Update on COVID-19 in Virginia
March 24, 2020
Dear Colleague:
As of today, 290 COVID-19 cases, including six deaths, have been reported to the Virginia Department of Health (VDH). Case information is updated daily on the VDH website. Please note the following updates for this rapidly changing situation:
Evaluation and Testing for COVID-19
- CDC recently released the Coronavirus Self-Checker to help people make decisions about seeking appropriate medical care. This system is not intended for the diagnosis or treatment of COVID-19 or other diseases.
- Despite expanding testing to more private laboratories and increasing capacity at participating laboratories, the demand for testing far exceeds the supply. Public health testing at Virginia’s state laboratory, the Division of Consolidated Laboratory Services (DCLS), is reserved for symptomatic people who meet the recently updated VDH priority investigation criteria.
- To expedite approval for public health testing at DCLS, VDH developed an online COVID-19 Testing Request Form for healthcare personnel (HCP). After submitting the request, HCP will receive an email confirming receipt. VDH staff will monitor this system Monday through Sunday from 9 am to 5 pm and will provide a testing approval decision within three hours for requests received during this period. If the patient is being discharged in the meantime, you may proceed with specimen collection. VDH approval is not required to collect a specimen.
- For COVID-19 testing at DCLS, collect one nasopharyngeal swab in viral transport media. Updated instructions are available on the DCLS website. Do not ship specimens without prior VDH approval.
- For patients being tested at a laboratory other than DCLS, contact the laboratory for details about testing availability and instructions. VDH approval is not required for testing at these labs.
- Regardless of testing status, please provide this VDH patient handout for people with confirmed or suspected COVID-19 who are being discharged. It is critical to instruct all those with suspected or confirmed COVID-19 to stay home, even if symptoms are mild, unless in-person medical evaluation and care are required.
- Virginia’s local health departments do not provide primary care and thus are not equipped to clinically evaluate patients with respiratory symptoms. Please do not refer your patients to a local health department for testing.
- A positive COVID-19 test result from DCLS or another laboratory is considered confirmed for case counting purposes. Confirmatory testing at CDC or another lab will not be performed.
Use and Supply of Personal Protective Equipment (PPE)
- The Virginia Healthcare Emergency Management Program is working with healthcare systems to evaluate, order, and distribute PPE. For shortages, report type of PPE or supply item(s) in shortage, the vendor, and the reason for the reported shortage (allocation, back-order, etc.) to your regional healthcare coalition.
- CDC published updated strategies for optimizing the supply of PPE, including eye protection, isolation gowns, facemasks, and N95 respirators for contingency and crisis strategies.
- On March 14, the Occupational Safety and Health Administration issued Temporary Enforcement Guidance – Healthcare Respiratory Protection Annual Fit-Testing for N95 Filtering Facepieces During the COVID-19 Outbreak. Annual fit testing of N95 respirators is being temporarily suspended to preserve and prioritize the supply.
Return to Work Criteria for HCP with COVID-19 and Mitigating Staffing Shortages
- CDC recently released return-to-work criteria for healthcare workers with confirmed or suspected COVID-19. This guidance describes test- and non-test-based strategies for determining when HCP may return to work. Because of limited testing capacity across the state at this time, the non-test based strategy is recommended. This strategy requires that 1) at least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, 2) at least 7 days have passed since symptoms first appeared.
Stay Healthy
VDH recognizes that this unprecedented pandemic is likely creating stress and anxiety for our residents and responders. We encourage everyone to follow these CDC recommendations to take care of yourself, your friends, and your family and to stay connected with others.
Thank you for all the work you are doing to protect the Commonwealth from COVID-19. For those not working on this response who are willing to volunteer, please register to become a Virginia Medical Reserve Corps volunteer at www.vamrc.org/vvhs or email vamrc@vdh.virginia.gov.
Please continue to visit CDC’s COVID-19 website and VDH’s COVID-19 website for the most current information or contact your local health department if you have questions.
Sincerely,
M. Norman Oliver, MD, MA
State Health Commissioner