HOSPITALIZATIONS ON PLATEAU; ICU AND VENTILATOR PATIENTS DOWN; CASES STILL RISING; LATINOS HAVE HEAVILY DISPROPORTIONATE % OF CASES

1. HOSPITALIZATIONS STAY ON PLATEAU

The Virginia Hospital and Healthcare Association’s (VHHA) daily report showed that total hospitalizations increased from 1413 TO 1463. There were 50 discharges yesterday so the estimated number of new admissions was 100.

The average number of estimated new admissions for the last 13 days has been 99 patients. Since April 21, the total numbers of patients hospitalized on any single day has remained within a range between 1331-1556.

The good news is that Virginia has not experienced a major surge in hospitalizations. At the same time, everyone would like to see the 95-100 person average be replaced by a consistent, visible decline.

There is better news on the severity front as the number of patients in ICUs and on ventilators were the lowest these measures have been since the VHHA began reporting on April 7th. Here are today’s numbers and the previous range.

Patients in ICUs: 348 (357-469)
Patients on Vents: 192 (193-303)

2. CASES CONTINUE STEADY RISE

The Virginia Department of Health (VDH) reported 821 new cases yesterday, moving the statewide total to 19,492, a 4.4% day over day increase. Deaths increased from 660-684.

In the past week, there were 5,957 new cases, a 44% weekly increase. In other words, there were almost half as many cases reported last week than in the entire course of the epidemic.

NOVA, the most populous area of the Commonwealth, continues to have the largest percentage increase of the 3 major metros, having a 5.2% increase yesterday.

Many observers believe that these numbers are the consequence of increased testing and do not necessarily represent an acceleration of the disease, in part because we are not seeing a significant increase in hospitalizations associated with the rise in cases.

I think “Yes, … but,” might be the most appropriate response here.

Perhaps the most notable objection to this perspective is that COVID-19 in Virginia has not necessarily been hospital-centric. The most severe problems have arisen in long-term care facilities (LTCFs) where individuals have often passed away without being transferred to a hospital setting.

The Commonwealth has now embarked on a major initiative to address issues in testing and personal protective equipment shortages in the LTCFs. But outbreaks in these venues as well as correctional settings and meat processing plants have been significant contributors to the case rise, especially outside of NOVA.

3. LATINOS REPRESENT 10% OF VIRGINIA POPULATION AND 37% OF REPORTED CASES

Finally, yesterday VDH released its case report by ethnicity and nothing stood out more than data point indicating that while those who identify as Hispanic or Latino are approximately 10% of Virginia’s population, they represent 37% of the cases for which we have ethnicity information. This begs for in-depth explanation.

I did note yesterday that the percentage of deaths among Hispanics/Latinos is far lower, 8%, perhaps because of younger age, less presence in LTCFs, and that the full impact of the disease that has only recently appeared in workplaces is yet to be fully realized.

But as the Commonwealth thinks about adjusting its strategies to target the actual landscape of COVID-19, addressing issues impacting Hispanic/Latino communities ought to be an integral component of the effort.

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