Essex County Virginia

05-10-2021 Three Rivers Update

Posted on 05/11/2021

           

Three Rivers Pandemic Update                                                 05/10/2021

 

Pandemic status:  The US continues to improve

  • Case numbers across the United States have improved; the current case rate in the US is about 42,000/day 7 day rolling average.Less than 10 states are reporting increasing case rates.
  • Virginia is improving as well, our new case rate is about 760/day 7 day average.
  • Three Rivers is stable; our new case rate is averaging less than 15 cases/day, 7 day average.
  • Across Virginia, about 47% of the population has received at least one dose of the vaccine. In Three Rivers, about 53% of our population over age 18 has received at least one dose.78.5% of our Three Rivers residents aged 65+ have received at least one dose.

Vaccination Program Update:  Everyone aged 16 and older is now eligible for vaccination in Virginia

NOTE:  16 and 17 year olds can receive the Pfizer vaccine only at this time, and must be accompanied by a parent or guardian and provide proof of age such as a driver’s license or birth certificate.

  • Virginia transitioned to phase 2 on April 18.For details of vaccination phases, please visit this website:https://www.vdh.virginia.gov/covid-19-vaccine/#phase1b
  • Vaccine demand has fallen dramatically; in Three Rivers, our administration capacity is about 5,000 vaccinations a week; currently we are delivering less than 2000 due to decreased demand.
  • Vaccination appointments are available through many sources to anyone who is eligible and desires one.Pharmacies, free clinics, Federally Qualified Health Clinics, medical practices, health care systems, and the Three Rivers Health District continue to offer vaccination appointments.
  • We have established EMS/Health Department collaborative vaccination clinics in local jurisdictions.This week there will be clinics in Essex, Westmoreland, Middlesex, Gloucester, King and Queen, King William, Lancaster, and Richmond counties, at either the health department or EMS facilities.Jurisdictional vaccination data can be reviewed here: https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/
  • The Federal Retail Pharmacy Partnership phase 2 is proceeding in Virginia.Walmart, Rite Aid, Walgreens, CVS, Kroger, Main Street, Mathews, White Stone and Tappahannock pharmacies in or near Three Rivers are delivering vaccinations through the federal retail partnership.Appointments for many of these vaccination opportunities are available through vaccinate.virginia.gov.

Phase 2 progression

  • People eligible for COVID 19 vaccination seeking a vaccination appointment can contact their health care providers for initial consultation. The vaccine is now available in many clinical practice settings.
  • Preregistration is no longer available for vaccination appointments at vaccinate.virginia.gov.In Three Rivers, we are using the new VASE (Vaccine Appointment Scheduling Engine) system, developed by the VDH in recent weeks to establish and manage appointments.Anyone wishing vaccination should visit vaccinate.virginia.gov; a link to Vaccine Finder is on the website, and everyone is able to search for vaccination clinics near them.People can also call 1-877-VAX-IN-VA to get help finding an appointment and registering for one.The call center will prioritize all people eligible in phase 1 and refer them to the districts for appointments as soon as possible.The call center is open from 8AM – 8PM 7 days a week to answer questions and offer appointment assistance.Appointments are available on line through vaccinate.virginia.gov 24/7.
  • With ample supply available statewide, it is no longer necessary for a patient to receive their second doses of a two-dose vaccine from the same provider that administered the first dose, as long as both doses are of the same vaccine brand. Anyone who received a first dose and does not yet have an appointment for the second dose should visit vaccinate.virginia.gov or call 877-VAX-in-VA to make an appointment at any clinic offering the same brand, and should bring their first dose vaccination record with them to the second dose clinic. The two doses of Pfizer-BioNTech vaccine should be given 21 days apart, and the two doses of Moderna vaccine 28 days apart. If that is not possible, the second dose for each vaccine may be scheduled up to 42 days after the first dose.
  • Virginia is placing a great deal of emphasis on equitable distribution of the vaccine, and is working to help reach communities of color to promote vaccine acceptance.
  • Vaccine hesitancy and refusal is a very great challenge; getting to 75% population vaccination levels, which is necessary to ensure herd immunity, will be very difficult, as we are seeing.

