Holsworth: May 8, 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.

 

COVID-19 UPDATE:

HOSPITALIZATIONS UP; TEST POSITIVITY DIPS; DEATHS UNABATED; POLICY QUESTIONS IN THE SHADOW OF DEVASTATING JOBS REPORT

1. Hospitalizations Up

The Virginia Hospital and Healthcare Association (VHHA) reported that there were 184 estimated new hospital admissions and 172 discharges yesterday, bringing the number of patients hospitalized from 1613 to 1625.

This is a new high in the number of patients hospitalized with COVID-19. If you’re looking at the 14-day trend, it is an increase of 226 patients since April 24th.

Despite the increase in the number of patients hospitalized, 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: 378 (348-469)
Patients on Vents: 199 (189-303)

In addition, hospitals are not reporting any supply or equipment difficulties.

2. Cases Rise with Slight Growth Decline, Test Positivity Rate Dips Yesterday, No Abatement in Deaths

Total cases rose by 772, from 21,570 to 22,342, a 3.6% day over day statewide increase. The three-day average case increase of slightly less than 700 cases is actually a modest decline from previous highs.

Governor Northam and VDH 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. It dipped yesterday to 11.6%.

COVID-19 deaths increased yesterday from 769 to 812, second largest single day increase since the pandemic came to the Commonwealth. There has been 30+ average deaths for the last 11 days.

3. Virginia’s Uneven Disease Landscape

COVID-19’s impact has been uneven across and within states. Virginia is no exception.

There are several ways of characterizing this here.

-Comparing the three largest metros, the percentage growth in NOVA has been consistently and notably higher in the last few weeks than Hampton Roads and RVA. And exurban locales adjacent to the major NOVA jurisdictions have experienced disease growth.

-Outside of the major metros, the Valley from Harrisonburg north, has been the hardest hit region. Outbreaks in poultry/meat processing facilities, long-term care facilities (LTCF) and jails/prisons have driven the case numbers.

– Selective outbreaks have arisen in multiple rural jurisdictions that have a meat processing plant, a LTCF or a correctional facility.

– There has been a disparate impact among racial minorities. 40% of cases statewide represent individuals who identify as Hispanic or Latino though they represent 10% of Virginia’s population. African-Americans comprise 20% of the state’s population and and have suffered 26% of the deaths.

– In terms of severity, the vast proportion of deaths in Virginia have occurred with individuals over 60. 92% of total deaths have occurred with individuals over 60 and 51% have occurred with individuals over 80.

4. Policy Questions

Here’s a sampling of the questions that the administration will have to answer, in most cases, sooner rather than later.

All these arise in the devastating shadow of the worst monthly jobs report since these were measured.

– At what point does the Governor say that the pandemic is sufficiently under control to ease restrictions? And precisely what restrictions should be eased?

– Should there be a regional approach to enabling economic activities to proceed? One approach for RVA and Hampton Roads and another for NOVA? And even another for the Southwest?

– What kind of testing (diagnostic and/or antibody) and what results would make people more comfortable returning to work and other activities?

– Almost 50% of the jobs nationally in the leisure and hospitality industry have been lost in the past 8 weeks. Regardless of what a Governor does, short of a vaccine, what are the chances that individuals will make choices that would enable these jobs to return?

– Should return to work policies make special exemptions or even requirements for individuals over 60 or would these be a form of ageism?

– What steps need to be taken to prevent a continuation and a repeat of the situations that have occurred in long-term care facilities, correctional institutions and meat processing plants?

– What steps should address the disparate impact of the disease on minority communities?