Holsworth: May 7, 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 7, COVID-19 UPDATE

HOSPITALIZATIONS SLIGHTLY UP; GROWTH IN CASES SLIGHTLY LOWER; HOTPOTS BEYOND HOSPITALS; REOPENER GOVERNORS’ CONTAINMENT THEORY

1. Hospitalizations; Slow Burn Persists

The Virginia Hospital and Healthcare Association (VHHA) reported that there were 110 estimated new hospital admissions and 91 discharges yesterday, bringing the number of patients hospitalized from 1594 to 1613.

This is a new high in the number of patients hospitalized with COVID-19. Since VHHA began its reports on April 8, the number of patients in hospitals had ranged from 1288 to 1594.

As of today, there are no issues with hospital capacity, no reports of hospital shortages of PPE, and the number of patients in ICUs and ventilators remain at the low end of the range in VHHA’s reporting.

Here are the number of patients in ICUs and on ventilators and the range since April 8.

Patients in ICUs: 396 (348-469)

Patients on Vents: 192 (189-303)

2. VDH 2 Day Report

Since VDH was not able to report yesterday while it dealt with technical problems, today’s report comes with 2 days of data.

Total cases rose from by 1314 from 20,256 to 21,570, a 2 day growth of 6.4%. The 657 case increase daily average for the last two days is lower than we’ve seen in the previous week and potentially good news. .

At the same time, officials and experts are increasingly suggesting that a reduction in the percentage of positive tests may be the best indicator of progress. This percentage was 15.2% over the last two days and does not represent much change.

Within the large metros, it is worth drawing particular attention to Hampton Roads. I have noted in several reports that its growth rate in far lower than NOVA and lower than RVA. Once again, it’s 2 day growth rate (3.2%) was half the statewide average. The situation in Hampton Roads has been far different for weeks than what we’ve seen in NOVA.

Outside of the major metros, the extent of cases in the northern Valley, Accomack County, and Buckingham where there are meat processing plants, correctional facilities, and LTCFs remain notable.

3. Hotspots Beyond Hospitals

Governor Northam has been using the term “hotspots” to describes locales and settings in Virginia where COVID-19 has been especially virulent and where issues such as the supply of personal protective equipment remain troubling.

I’ve tried to suggest that these hotspots are actually the defining feature of Virginia’s disease landscape (and probably many other states as well.) Social distancing has been effective in preventing neighborhood to neighborhood spread. But it’s the long-term care facilities (LTCFs), correctional institutions, meat processing plants, and the neighborhoods where front-line workers (often minority) reside that COVID-19 has ravaged.

So while there was not a single hospital reporting concern about personal protective equipment, we continued to see news accounts of shortages among private ambulance companies and workers in several LTCFs.

VHHA announced yesterday that it would utilize resources to which it has access to assist the LTCFs in addressing the conditions that have arisen there. This was a welcome announcement.

4. Hotspots and Reopener Governors

I think that there is a largely unarticulated theory about “hotspots” that the reopener governors have adopted as they loosen restrictions.

In this view, the virus has been largely “contained” within hot spots and so long as social distancing practices remain in effect and is combined with increased testing and tracing, conditions are unlikely to get that bad elsewhere. They believe that a good measure of economic activity can be restored while containment continues.

The major difference between FULL SCALE REOPENERS and more CAUTIOUS REOPENERS is that the latter will adopt a regional and not a statewide approach and will keep tighter restrictions longer on a major metro area such as NOVA.

Public health experts are almost uniformly skeptical about how successful these containment strategies will be. They believe that more case reductions and an effective testing/tracing/isolating regime has to exist prior to a wide scale reopening. But in the vast majority of states, this is an argument that the governors’ concern about the economy has already decided.