February 20, 2021: UVA officials address record COVID cases; herd immunity may take a while according to UVA study
We’re now at a point in this murky pandemic where one thing is clear - uncertainty about the future is a commonly held concern. This week, Albemarle and Charlottesville both reported one-day records as a second local surge hit due in part to the arrival of UVA students from across the country to begin in-person instruction. On this Saturday, February 20 edition of the Charlottesville Community Engagement Newcast and Newsletter, we hear the response from the University of Virginia as a Town Hall held Friday afternoon.
We’ll also check in with officials at UVA Health and hear a statement from the Blue Ridge Health District related to long lines this past Wednesday at the vaccination clinic at the former K-Mart. The idea of this newsletter is intended to make things a little less murky as you make your decisions about your life in the days, weeks, and months to come.
Before we begin today, a quick look at the numbers from the Virginia Department of Health. Statewide, new cases in the Commonwealth are dropping and the seven-day average is now at 2,055 a day. That average was 3,035 last Saturday and 6,149 on January 20. The seven-day average for positive PCR tests is now at 8.2 percent. Down from 13.5 percent a month ago.
But locally, the Blue Ridge Health District has experienced its highest-ever number of new cases this week with 936 since Sunday. The majority of those cases were in Albemarle and Charlottesville. The city had 80 new cases on Wednesday, 99 cases on Thursday, 107 on Friday before going back down to 60 today. That matches the the one-day high for all of 2020 on September 18, which was the last time UVA students returned to in-person instruction.
Before we get to the Town Hall, a few more facts to keep in mind. There have been 117 fatalities in the Blue Ridge Health District, and no new deaths have been reported since February 11. Two-thirds of the 12,668 cases in the district have been contracted by people under the age of 50, yet only two of the 117 fatalities are from people below that that age, and those two individuals were in their forties. More than three quarter of those deaths have been from people over the age of 70.
The University recognized the concern in the Charlottesville community and held a town hall Friday. Jim Ryan is the UVA president. (watch the town hall)
“On Tuesday, we enacted temporary restrictions designed to slow the spread of the virus that causes COVID-19,” Ryan said. “Our hope is to lift these restrictions by the end of next week but that will depend on what we see over the next several days.”
These include a ban on in-person gatherings and encouraging students both on and off campus to stay at home. In-person instruction remains open, as do research activities. The restrictions were intended to stave off potential holiday-related gatherings.
“It was Mardi Gras, the next day was a day off from classes, and we thought students would be getting together that night,” Ryan said. “This was not a decision we made lightly and it was a decision informed by the unanimous advice of our medical doctors.”
The town hall was intended to respond to allegations that the spike was increased by fraternal organization who held in-person recruitment activities this year. That didn’t happen in the fall, when those activities were not permitted. Ryan said the increase was not related to these activities.
“The positive cases so far have been distributed across the entire student population and include students living both on-Grounds and off-Grounds, undergraduate and graduate students, and students affiliated with a large number of groups,” Ryan said.
Ryan said research into the cases did not single out one of those groups, but contact tracing appears to indicate a general trend of people not adhering to the rules.
“This doesn’t mean that all students who contracted the virus were being intentional scofflaws flouting the restrictions,” Ryan said. “Instead the picture is a lot more complicated with some students who were undoubtedly ignoring health and safety protocols and others who made innocent and understandable mistakes or simply let their guards down which many of us if we’re honest, myself included, have done over the course of the last year.”
Ryan said fraternity and sorority rush contributed to the cases, but were not the entire cause of the spike.
“We should be aware of and reject a single simplistic narrative where there’s one villain or one villainous group to blame,” Ryan said. “The fact is that there are multiple causes across a range of groups and individuals. Some were willful and others far more innocent.”
Ryan said the UVA administration did not have the ability to ban the recruitment events without imposing a total ban on all organizations from having any meetings. During his interlude, he said the University did not want to become a totalitarian state.
“This was another situation where we are trying sincerely to strike the right balance between freedom and trust on the one hand, and complete control on the other,” Ryan said. “If we got that balance wrong, I’m sorry, and please lay the blame at my feet as I’m ultimately responsible.”
Ryan implored students and faculty to obey the rules to avoid continued restrictions to avoid community spread.
Now, how can we track that going forward? Since last August, UVA has had a COVID dashboard with cases that has results from all of the various testing methods under way. When this is reported every weekday at 4 p.m. it gives a first look at transmission rates related to the UVA. These cases later show up on the Virginia Department of Health dashboard, which is updated daily.
Dr. Mitch Rossner is the chair of the UVA Department of Medicine.
