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A year of COVID-19: Successes and failures in Virginia's response to the novel coronavirus

A year of COVID-19: Successes and failures in Virginia's response to the novel coronavirus

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Gov. Northam on the state's efforts regarding health equity

Just over 600,000 Virginians — about 1 in every 14 — have contracted COVID-19, and more than 10,000 have died after being infected with the virus.

In a year of grim loss and a once-in-a-lifetime crisis, those numbers reflect a state, led by the nation’s only doctor governor, that has fared better than most in rates of infection and death in a country ravaged by COVID-19.

But the state’s response wasn’t without significant shortcomings, and a look back shows a lack of preparation and swift action left the state vulnerable at critical junctures.

In the beginning, a lack of coordination with private testing vendors stunted the state’s ability to test enough Virginians for the virus, which left the state in the dark about its spread and to deadly consequences at several of the state’s nursing homes.

Throughout the year, the state faced criticism from the business community over restrictions that it thought changed too suddenly, and without much clarity. Virginians left jobless by businesses that shut down or downsized were left to deal with an unemployment insurance agency that struggled to staff up.

More recently, the state stumbled as it began to distribute vaccines at a slower rate than any of its neighbors and almost every other state — despite months of planning. That came at the detriment and to the frustration of vulnerable Virginians — particularly the elderly and non-English-speaking residents.

For all of its challenges, the state had some successes. Last summer, Virginia became the first state to issue regulations for businesses meant to protect workers — particularly those who couldn’t work remotely.

And while Virginia’s hospitals faced significant strain due to the virus, the state was spared the kinds of scenes broadcast from states like New York and Texas, where ventilators were severely rationed, patients were treated in parking lots, and bodies piled up outside.

Virginia never deployed its plans for overflow hospital sites, including one for Richmond’s convention center downtown.

The death rate here, 12 for every 10,000 people, is the 14th-lowest — below the national average of 16 per 10,000.

“If you compare us to other states, I mean the number of cases and number of deaths is actually lower than a lot of others,” Gov. Ralph Northam said in an interview, thanking state officials and staff.

“Day in and day out for a year, we’ve been fighting this, looking at the data and doing what we think is in the best interest of Virginia. That’s something I’m proud of.”

Testing troubles

Twice in the pandemic, Virginia found itself ranked near the bottom in its fight against the virus, compared with other states.

Through mid-April and early May, Virginia was testing a smaller share of its population than any other state — leaving state and local officials in the dark about how quickly and where the virus was spreading. That happened as other states secured contracts with private providers across the country to boost their testing efforts, even with companies here in Virginia.

In an effort to bump up its ranking, Virginia began to mix in the results of new antibody tests — tests for past infections — rightly suspecting other states were doing the same, the Richmond Times-Dispatch first reported. The inclusion of those tests only slightly altered the view of the virus’s spread in Virginia at the time, but attracted criticism from health experts and threw into question the integrity of the administration’s data.

Eventually, the state hired an outside expert to help secure tests from private companies and hospitals, and deployed the Virginia National Guard to boost its manpower — increasing the number of tests.

History repeated itself at the start of this year, when Virginia’s lackluster vaccine rollout shoved the state to the bottom of national distribution rankings.

A month after the first doses arrived here, data from the Centers for Disease Control and Prevention showed that of all states, Virginia had distributed the smallest share of the vaccines it had received. The struggles challenged statements by Northam that Virginia’s vaccine distribution would be limited only by federal supply.

Northam’s chief of staff, Clark Mercer, said in a recent interview that the rankings sent the administration into a frenzy to figure out why. Hospitals, in part due to lack of guidance from the state, were storing second doses they wouldn’t need for weeks. A federal partnership with CVS and Walgreens to vaccinate nursing home residents got off to a slow start, and was requesting new doses of the vaccine at a faster rate than it was delivering them.

Furthermore, the state’s data reporting to the CDC was delayed by one to two days. The state was sending its data too late in the day, missing the CDC’s tallying for the day.

“I bought a Starbucks gift card for the staffer who had to get up at 4 a.m. and do that,” Mercer said.

“I had a dry erase board in our war room, and put our ranking up on the dry erase board. ... And we went from 49 to sixth in like two weeks.”

