Three Rivers Pandemic Update: October 11

https://www.vdh.virginia.gov/coronavirus/covid-19-in-virginia/covid-19-in-virginia-locality/

Pandemic Status: Delta surge is improving

  • The new case rate in the US continued to decline last week; it is currently about 94,000/day 7 day rolling average according to the Johns Hopkins Coronavirus Resource Center.
  • Virginia declined slightly in new case rates as well; currently we have about 2690/day 7 day average, new cases.
  • Three Rivers case numbers declined are averaging less than 50/day – improving to 298 cases last week.
  • The current 7 day average number of people hospitalized in Virginia with COVID 19 has declined to 1585.
  • About 68.5% of the total population in Virginia has received at least one dose of vaccine. In Three Rivers, Lancaster County has our highest vaccination rate at 68.2% of the total population with at least one dose. Richmond County is our least vaccinated jurisdiction at 52% of the total population with at least one dose. Over 84% of our Three Rivers residents aged 65+ have received at least one dose of the vaccine. Vaccination numbers in Three Rivers are continuing to climb slowly.
  • VDH data show 11,088 average daily vaccine doses administered across Virginia.
  • All Three Rivers counties remain in high transmission except King and Queen County, which is now one of 2 jurisdictions in Virginia in substantial transmission. 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. Please visit vaccinate.virginia.gov or call 1-877-VAX-IN-VA to find vaccination opportunities.

We have resumed COVID 19 testing 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.

CDC recommendations for Pfizer-BioNTech vaccine boosters are finalized. Virginia COVID vaccine providers have begun delivering Pfizer booster vaccinations in accordance with CDC recommendations. The CDC Statement on ACIP Booster Recommendations may be viewed here: https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html

The CDC issued an urgent health advisory last week to increase COVID-19 vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future to prevent serious illness, deaths, and adverse pregnancy outcomes. CDC strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks. As of September 27, 2021, more than 125,000 laboratory-confirmed COVID-19 cases have been reported in pregnant people, including more than 22,000 hospitalized cases and 161 deaths.

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 our second drive through flu vaccine events (flu vaccine only) this year at the Newington Baptist Church in Gloucester on October 16th from 10AM – 2PM.

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.
  • Variant B.1.621, also known as the Mu variant, was classified by the World Health Organization as a variant of interest on August 30. The Mu variant has a number of mutations that may allow it to escape vaccine immunity and immunity from previous COVID 19 infection. The Mu variant may be able to evade antibodies in a manner similar to the Beta variant, which was first detected in South Africa. The Mu variant is mostly active in South America at this time. It has been detected in most states in the US, including Virginia, but accounts for less than 1 percent of cases currently. It is not considered an immediate threat in the United States.
  • 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 currently 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. 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.

  • The CDC recommends a booster shot of the Pfizer-BioNTech COVID-19 vaccine in certain populations. CDC recommends:
    • People 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer COVID-19 vaccine at least 6 months after their Pfizer primary series.
    • People aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer COVID-19 vaccine at least 6 months after their Pfizer primary series.
    • People aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer COVID-19 vaccine at least 6 months after their Pfizer primary series, based on their individual benefits and risks.
    • People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer COVID-19 vaccine at least 6 months after their Pfizer primary series, based on their individual benefits and risks.
  • At this time, the FDA’s authorization and CDC’s recommendations only apply to these select populations who received the Pfizer vaccine as their primary series. People in the recommended age groups who received the Moderna or J&J/Janssen vaccine will likely need a booster shot. The FDA will consider further data from Moderna and J&J on 14 and 15 October respectively; booster shots are expected to be authorized for these vaccines within several weeks.
  • The FDA is considering Pfizer data on vaccine efficacy among 5-11 year old children. The FDA is expected to meet formally to consider this data on October 26. We may see availability of Pfizer vaccine for 5-11 year olds in November.
  • 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 and is increasing in use. 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 will seek FDA Emergency Use Authorization as soon as possible. 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. Due to increasing case numbers and other reasons, we are experiencing much greater demand for COVID 19 testing. We are receiving reports of difficulty in finding COVID 19 testing opportunities, especially from asymptomatic people looking for testing for travel, post COVID 19 exposure and other reasons. We are offering COVID 19 testing in our local health departments by appointment.
  2. Surging case counts have forced our containment team to prioritize case investigation and contact tracing in accordance with established VDH recommendations. Outbreaks are prioritized for investigation, especially in vulnerable facilities and high risk populations. We are sending letters with isolation and contact instructions to all COVID 19 positive people who we are unable to contact by telephone. With improving case counts, we hope to be able to resume full containment activities soon.

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 are seeing COVID 19 transmission in-school at higher rates with the Delta variant than we saw in January with the Alpha variant. We are currently tracking COVID 19 transmission in the classroom setting in multiple schools, as well as in athletic teams from multiple jurisdictions. We are also seeing much higher spikes in case rates ages 0-18 than we saw in January, reflecting the enhanced ability of the Delta variant to infect children. An encouraging pattern is emerging, however. 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