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Surge in cases continues

COVID-19 data was nothing short of jaw-dropping this week, with humongous jumps in virus numbers reported both locally and statewide, but Piedmont Health District Director Dr. H. Robert Nash warns these latest numbers may be a bit misleading.

The Virginia Department of Health (VDH) this week was reporting an eye-widening 214 new coronavirus cases out of Prince Edward County between last Monday, Jan. 11, and this Monday, Jan. 18.

The other counties in the health district saw similar leaps. On Monday, Charlotte County was up 97 cases. Lunenburg rose 54 cases, and Buckingham was listed as having seen 127 new cases in the week. Cumberland was up 36 cases.

And although the state has been reporting record highs in COVID-19 cases each week for over a month now, numbers skyrocketed Sunday, Jan. 17, to reflect a staggering reported case record for the day at 9,914 reported cases for Virginia.

The numbers shocked many across the commonwealth. Nash offered an explanation on Monday that may clarify the sudden surges.

According to Nash, all COVID-19 testing sites across the state send their available test results electronically to the health department’s central office in Richmond, at which point health district officials must investigate each positive case assigned to the district to verify that those cases are indeed from the localities they are assigned to.

Nash said the health department often has to transfer many of these positive cases to the appropriate district or county, as they sometimes come in mislabeled.

“A lot of folks don’t know the difference between Prince Edward, Prince William and Prince George,” he provided as an example.

Nash said that as of Friday morning, Jan. 15, Richmond began to auto-populate case data with its electronic positive test results to be immediately posted online before being screened at the county or district level, bypassing much of the identifying data that goes along with those numbers.

Nash said numbers reported over the weekend may be “erroneously elevated” due to not yet being screened by the local epidemiology team and then vetted and appropriately accepted in their respective district/counties or transferred over the county in which they do belong.

“A good number of those cases could belong to other districts and other counties,” he explained.

Nash said it’s not uncommon to see dips in data graphs where it is apparent some case numbers after review have been removed from a county and transferred to the appropriate locality.

He said he suspects a number of positive cases will be removed in the coming week after numbers have been vetted.

Nash added as the same phenomenon may be going on with case records, it’s important that residents take the latest figures with a grain of salt.

“It appears as though we’re in an increase. It appears as though we’re in a surge. The actual validity of the magnitude of the numbers, we really have to take it with a grain of salt right now, because we need to verify those numbers. They’ve not been reviewed on a case-by-case basis right now. The trends? We can believe in the trends. I mean, there are increasing numbers of cases.”

With the start of Phase 1b of vaccinations only a day away, Nash said Monday the health department was eager to get going, providing some further insight as to how the process is evolving.

Nash said that on Tuesday the health district will begin implementing its POD (point of distribution) vaccine clinics.

The health district, he said, will be running closed PODs in which appointments are made for specific individuals who have already filled out their paperwork and had their medical history reviewed to come in and receive their first dose of the vaccine.

Nash said right now the health district is completely restricted to performing the vaccinations at the health department locations, which is mostly the result of strict vaccine handling requirements.

He said vaccinators have only six hours after thawing the vials of vaccine to use all 10 doses held within each vial. Therefore, the health department is scheduling its clinics in blocks of 10 individuals. The department does two clinics at a time for a total of 20 people, as only two nurses on hand can dispense the vaccine. Twenty vaccines are distributed in the morning and 20 in the afternoon.

Nash highlighted the health department unfortunately is currently very limited by the number of providers who can administer the vaccine.

However, he said the department is developing plans to dramatically quicken the pace. According to Nash, the health department can contract with up to 25 outside doctor’s offices and independent pharmacies authorized to administer the vaccine, which the department can distribute to them directly.

He said the health department currently has four completed contract agreements and 15 pending for distribution partners, a good number of which will be coming on board within the next week or two.

Additionally, Nash said Longwood student health and nursing faculty have also completed their training to serve as community partners authorized for the administration of the vaccine, and officials are diligently working with Longwood to get their 70 student nurses trained and certified to administer doses.

He added this will also help alleviate a backup currently being experienced in vaccine scheduling.

Nash said that on Wednesday United States Secretary of Health and Human Services Alex Azar instructed Phase 1b of vaccine distribution had to be expanded to include those 65-and- over rather than the previously-indicated 75-and-over rule.

Nash said many members of that large 65-and-over group call the health department asking to arrange for a vaccination only to be told clinics are fully booked through March.

He said with the addition of help from Longwood and those 19-25 credentialed distribution sites, appointments should begin to open up quickly.

He added nursing students will be very helpful in the future when a drive-thru POD is able to be implemented.

“At that point we’ll probably be vaccinating over 1,000 (people) a day,” he said.

Nash said it’s important to remember the health department’s understanding of the virus is still growing, and directives should be expected to change.

He said while he understands everyone’s eager to receive their vaccine doses, it may take a few more weeks to get the community saturated with providers.

He added while officials don’t know how long immunity will last following inoculation, it will take seven to eight weeks before someone who has received both doses reaches clinical immunity.