Vaccine hesitancy and refusal

  • There are many reasons people are hesitant to receive a COVID 19 vaccination.Some people are distrustful of the government, and do not want to comply with the government recommendation to seek vaccination.Others fear adverse vaccine effects.Some do not believe the COVID 19 virus poses a significant threat to them, and that the pandemic risk has been overblown.Some feel that viral protective measures, including vaccination, are a violation of their individual freedoms and rights.
  • Whatever our experiences and core beliefs are, we owe it to ourselves and others to understand the COVID 19 pandemic and COVID 19 vaccines with as much truth as possible.The COVID 19 virus has demonstrated over and over again that it is highly contagious and is capable of causing extremely serious disease and many hundreds of thousands of deaths.The current situation in India is another graphic demonstration of COVID 19 virus capability.The ability of this virus to genetically drift and potentially resist immunity and therapy is also very concerning.This ability to drift and defeat our defensive measures is perhaps the biggest concern.
  • COVID 19 vaccines have been used in many millions of people.They do not alter our genes at all, nor do they cause COVID 19 disease in anyone who receives them.They do expose our immune systems to factors that will allow us to fight and defeat the COVID 19 virus if we are exposed to it.Any of the COVID 19 vaccines can cause an allergic reaction, but any medication we take is capable of doing this as well.The Johnson and Johnson vaccine has been associated with the extremely rare blood clotting disorder described below; all of us, especially young women of childbearing years, should be aware of this when we choose a COVID 19 vaccine.
  • COVID 19 disease is far, far more dangerous than any of the COVID 19 vaccines.If you have doubts or questions about COVID 19 vaccination, consult with your health care provider to consider the facts they tell you and to make a decision whether or not you will take the vaccine.If you search on the internet, make sure the sources you consult are good ones; the CDC and the World Health Organization are great sources of information.The information available through either of these organizations is based on scientific evidence and best scientific judgement.Other sources, such as universities and major health care organizations (Mayo Clinic for example), are also trustworthy.

Vaccine and virus update

  • All three available vaccine types are available across the Commonwealth.Public health authorities recommend taking the first vaccination opportunity afforded to us regardless of manufacturer; there is no guarantee any of the available vaccines will prevent infection, although evidence is growing that they effectively do so in many people.They are all very effective in preventing serious and critical COVID 19 disease, and can turn a life threatening infection into a much less serious health threat.All available vaccines are probably effective in reducing viral transmission potential in the event of infection as well.
  • The COVID 19 virus continues to genetically drift.
  • The United Kingdom, South African, and Brazilian variants are all in the United States now.All three strains have been detected in Virginia; all have been detected in the Eastern Region. The UK strain is now dominant in the US.
  • Comparable variants with similar mutations have also emerged in California, New York, and other areas of the United States.
  • These strains are more contagious; whether or not they cause more serious disease is being studied.
  • The VDH has established a COVID 19 Variants of Concern Dashboard.The dashboard can be accessed here:https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/variants-of-concern/
  • Vaccine effectiveness against these strains continues to be evaluated; it appears our existing vaccine is very effective against the UK strain.Proceeding with vaccination is strongly recommended for all of us.
  • Wearing more efficient masks, such as the KN-95 mask, or double masking, has emerged as a recommendation to protect against these more contagious strains.
  • We are in a race to vaccinate people as fast as we can to drive case levels down if possible. The higher the case levels in the population, the more opportunity exists for the virus to continue to drift.Protective measures such as masking and social distancing remain very important.
  • Johnson and Johnson vaccine usage in the US has been resumed.The particular kind of blood clot that developed in a small group of younger women, characterized by low platelet counts, is similar to the blood clots seen in a number of patients in Europe with the AstraZeneca vaccine.Both these vaccines use an adenovirus vector as opposed to mRNA.In the US, the clots have been in the cerebral venous sinus.This may be an autoimmune reaction, where antibodies are produced against elements of the blood clotting mechanism.This adverse reaction and complication that may be associated with use of the Johnson and Johnson vaccine is extremely rare; as stated above, the risk of COVID 19 disease is far greater than the risk posed by the vaccine.
  • The following language has been added to the Johnson and Johnson vaccine fact sheet: Blood clots involving blood vessels in the brain, abdomen, and legs along with low levels of platelets (blood cells that help your body stop bleeding), have occurred in some people who have received the Janssen COVID-19 Vaccine. In people who developed these blood clots and low levels of platelets, symptoms began approximately one to two-weeks following vaccination. Most people who developed these blood clots and low levels of platelets were females ages 18 through 49 years. The chance of having this occur is remote. You should seek medical attention right away if you have any of the following symptoms after receiving Janssen COVID-19 Vaccine:
    1. Shortness of breath
    2. Chest pain
    3. Leg swelling
    4. Persistent abdominal pain
    5. Severe or persistent headaches or blurred vision
    6. Easy bruising or tiny blood spots under the skin beyond the site of the injection.
  • Moderna and Pfizer are conducting pediatric clinical trials, and Janssen is conducting a clinical trial in adolescents.Pfizer requested Emergency Use Authorization from the FDA on April 9 to extend use of its vaccine to 12-15 year olds.We may have vaccine availability for 12-15 year olds before the end of this school year.We have started discussions with school officials to explore the potential for offering vaccine before this school year ends.
  • Persons who have had COVID 19 disease can seek vaccination after their isolation period ends, and after their symptoms, including fever, have resolved.
  • After receiving COVID 19 vaccination, public health authorities are recommending we all continue masking, maintaining social distancing and avoiding crowded areas after being vaccinated.
  • The vaccine may not prevent all COVID 19 infections
  • Public health authorities will let us know when it is safe to relax protective measures.This will occur when case numbers in the population fall to very low levels.
  • The CDC has published Interim Public Health Recommendations for Fully Vaccinated People; those recommendations can be found here:https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

