Three Rivers Pandemic Update: November 1

VACCINE and BOOSTER CLINICS FOR NOVEMBER:

For more clinic locations and to sign up online go to this link: https://www.vdh.virginia.gov/three-rivers/

Pandemic Status: Delta surge slowly improved in Virginia

  • The new case rate in the US stabilized last week; it is currently about 77,000/day 7 day rolling average according to the Johns Hopkins Coronavirus Resource Center.
  • Virginia continued to decline in new case rates; currently we have about 1431/day 7 day average, new cases.
  • Three Rivers case numbers are also slowly improving; we were down to 158 cases across all jurisdictions last week.
  • The current 7 day average number of people hospitalized in Virginia with COVID 19 has declined to 1102.
  • Vaccination rates continue to slowly climb. About 62.9% of the total population in Virginia is fully vaccinated. In Three Rivers, Lancaster County has our highest vaccination rate at 63.4% of the total population fully vaccinated. Richmond County is our least vaccinated jurisdiction at 48.4% of the total population fully vaccinated. Vaccination numbers in Three Rivers are continuing to climb slowly.
  • With all 3 vaccines authorized for booster administration, vaccine doses administered are climbing. VDH data show 31,617 average daily vaccine doses administered across Virginia.
  • Westmoreland, Essex, King and Queen, King William, Lancaster and Mathews counties are in high transmission. Northumberland, Middlesex, and Gloucester counties are in substantial, and Richmond County is in moderate transmission, according to the latest VDH data. A VDH map showing indicators of community transmission can be found here: https://www.vdh.virginia.gov/coronavirus/covid-19-in-virginia/community-transmission/

Everyone age 12 and older is now eligible for vaccination in Virginia. Later this week, children age 5-11 should also be eligible for vaccination. Please visit vaccinate.virginia.gov or call 1-877-VAX-IN-VA to find vaccination opportunities.

Last Friday, the FDA authorized the Pfizer-BioNTech COVID-19 vaccine for emergency use in children 5-11 years old. This vaccine is effective; immune responses of children 5 through 11 years of age were comparable to those of individuals 16 through 25 years of age. In the clinical trials study, the vaccine was 90.7% effective in preventing COVID-19 in children 5 through 11. The vaccine is also safe; the vaccine was studied in approximately 3,100 children age 5 through 11 who received it and no serious side effects have been detected in the ongoing study. We expect the CDC’s Advisory Committee on Immunization Practices to concur when it meets on 2 November, with the CDC Director approving vaccine administration as early as 3 November. We could be able to begin our COVID-19 vaccination program for children age 5-11 later this week.

The CDC released current guidance for COVID-19 safety during the holidays. Vaccination and exposure prevention are critically important to protect ourselves against infection. The CDC holiday guidance can be found here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html

Flu vaccine is now widely available. This flu season is likely to be far more severe than we saw last year. Please get your flu shot this fall. There is no problem getting the flu vaccine and the COVID 19 vaccine at or near the same time. The Three Rivers Health District will be offering flu vaccine at the following venues and times:

  • 11.5.21 – 202 South Church Lane, Tappahannock VA 22560, 10am – Noon
  • 11.12.21 – Newington Baptist Church 6169 Main Street, Gloucester VA 23061, 3pm – 5:30pm

Virus, Vaccine, and Viral Therapeutics Update

  • The COVID 19 virus continues to genetically drift. The Delta variant remains responsible for the vast majority of COVID 19 disease in Virginia.
  • The United Kingdom is currently experiencing a surge in COVID-19 cases, attributable to the Delta variant, which accounts for 99.8% of all cases there. British scientists are investigating a Delta sub-variant, AY.4.2, which accounts for 6% of UK cases at this time. There is some early evidence that the percentage of cases caused by AY.4.2 variant is increasing; at this time it is considered a “variant undergoing investigation”, not a variant of concern. AY.4.2, also known as Delta Plus, has been detected in the United States. At this time there is no evidence that AY.4.2 is able to evade our current vaccines or therapeutics.
  • 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/
  • The COVID 19 vaccines are among the best and safest vaccines ever developed. As with all vaccines and medications, there are potential adverse effects. All the adverse events following vaccination are extremely rare, and the risk of COVID 19 disease far exceeds the risk of any of the adverse events that have been reported.
  • Our vaccines are highly effective in preventing serious disease, hospitalization, and death from COVID 19 infection. According to VDH data, Over 97% of persons hospitalized with COVID 19 are not fully vaccinated. Fully vaccinated people are highly unlikely to experience severe disease, hospitalization, or death from the Delta variant of COVID 19.
  • The COVID 19 vaccines also help prevent COVID 19 disease. VDH data show that unvaccinated people get infected with COVID 19 at many times the rate of fully vaccinated people. Thus far in Virginia, among fully vaccinated people, less than 1% have developed COVID-19 disease. The VDH COVID 19 Cases by Vaccination Status dashboard can be found here: https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/covid-19-cases-by-vaccination-status/
  • The CDC recommends a third (additional) dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine for people with moderately or severely weakened immune systems. Information from the CDC on COVID 19 vaccination for moderately to severely immunocompromised people can be found here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html

The third dose is an additional shot in the primary vaccination series, and is not the same as a booster dose, addressed below.