“The COVID-tracker has probably the most up to date data that you’ll see,” Rossner said. “Some of the other data that’s reported in other venues may lag up to several days behind that.”
Another item tracked on the UVA COVID dashboard is the number of available rooms for quarantine and isolation. Also, hospitalizations.
“Thankfully the number of new hospitalizations in the last couple of weeks has also come down,” Rossner said. “Also, thankfully we have not seen any students developing serious illnesses or requiring hospitalization.”
Dr. Rossner said the presence of the COVID variants will present new challenges and will likely infect those who do not follow protocols.
“It’s a good wake-up call for all of us,” Dr. Rossner. “Have you edged closer to six feet? Had that mask slipped below your nose? Really it points out that despite pandemic fatigue, it’s really not the time to be slacking off on these public health measures.”
The current restrictions will remain in place through February 26 and will be re-evaluated next week.
The first question at the town hall was about enforcement. Dean of Students Allen Grove said UVA officials did issue sanctions on some individuals last year.
“For well over 50 years, the Board of Visitors at the University has delegated the authority to discipline students for violation of the standards of conduct to students through the University Judiciary Committee,” Groves said. “Our office investigates reports and complaints and then files with the University Judiciary Committee and they have a hearing and sanction. The violation must be shown beyond a reasonable doubt for a sanction to be imposed. We do have in our office the authority to interim suspend a student for an egregious violation and we did impose a number of those in the fall.”
The website for the student-run UJC states that the body heard 9 cases involving 43 violations of COVID policy, but Groves said those numbers are now out of date as official hearings were not held until January.
“We have brought cases for COVID violations against a number of individual students and also student organizations including five of our fraternities,” Groves said.
A major concern is that these student cases will lead to transmission to the broader Charlottesville community. Infectious disease expert Dr. Costi Sifri has been leading up UVA’s interaction with the Blue Ridge Health District to explain how they will know if that occurs.
“We work closely with contact tracers to understand what the interactions are between students and with the community at large and to have those understandings,” Sifri said. “There are parts of the UVA community that have overlap with the rest of the community and as part of that contact tracing effort we are here to work to make sure that we have effective mitigation strategies in place. And of course it’s really important to have active lines of communication between the Department of HEalth and with the contact tracers and those of us who have this public health role for the university.”
Dr. Taison Bell is a critical care specialist at UVA who was named by Business Insider magazine last year as one of its 30 Leaders Under 40 Changing Healthcare. He said the COVID crisis has had the potential to improve community health for many in the area.
“Being a good partner to the community means that we are using the community leaders that have been doing a lot of the work that’s been taking place before COVID-19 and really using them to really reach their community,” Dr. Bell said. “And in particular, changing the model of medicine where we actually go into communities is really the name of the game when it comes to COVID-19 when it comes to public health messaging and making sure people have the resources they need and ultimately getting the vaccine rolled out.”
To close out this segment, let’s hear President Ryan ask one of the questions.
“Mitch, I think this one is for you,” Ryan said. “Why do we have faith that we’ll not get a resurgence of cases the moment restrictions are lifted.”
“Well, part of the basis of restrictions is really to flatten the curve, but after we flatten the curve, the key thing is really going to be for all of us to maintain that vigilance, those public health measures going forward,” Dr. Rossner said. “That’s going to be the critical thing. This is not a short-term ‘wear your mask for the end of the week and then when the case numbers look better we can go back to business as usual.’ This is really a wake-up call for us that we have to to really adhere to these health measures on a continuous basis. If we do that we can be successful, but flattening the curve this next week or so is really to get those case numbers down and get us back into a position where we can be successful.”
In the meantime, vaccinations continue, despite logistical issues like the one experience this week at the Blue Ridge Health District.
“We’ve provided over 40,000 vaccine doses since the onset of our vaccine efforts and at this point I think around 25 percent or more of all citizens in Charlottesville have been vaccinated with at least one dose and it’s around 15 percent or higher in Albemarle,” Dr. Sifri said. “We are trying to be the lever-arm for the health district to roll out the vaccine for our region.”
(this is the point of the written newsletter where I remind you this is also a podcast)
In almost a year of pandemic coverage, one thing I’ve been struck by is the sheer amount of research that takes place in the UVA Health System. One item that struck my eye this week was the release of a paper that found that only two percent of Virginians had COVID-19 antibodies in their blood as of mid-August. That could mean that “herd immunity” is a long way off. Dr. Eric Houpt is the chief of UVA Health’s Division of Infection Diseases and International Health.
“It was a broad survey of about 5,000 people in Virginia to see how many have been exposed to COVID-19,” Dr. Houpt said. “If you do some mathematical calculations you can project where we are today and that would project that we’re at about 15 to 20 percent that have been exposed to COVID-19 in Virginia.”