How to volunteer with the Three Rivers Health District

  • The Medical Reserve Corps (MRC), our volunteers, are absolutely critical to our efforts at all times.We are extremely grateful for our volunteers, we could not carry on this pandemic mitigation effort without them.
  • If you are interested in becoming an MRC volunteer, or have family or friends that are interested, please visit www.vamrc.org to learn more.
  • If you have questions about the process, please reach out to the Three Rivers Medical Reserve Corps Coordinator at 804-758-2381. We welcome your help and participation in the fight against COVID 19.

 

Testing, pandemic containment efforts

  • Community testing and testing in response to vulnerable facility outbreaks can be requested by facilities and jurisdictions by using commercial firms on contract with the Commonwealth of Virginia or the Virginia National Guard.
  • Continued testing will remain very important in the coming months.
  • Our containment team is investigating all new cases with contact tracing of all high risk exposures; this capability is completely intact.
  • Our Executive Order Compliance team continues with full capability and activity.
    1. Sixth Amended Executive Order 72 is currently in effect, and Seventh Amended Executive Order 72 will further relax mitigation requirements on May 15. Governor Northam plans to remove the remaining mitigation requirements on June 15, if case rates continue to fall and vaccinations continue to increase. Mask requirements will be evaluated separately. The CDC updated its guidance on April 28 about what people can do when they are fully vaccinated (which occurs two weeks after their final vaccine dose). The new guidance no longer calls for people who are fully vaccinated to wear masks outdoors unless they are in crowded settings. Governor Northam amended Executive Order 72 on April 29 to align the mask requirements with the CDC guidance.
    2. The CDC revised guidance for fully vaccinated persons can be reviewed here:https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

 

K-12 School Status:  Return to in-person learning continues to be successful

  • The CDC published comprehensive K-12 school guidance based on latest evidence concerning viral transmission in children and adolescents and on the experience base gained during school operations over the past year.The guidance, which facilitates return to in-person learning, leverages the protective measures we have had in place all year and is tied to levels of community transmission.The guidance stipulates universal and correct use of masks, maintaining at least 3 feet of physical distancing, handwashing and respiratory etiquette, cleaning and maintaining healthy facilities, and maintaining effective case investigation/contact tracing in cooperation with local health departments.The detailed CDC school guidance can be found here:https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html
  • The VDH and VDOE have also revised guidance concerning school operations.The VDH/VDOE language emphasizes the benefit of 6 feet as standard practice, but accepts 3-6 feet of social distancing with masking if 6 feet cannot be maintained with a full return to in person learning, at all levels of community transmission.
  • The VDH is piloting a COVID 19 school testing program this spring, to enhance safety and confidence for in-person school attendance.This program may expand in the fall.
  • Sports teams are an area of interest and higher risk; since high school sports began in the spring term, several outbreaks involving sports teams have occurred. We will cooperate with schools in case identification, contact tracing and quarantine activities to help mitigate the effects of sports related outbreaks.

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