  • Virginia COVID vaccine providers are now delivering Pfizer, Moderna, and Johnson and Johnson booster vaccinations in accordance with CDC recommendations. On October 21st, the CDC endorsed expansion of booster vaccine recommendations for all three available vaccines in the U.S. For individuals who received a Pfizer-BioNTech or Moderna COVID-19 vaccine, the following groups are eligible for a booster shot at 6 months or more after their initial series:
    • 65 years and older
    • Age 18+ who live in long-term care settings
    • Age 18+ who have underlying medical conditions
    • Age 18+ who work or live in high-risk settings

For people who received the Johnson and Johnson vaccine, booster shots are also recommended for all those who were vaccinated two or more months ago.

  • The CDC recommendations including the ability to “mix and match” with a booster vaccine that is different from the primary series received. Eligible individuals may choose which vaccine they receive as a booster dose. Some people may have a preference for the vaccine type that they originally received and others may prefer to get a different booster. CDC’s recommendations now allow for this type of mix and match dosing for booster shots.
  • Vaccines will remain readily available to all unvaccinated individuals as our highest priority. We recommend COVID 19 vaccination for everyone eligible in the strongest possible terms.
  • Monoclonal antibody (MAB) therapy is readily available in Virginia. Monoclonal antibody therapy is administered in the outpatient setting to COVID 19 positive individuals who are at increased risk for developing serious disease requiring hospitalization.
  • Merck and Ridgeback announced their oral antiviral drug Molnupiravir reduced the risk of hospitalization or death by approximately 50 percent for patients with mild or moderate COVID-19 disease. Merck has applied for FDA Emergency Use Authorization. This could be the first of a powerful new series of medications to further reduce the risk of COVID-19.

Testing, pandemic containment efforts

  1. We have resumed COVID 19 testing in our local health departments in conjunction with our continued vaccination outreach. COVID-19 Rapid Testing and PCR Testing are available through the Three Rivers Health District COVID-19 Testing Team by appointment. Please call your local health department or call 804-815-4191 to schedule an appointment for testing.
  2. The Virginia Department of Health has the ability to purchase some over-the-counter testing resources that do not require an ordering provider. The tests that will be available, based on needs, are listed below. These tests will be paid for by VDH Central Office testing grant funds, and are intended for facility or institutional use:
    1. BinaxNOW Antigen Card Home Test via eMed virtually-guided single antigen test
    2. Quidel QuickView At Home serial antigen test
    3. Ellume COVID-19 Home Test Kit single antigen test
    4. Cue COVID-19 Test Kit single molecular test (requires analyzer)
    5. Lucira CHECK-IT COVID-19 Test single molecular test
  3. Our containment team has resumed full case investigation and contact tracing in accordance with established VDH recommendations.

K-12 Update

  • The Virginia Department of Health (VDH) and Virginia Department of Education (VDOE) have partnered to launch a vendor provided COVID-19 testing program for the 2021 – 2022 school year, Virginia School Screening Testing for Assurance (ViSSTA). The ViSSTA program will be initiated in schools choosing to participate this month. More details are available at the VDH K-12 testing website here: https://www.vdh.virginia.gov/coronavirus/k-12-testing/
  • The ViSSTA testing program, which has great potential to relieve pressure on our COVID 19 testing system, has 3 components:
    • Routine (e.g. weekly) screening testing utilizing PCR testing of cohort or designated groups of students or staff.
    • Virtually-guided at-home/in-school self-test kits (intended for diagnostic testing of persons with symptoms or persons who have been identified as close contacts) using the Abbott BinaxNOW product.
    • Support of school-based community testing events.
  • We have seen COVID 19 transmission in-school and in athletic teams at higher rates with the Delta variant than we saw in January with the Alpha variant. Outbreaks are, however, decreasing. Outbreaks are usually limited to several students; containment measures in the schools are limiting the extent of outbreaks and schools are able to remain open for in-person learning.
  • We will follow each school system closely and be ready to support them in any way we can as the school year proceeds.

Additional useful links

  1. The FDA fact sheets for recipients and caregivers for the Pfizer vaccine can be found here: https://www.fda.gov/media/144414/download
  2. The FDA fact sheet for recipients and caregivers for the Moderna vaccine can be found here: https://www.fda.gov/media/144638/download
  3. The FDA fact sheet for recipients and caregivers for the Johnson and Johnson vaccine can be found here: https://www.fda.gov/media/146305/download
  4. The Virginia Department of Health is maintaining COVID-19 Vaccination Dashboards, which are available here: https://www.vdh.virginia.gov/coronavirus/covid-19-vaccines-received/ and here: https://www.vdh.virginia.gov/coronavirus/covid-19-vaccine-summary/
  5. The VDH COVID 19 outbreak dashboard can be found here: https://www.vdh.virginia.gov/coronavirus/covid-19-data-insights/
  6. Links to useful information about COVID 19 myths and facts:
    1. American Academy of Family Physicians: https://www.aafp.org/dam/AAFP/documents/patient_care/public_health/COVID19-Vaccine-Myths.pdf
    2. CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html
    3. American Association of Medical Colleges: https://www.aamc.org/news-insights/transcript-vaccinevoices-covid-19-vaccine-myths-debunked