Dr. Houpt said the virus will have a harder time spreading when 60 to 80 percent of the population have antibodies.
Blood samples were taken from people from five locations across Virginia who were visiting the doctor for routine reasons and not for COVID.
“About two out of three of the positive individuals that had antibodies had been exposed to COVID-19 [but] had never had any symptoms at all,” Dr. Houpt said. “That’s in keeping with other findings. Some studies find 40 percent, some 50 percent asymptomatic.”
Dr. Houpt said the results mean it is likely that most Virginians are still susceptible to the virus, and public health measures such as mask wearing in public should be the norm for the foreseeable future. He also said this means people should get the vaccine as soon as they are able.
“We still have a long way to go,” Dr. Houpt said. “The best way to get there for sure is through vaccination.”
The study will be repeated in the summer. For more on the work, read the press release on the UVA health site.
The antibody study came up at the weekly COVID briefing by UVA Health, which was held Friday morning. Dr. Sifri participated on that call as well.
“There remains many people who are susceptible to infection and I think [the study] really emphasizes the importance of the vaccination program
One concern is that the U.K. and South African variants may provide challenges to the vaccines. Dr. Sifri recommends people get the vaccines anyway.
“It’s really important to keep in mind that the Johnson and Johnson vaccine and others that have been looked at in South Africa appear to protect against severe disease, hospitalizations, and deaths,” Dr. Sifri said. “So while it may be less effective it also appears that these vaccines do offer protection against the most important outcomes for COVID protection.”
Governor Northam has asked all school divisions across Virginia to plan for at least some return to in-person instruction in the near future. Charlottesville plans a four-day return to school on March 8 for pre-K through 6th students whose families have requested in-person instruction, as well as middle and high school students identified as needing face-to-face support. Albemarle County is currently at Stage 3 learning and will move to Stage 4 learning on March 15, which means four-days a week for pre-K through 3rd grade and two-days a week for 4th through 12th grade.
Some families have expressed concern that the latest spike in cases might put those plans in jeopardy.
“What we’ve learned over this past year and it’s really been highlighted lately by the CDC is that in-classroom instruction can occur in a safe manner, safe for the students and safe for the teachers,” Dr. Sifri said. “It has to be done thoughtfully and appropriately with attention to social distancing, mask wearing, hand hygiene, and the air handling systems and those HVAC types of issues in schools. If there is close attention to those, schools can reopen.”
Dr. Sifri said in Virginia, vaccination of K-12 teachers is a priority, which he said would provide an extra layer of protection, but that the community health protocols should still be used.
“The advice and recommendations have not changed,” Dr. Sifri said. “If you’ve been vaccinated, still we should continue to wear masks for several important reasons. The first is that while the vaccines are very effective for the widely circulating strains, 95 percent protective. 95 percent isn’t quite 100 percent. It’s close and outstanding, but not 100 percent.”
Dr. Sifri said the second reason is that it’s theoretically possible that someone vaccinated can still be a carrier.
“The third I think important reason is to understand that not everybody knows, we don’t know who does or who does not have a COVID vaccine in our community so if you’re not wearing a mask in a place where people are not aware that you have been vaccinated, that could lead to significant concerns to other people that you are perhaps endangering their health and safety.”
Dr. Sifri said the day may come soon when this advice changes as more is known about vaccine performance.
“That’s of course at a time when I think we have a lot more people vaccinated but I think we can look forward to that day so at least for now I think we need to continue to wear a mask,” he said.
Finally today, the Blue Ridge Health District put out a statement on its Facebook page on Thursday explaining what happened on Wednesday at its vaccination clinic. The full details are available on the Facebook page, but some highlights are worth clipping out.
“The clinic was intended for 400 hundred individuals ages 65+ that live in Albemarle County, certain essential workers, and those who were on Saturday’s waitlist for a vaccine clinic for communities of color,” reads the statement.
That Saturday clinic had to be postponed due to inclement weather.
Participants for the Wednesday clinic were selected from the surveys BRHD have issued and sent a link to the new registration system created by the Virginia Department of Health known as PrepMod.
“The PrepMod link for scheduling appointments was widely shared throughout the community, despite our request not to share the link,” the statement continued. “Thus, there was an overwhelming number of people not invited to the clinic who scheduled an appointment, leading to a limited amount of appointments for those who were actually invited.”
Despite long lines and having to turn some people away, the BRHD administered nearly four times more doses than expected in a 14-hour period.
“We are proud to have vaccinated 1,500 people yesterday with zero doses going to waste,” the statement reads. “Of the 1,500, 210 represent individuals who are now fully vaccinated.”