Even as Virginia’s ranking improved, it took a few more weeks for the state to deploy a statewide system for residents to register for vaccines — replacing a patchwork of local registration websites two months after the first doses arrived. It took that long, too, for the state to staff up its call center to help technology-challenged Virginians and those needing language assistance.

Virginia now ranks 10th among states, having administered 83% of the vaccines it has received. One in 5 Virginians have received at least one dose of the COVID-19 vaccine. About 1 in 8 are fully vaccinated.

Encouragement or enforcement?

In April of last year, a video surfaced showing a Black man being removed from a Philadelphia city bus for not complying with a local rule requiring masks on public transit.

The video had an impact on Northam’s approach to the state’s public restrictions, which relied heavily on personal conviction and decidedly less on enforcement.

“He showed it around to a number of staff, and he’s like, ‘That is not going to happen in Virginia,’” Mercer said. “That is not something that we’re going to allow to happen.”

That approach was cemented after protesters in Richmond decried police brutality against Black people, and the state’s law enforcement arm weathered criticism for its interactions with protesters.

The administration was open to civil citations in egregious cases, but until recently only had the power to seek misdemeanor charges for serious violations. Another factor, Mercer added, was that “the police didn’t want to do it.” (In October, Northam signed legislation that took effect March 1 granting the administration the authority to levy civil fines of up to $500 for violation of an emergency order.)

Early on, the approach prompted some criticism from Virginians worried about rules with no teeth at a time of fear and uncertainty. But the loudest critics, from the conservative right, said the state’s public restrictions at times violated people’s civil rights, were overly zealous or were not backed up by data. Car rallies in Richmond resounded with protests of Northam’s restrictions.

Business groups, too, complained that restrictions were so heavy-handed that they would strangle the state’s economy. Virginia faced significant criticism from the retail and hospitality industries for tightening or broadening business restrictions with little notice and at-times confusing guidance.

“There was a point in time last summer when I called the administration because I was trying to explain to them how much businesses needed to plan. They would change their mind week to week,” said Sen. Siobhan Dunnavant, R-Henrico.

“I’ll never forget how many restaurants thought they would be able to reopen inside, but then the news came out that they would only be able to open outside. And in Richmond where that space is more limited, many had food to throw out.”

Dunnavant said there weren’t clear metrics that businesses could follow to anticipate changes in restrictions. Similarly, she said, the Northam administration’s decision last summer to let many school districts hold classes 100% virtually was wrong and was not explained by data. The administration disputes this, arguing that not enough was understood about the virus’s spread in schools.

“As every person tried to digest the information they could get their hands on, there was much more anxiety than there needed to be,” said Dunnavant, an obstetrician and gynecologist. “I felt very, just shocked that it was so hard to find meaningful data and apply it.”

Data infrastructure

Virginia Health Commissioner Norman Oliver recalled in an interview at least daily meetings among high-ranking administration officials to decide on a course of action based on a limited view of a novel virus. He said his own public health advice to the administration tended to be more cautious than what Northam’s restrictions bore out.

Oliver, however, acknowledged that the pandemic revealed “how horribly under-resourced [the state’s] data-handling infrastructure is.”

As an example, he recalled demands from lawmakers, analysts and the news media for ZIP code-level COVID-19 data — a heavy lift for the Virginia Department of Health.

“The team that would have to do that would have to spend ... working day and night over three or four days to probably do that. Well guess what? These are the same people who do the daily webpages with all our other metrics. And so things got behind on that,” Oliver said.

“You can’t stand up at a news conference and say, ‘I only have four people working on this.’ But that was the truth.”

Oliver said the pandemic has forced changes at the agency. He recently named the first director of public health informatics, and said he will continue to advocate for increased funding to strengthen the VDH’s data systems.


The pandemic made Virginia’s disparities painfully clear. Low-income Virginians, Virginians of color and those at that intersection were more likely to contract COVID-19 and more likely to die of the disease. Early on, they were less likely to have access to testing, and later, less likely to access vaccines.

