Data from the Virginia Department of Health:
They have redesigned their dashboard so it’s easier to follow. One of the most important features is the track feature that outlines hospitals and deaths, which shows that we have a downward slope to the peak.
I’m not sure if those numbers are percentages or total numbers, and that is very important to control the numbers of total cases, to show which is a more important figure.
We want to be able to see the data and track it in a reasonable way.
Next is the testing variable; I have been frustrated with testing, and I support testing those who have been symptomatic or who have had exposure. There seems to be a bit of disorganization in this process. I made a phone call this morning, and there’s some more work to do.
A few things are happening:
We are able to do more tests more easily because the CDC is about to announce an at-home test that meets the criteria that they support and recommend.
This makes it easier for individuals to get tested because they don't have to go somewhere. It decreases the amount of PPE needed to do testing. This has been an enormous challenge, and this removes one of the barriers to robust testing in Virginia. This also impacts swabs: Virginia received 200,000 swabs on Monday. We will receive another 40,000 per week.
A third challenge is throughput. Once you have the test, one of the challenges is deciding who runs it, and dealing with the timeframe to hear back. This is where Virginia needs to stretch, and we have the opportunity to fix this. We have a lot of private entities that have the capacity to do rapid testing. I have spent the past many weeks connecting different organizations to the state. These medical entities need the economic stimulus. Also, the state doesn’t have the ability to process these tests as quickly. There are only so many tests that the state can evaluate.
If we can combine this public and private partnership to test more people, to ensure the tests are high quality, and ensure that the tests are done quickly, we can change the trajectory for testing.
The final question deals with what the tests should be used for. No one’s quite answered that question; right now, we are testing those who may be symptomatic, and those who need treatment. Testing everyone with or without symptoms doesn’t really add value to how we can care for people. We need some clear direction about how the tests are going to be helpful. How does knowing who has antibodies and who doesn’t help us resolve this issue for contact tracing?
We need more people doing tests, we need a clear algorithm for who gets tests and how we use that information, and we need contact tracing.
We have resources available to handle contact tracing. This is going to start at the local level, and I’ve been in touch with localities, and we are putting together resources to help. We are putting together a way to put together an army to handle contact tracing in Henrico and Hanover counties. I am also going to challenge the state to blow this open; there are furloughed healthcare workers, retired individuals, and others who are willing to fill that need.
I will be requesting funding this week for the public/private partnerships throughput, determining the algorithm, and building an army for contact tracing.
There have also been some questions about a special session of the General Assembly, so there are two branches of government working to bring about results. The conversations that happen when two branches of government are working provide better results.
What are your thoughts on the decision out of Lynchburg regarding indoor shooting ranges? What are your thoughts on the statement made by AG Barr regarding constitutional rights?
This includes our third branch of government: the courts. We use the third arm of government to have conversations about these types of issues. If you feel that you have an issue with how these issues are playing out, there are avenues. That is happening with Gold’s Gym, they believe they should be open. The arm of government I have a say in is the legislature and I am working to get a special session; we weren’t able to get ⅔ when we were there last week.
What about Executive Order 55?
There have been some assertions made about staying at home. There is no shelter in place, you will not be penalized for leaving your home. There is no misdemeanor consequence. Article 1 of Executive Order 55 speaks about the stay at home order, and what those recommendations are. At the end of the document, it outlines that violations of articles 2-5 count as a class one misdemeanor. Therefore, stay at home is not a misdemeanor. You can find Executive Order 55 HERE.
What about the VDH overhaul?
I suspect the changes in cited tests were just an issue of a backlog. We’ll send that question out to them to try and get a more precise answer.
Can you disclose the true facts of this virus, instead of political conversation? I don’t feel as though the press is putting forward genuine information to the public. What actually is COVID-19?
COVID-19 is an unusual cold virus, a coronavirus. This particular cold virus has a unique potential to give someone an inflammatory respiratory response called SARS. There are a couple of other coronaviruses that do this too, but they are much more deadly if there is a coronavirus that is linked to the SARS consequence. COVID is an abbreviation for that virus, and 19 was put on it because that’s the year where it came up, and that was the designation that it was given.
If you’d like to resend a specific question looking for particular facts, I will do everything I can to get them to you. All data is burdened by how that data is collected; data isn’t perfect.
When getting data, you must trust but verify. All information needs to be verified. Historically, the press was relied upon for being factual because all their information was verified by two or three sources before publishing. There have been some challenges in that, there have been some decreases in the confidence in the press, but it is our job to be skeptical. In medicine, studies have to be well-constructed, they need to be verified so that they are duplicated to see if we get the same results, and they need to be peer reviewed.
If you have questions, please feel free to email me at firstname.lastname@example.org, and we will work hard to get you a factual answer.
I’ve heard that several small restaurants are opening up, how will that be dealt with? Is it considered illegal?
I will find out, but as far as I know right now, gatherings of more than 10 are not allowed, but I will get back to you with an answer about restaurants because the restrictions have been changed over time. I hear the rumor mill too, but I will get back to you.
Are resources being provided for mental healthcare?
Yes, they are. Approval for Medicaid now is available, many things that were not covered before are covered now. Access to mental health may be easier now through telemedicine.
Is it the state’s responsibility to get adequate testing resources in place?
This is how this works: the localities are enacting help at the local level. The state is the coordinator of all that, and the federal government supports that. However, this is very much a states and localities driven initiative. That is how we are governed always, and that is how things are being implemented for this emergency.
As a doctor, are you working on a resource of accurate testing providers?
That is the realm of the CDC and the FDA, and they are. They’re looking at the tests that have to be accurate, and what they’re tracking now is not having FDA approved tests. What they have is emergency approval and tests are being done to see if these tests are accurate, with specificity and sensitivity.
Have there been any updates on what we can be doing at home to ready our immune systems?
I believe you should be exercising, and getting vitamins C and D. I am a big advocate of exercise, get outside now while the weather is nicer. Keep your surfaces clean.
What will the tracer jobs be like? Why didn’t we have a mandatory mask order?
I don’t know why there was no mask order, but I do know that the CDC came out in early April and suggested everyone wear a mask. I do believe in freedom to make good decisions, so I don’t like the government mandating we do anything. I hope asking is enough, and we all show personal responsibility to do that.
Do you have accurate numbers on who in Virginia has recovered from the virus? Those numbers seem hard to find.
The reason they may be hard to find is because we don’t know how many people had the virus. We do know how many people were discharged from the hospital. Having an algorithm is so important for determining who needs hospital care. I think people are too hungry for testing, but testing should be used prudently and with follow through.
Do you have more specific data regarding risk factors in individuals who have required hospitalization, or that resulted in death from COVID? Can the data help guide the isolation recommendations moving forward?
I understand we are working to get that data. That is the comorbidity data that we are looking for. It took us a long time to get age-related data, especially related to death. I have not seen any sources of data that have comorbidity relations to the deaths.