Virginia is ‘pivoting away’ from field hospitals

Dr. Danny Avula of Richmond/Henrico health departments says hospitals likely can handle coming surge.

Published April 17, 2020 by Kate Andrews

Virginia is “pivoting away” from needing field hospitals to handle patient overflow because health systems believe they’ll be able to manage any surge in COVID-19 cases, said Dr. Danny Avula, the director of Richmond and Henrico County’s health departments, Friday evening.

“We have not seen any significant increase in hospitalization [and] ventilator use is under 25%,” Avula said during a news briefing. “It feels like the calm before the storm, and hopefully the storm will never come.”

Examining the University of Virginia’s COVID-19 forecasting model, Avula said, Virginia seems likely to have a “lower but longer curve,” although he said the peak may be sooner than the August timeframe predicted by the U.Va. Biocomplexity Institute. Testing availability is continuing to expand, Avula said, and it’s possible that antibody testing allowing doctors to determine if a patient has recovered from COVID-19 will be available in Virginia within the next month.

Avula attributes the relative calmness of Virginia’s coronavirus curve to people staying at home and following Gov. Ralph Northam’s social distancing orders. As for the state’s three planned field hospitals — announced for the Hampton and Richmond convention centers and the Dulles Expo Center in Loudoun County, Avula said, “We’ve actually started to pivot away from those. There may never be a need for that significant of a build-out.”

Instead, he said, by using areas of hospitals such as elective-surgery wards and unused wings and floors, “our health systems think they’ll be able to manage whatever amount of surge that comes.”

The U.S. Army Corps of Engineers, which scouted dozens of facilities in the eastern half of the state for field hospitals, has been working to get contractors in place quickly to convert the three convention centers into field hospitals to accommodate patient overflow, as Northam announced in early April. The change in focus, Avula said, has happened in just the past 48 hours.

Avula’s comments came on a day that saw the largest one-day increase in COVID-19 cases statewide, a jump of 602 confirmed cases, bringing to the total number of cases identified statewide to 7,492. According to the Virginia Hospital and Healthcare Association, there are currently 1,308 people hospitalized statewide with confirmed cases of COVID-19 or waiting on test results, while 1,110 others have been discharged. Only 22% of the state’s available ventilators are in use, and there are 5,587 beds available, VHHA reports.

Despite a better outlook than a couple of weeks earlier, Virginians still need to be careful, Avula added, especially anyone who is older or is in contact with someone who is elderly. The vast majority of deaths in Richmond and Henrico have been associated with nursing homes, Avula noted, including 68 out of 74 fatalities in Henrico.

Currently, Avula is working with 18 city and county nursing facilities with COVID-19 cases — including Canterbury Rehabilitation & Healthcare Center, where 49 residents have died as of Friday. However, even at Canterbury, there’s a glimmer of hope, Avula said, as no one has died there in the past 24 hours.

His office also is working closely with VCU Health and VDH to provide walk-up testing in some city neighborhoods, beginning on Tuesday. So far, African Americans are disproportionately affected by the virus in Henrico and in Richmond, where all nine COVID-19 deaths were among elderly African Americans, Avula said. The focus will be on public housing communities and other areas at particular risk, he said.

To keep crowds down, Avula said he is not advertising the times and locations of walk-up testing but instead advised anyone in Richmond who feels that they may have the virus to call (804) 205-3501, and they will be assigned a time and location for testing. His staff members will wear full gowns, gloves and masks, he added, and masks and hand sanitizer will be distributed to anyone who needs them.

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