Avula: Virginia COVID-19 cases could jump 10X in next week and a half

Richmond/Henrico health department director says Virginians should "be prepared" for an explosive jump in cases.

Published March 27, 2020 by Kate Andrews

Dr. Danny Avula, director of the Henrico County and Richmond health departments, warned Friday, “We need to be prepared that we might have a 10x jump [in the number of COVID-19 cases] in the next week and a half” in the state, which would overwhelm hospitals. Virginia has 604 cases of COVID-19 as of Friday, according to the state health department, so Avula’s estimate could mean as many as 6,000 cases in the state within the next 10 days.

Avula mentioned other states — including Michigan, Illinois and Louisiana — that had positive cases in the 200 range last week and are now seeing thousands of cases. Michigan had 3,657 positive cases Friday; Illinois, 3,026; and Louisiana, 2,746. “The hope is the mitigation efforts that we put into place will slow that, but I also know that those [states] have done similar things,”  Avula said during a Friday evening news conference outside the Richmond Health Department building downtown.

Right now, Central Virginia hospitals have about 40% to 50% ICU beds available, a number Avula expects to dwindle. Personal protective equipment (PPE) like N95 masks and gloves also are needed, although he noted that the state government has placed orders for 1 million surgical masks and 500,000 N95 masks that are expected to arrive next week from the Strategic National Stockpile and other sources.

Enforcement of the governor’s order that businesses like restaurants have no more than 10 people inside has also begun, Avula said. Richmond Health Department inspectors teamed up with Richmond police officers Thursday night to warn businesses in violation. So far, unlike governors in many other states, Gov. Ralph Northam has not issued an explicit shelter-at-home order and restaurants are allowed to provide takeout and delivery services, while following a 10-patron limit for pickup orders.

There’s also a shortage of COVID-19 testing kits, Avula said. After two “pop-up” community tests last week that tested more than 100 people, Avula said his department had to cancel an event planned for this week because they didn’t have enough test kits.

After someone has tested positive for the virus, the recommended protocol is to retest them twice after they’ve appeared to recover, Avula said. After a person has had two negative tests in a 24-hour period, they are considered fully recovered. But that’s impossible due to the lack of kits, Avula said, so his departments now consider recovered patients virus-free if at least seven days have passed without symptoms; they haven’t had a fever for 72 hours; and they’re completely free of all respiratory symptoms. So far, “less than five” patients in his region have recovered, Avula said.

Avula also addressed the major health crisis in his district, an outbreak among residents and staff at Canterbury Rehabilitation and Healthcare Center that has claimed six lives. Four people — among them a woman in her 80s and a man in his 70s — were positive for COVID-19, results confirmed by the Virginia Department of Health. Two other deaths, announced Friday afternoon, are “presumed positive” coronavirus cases. One man who died Friday was tested by a private lab, and VDH has not yet verified the test, Avula said. The second man had symptoms that came on more recently, and Avula said he did not know if test results have come back for the patient. One of the men died at a hospital and the other at the center, he said.

The rehabilitation center, where about 800 people live, announced in a news release that 19 residents and six employees have tested positive, although some of the COVID-19 tests have not yet been confirmed by VDH, Avula said.

Canterbury locked down its facility and has not allowed visitors for two weeks, as have other regional long-term care centers, Avula said. The facilities are screening staff members and keeping nursing homes clean and disinfected, following state and federal health guidelines, he added. Many, however, also are forming “informal networks,” sharing advice and questions, Avula noted.