Pressed on the issue, state officials have said the novel coronavirus exploited existing, systemic disparities in Virginia and elsewhere, like inequitable access to health care and transportation. Virginians of color were also more likely to hold front-line jobs without the ability to work remotely, and thus face exposure to COVID-19.

“The fact that the African American and Latinx communities have been disproportionately affected by the burden of COVID-19 ought to be a real motivator for us to ensure that we go all out to ensure that they get vaccinated,” Oliver said.

“I do think this administration has actually put more attention and resources to this than many, many other states. But I think we have a long way to go to achieve what we want to achieve.”

The pandemic also pushed many Virginians already struggling to make ends meet to their financial brink. Virginians relying on unemployment benefits were served by an agency that struggled to handle a massive surge of claims.

“They were out of work and they just could not get through. It was a genuine challenge to staff up quickly,” said Phil Hernandez, a policy expert with the Commonwealth Institute, a progressive think tank. “I think it had an impact on people accessing benefits and contesting claims — all of that was slowed down because [the agency] didn’t have the bandwidth.”

Hernandez praised decisions by the state at the start of the pandemic to waive the one-week waiting period for people to receive their unemployment benefit checks, and to waive a requirement that applicants show proof they were actively seeking other work.

He added, however, that government officials should make sure the program can function efficiently when an emergency arises, and that much of the backlog seen during the pandemic was the result of “neglect.”

“We can’t always think of unemployment insurance systems when the house is on fire,” Hernandez said. “We need to invest in systems that work and that can be nimble when we need them.”

Language barriers

Access to information and resources has also been a shortcoming of the state’s response to the novel coronavirus.

In April, near the start of the pandemic, The Times-Dispatch reported on the struggles of non-English-speaking Virginians in trying to access information about the state’s health guidelines. Nearly a year later, the newspaper reported on the use of Google Translate by the state’s health agency to translate vaccine information to Spanish and the weekslong delay to establish a hotline to help people who don’t speak English or Spanish register for a vaccine.

Sookyung Oh, the Virginia director of the National Korean American Service and Education Consortium, said the state has been slow to address language barriers. Oh said her group has worked with several state agencies to ensure people who don’t speak English or Spanish can access information and resources, including the Virginia Employment Commission and the Department of Housing and Community Development.

One of their requests is that the state translate its unemployment insurance form into the languages most requested by the constituents they serve, which includes Arabic and Korean.

“We started talking to them last April about all of the ways non-English and non-Spanish speakers do not have equal access to the programs administered by the VEC,” Oh said. “State agencies are receiving federal funding. They should offer equal access.”

About 12% of the state’s population was born outside of the U.S.

She said one small victory was adding a third option to several agency hotlines that simply had “press 1 for English, 2 for Spanish.” The third option allows users to request translation services in another language. “We just thought, ‘Wow. What about everyone else in Virginia?’”

Personal toll

As Virginia enters the second year of the pandemic, Mercer and Oliver emphasized the significant, personal toll of the last year on the state’s workforce — particularly at the agencies leading the response to the virus.

At the governor’s office, the pandemic followed a year of controversy for Northam, who nearly left office in 2019 after disclosure of a racist photo on his medical school yearbook page.

Mercer recalled that weeks before the virus threatened Virginia, he had urged his staff to make a final give-it-your-all sprint to complete Northam’s signature budget — the only one his administration would craft and implement. (Virginia governors cannot serve consecutive terms, and they prepare one new two-year budget during their tenure.)

Then, the virus figuratively tore it to shreds, sending staff back to the drawing board.

“I just saw the faces of the staff. We had been through a lot together, and it was like, yeah, this is nowhere near over,” Mercer said.

Oliver said the staff members at the VDH — many of whom had rarely faced pressure from the public or the press before the pandemic — are in many ways depleted.

He said the agency launched a portal with wellness resources for staff, including psychological support.

Oliver, who has spent much of his tenure atop the VDH commuting between his home in Charlottesville and a place in Richmond, said the fight against COVID-19 has drained him, too.

“I do feel tired,” he said, speaking from his driveway, having just arrived in Charlottesville. “I’m completely whipped. People have been going 24/7 since January of last year. Some of us have reached a breaking point.” 649-6254

Twitter: @MelLeonor_


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