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In a first since January, Virginia records more than 4,000 new cases for second consecutive day as start of Labor Day weekend
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In a first since January, Virginia records more than 4,000 new cases for second consecutive day as start of Labor Day weekend

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Dr. Danny Avula talks about rising COVID infections in kids

In a first since late January, more than 4,000 Virginians have tested positive for the coronavirus in back-to-back days, right before Labor Day weekend.

Thursday saw a seven-month high of 4,255 new infections. On Friday, the Virginia Department of Health reported 4,070.

Virginia hasn’t reached the levels seen during the height of the winter surge, when the state was averaging 6,142 cases per day and about 3,200 COVID patients. But the number of people infected statewide is already more than triple the figures VDH recorded this time last year. In August and September of 2020, the highest single-day increase in cases was 2,015.

Nearly every day this past month exceeded that.

But why is this happening a year later, when Virginia has administered over 10 million COVID doses and 57% of the state is fully vaccinated?

Simply put, these percentages aren’t enough to beat an evolving virus.

The hyper-contagious delta variant has helped facilitate the unconstrained spread, now accounting for 47% of cases caused by a COVID strain. Though the state lab tests only a fraction of positive testing samples, Dr. Danny Avula, the state’s vaccine coordinator, estimates the actual number is likely upward of 90%.

“The bulk of our population will likely be exposed to the delta variants at some point in the next few months,” Avula said in an August briefing. “They’re either going to be exposed to it fully vaccinated or they’re not.”

And unlike in 2020, schools are reopened, there are fewer restrictions and more residents are congregating in crowded spaces. Nationally, there’s an influx of people traveling despite the Centers for Disease Control and Prevention advising people not to travel this Labor Day weekend — especially if unvaccinated.

For domestic travel within the U.S., where all 50 states are facing high levels of community transmission, proof of vaccination or a negative COVID test is not required to fly. Face coverings, however, are mandated on any form of public transportation.

Roughly 1.9 million passengers boarded flights on Thursday, which is more than double the number on the same day last year, according to Transportation Security Administration. This figure is also higher than the numbers recorded over Thanksgiving, Christmas and New Year’s Eve — three holidays that partially fueled the spike in January.

Virginia is currently averaging more infections than the week after Thanksgiving, but hospitalizations have lagged slightly behind — a fact health officials have chalked up to increased vaccinations.

Dr. Michael Stevens, interim hospital epidemiologist at VCU Health, urged Virginians on Friday to mask up for the holiday weekend regardless of vaccination status, noting that although the vaccine protects against severe illness — “if your immune system is working the way it’s supposed to” — being infected is still a possibility.

“The real danger is that you could transmit it to somebody else,” Stevens said in a statement. “And masking will help reduce the likelihood you’re going to transmit it to other people.”

COVID cases post-vaccine aren’t proof the vaccines are failing, and getting sick doesn’t remove the protection against the virus. Instead, Avula said, the infection would likely reinforce defenses previously built up.

The damage continues to be far worse, and much more dangerous, for those who haven’t received a single dose.

VDH data updated Friday shows that the gap between unvaccinated residents and those who have received all their recommended doses is widening. While there are infections yet to be reported, Virginians who haven’t had a vaccine were 13 times more likely to be infected than fully vaccinated people in the week ending on Aug. 21.

Case rates among fully vaccinated people are beginning to drop once again after delta variant spread caused a slight bump in late July and early August.

But there are limitations to this data. While the amount of people seeking out diagnostic COVID tests has nearly doubled in the past month to around 157,000 per week, that’s less than 2% of the state population.

Virginia was testing more than 300,000 people at the peak of the winter surge in January, but as cases slowed early summer, testing efforts scaled back. Avula acknowledged in an interview this week that the testing infrastructure is “feeling the strain of ... more people concerned about whether they have COVID or not.”

Health care providers and pharmacies are reporting that the increased demand has stunted the ability to provide the level of same-day testing available a few months ago. Last week, Henrico-based lab company said testing has gone up 75% from low points in the spring. Across Patient First’s nine medical centers in the Richmond area, there’s been such a significant jump in patients that visit times are longer than usual.

Avula said this has ratcheted up the use of at-home testing, which he recommends if there aren’t appointments for in-person testing.

“[Testing] will only become more of an issue, so health departments are certainly continuing to offer testing, and then we’re working with other institutions and schools to be able to contract with testing vendors to meet some of that demand,” Avula said. “Especially in places that are requiring vaccinations or providing the option ... of weekly testing.”

But results from at-home tests aren’t included in VDH’s case count unless an individual is part of a contact tracing investigation or reports the infection to a primary care provider.

According to VDH, the health agency interviewed only a quarter of cases reported the week of Aug. 26. Barely half had a known source of exposure.

The health department noted that people not responding or giving incorrect contact information compounded with high case volumes could prompt localities to prioritize specific groups for follow-ups such as those tied to outbreaks.

As of Friday, 34 out of the 48 outbreaks in progress — or 71% — are among day cares, K-12 schools, camps or universities.

K-12 schools account for the greatest chunk with 17 outbreaks, which have at least 149 cases linked to them. Daycares or pre-K settings have the second-most with 13 outbreaks in progress and at least 95 infections.

And by next Wednesday, all of Richmond-area public schools will be back in classrooms for in-person learning.

The VDH site updated weekly on Fridays emphasizes that “the presence of an outbreak at a school does not reflect a school’s ability to educate its students or to protect the health and safety of its school community.”

But the dashboard — like the tally of cases statewide — is an undercount of what’s truly happening.

VDH lists Chesterfield County, which started school Aug. 23, as having one outbreak with five cases and Amherst County Public Schools as having 45 infections. On Thursday, Amherst moved to close all of its schools through Sept. 13 after identifying close to 200 cases. Chesterfield’s school system has documented over 230 cases among students and staff.

ACPS has 4,045 enrolled students in the fall of 2020, according to the latest update from the Virginia Department of Education. CCPS has almost 61,000.

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