Gov. Ralph Northam and state health officials repeatedly reiterated a reassuring message throughout their first news conference on COVID-19, the novel coronavirus that’s spread to 16 states and at least 129 patients since cases of the virus first emerged in the United States in January.
“Virginia is not an area where the virus is spreading in the community right now, so the risk is low,” said state epidemiologist Dr. Lilian Peake, citing the 17 tests Virginia has conducted.
“Right now, you have more risk of getting the flu in Virginia than novel coronavirus,” she added later.
But Virginia is facing the same barriers on testing capabilities as other states, restricting the ability to test patients outside the limited criteria shared by the federal Centers for Disease Control and Prevention. For weeks, labs were forced to send samples to CDC headquarters in Atlanta after tests independently developed by the agency malfunctioned in several states. Last week, the state’s Division of Consolidated Laboratory Services announced it was finally able to test samples in Virginia, shortening the time it took to receive results.
Peake said it now takes the state between one or two days to confirm test results — a significant reduction from the three days to a week it took to receive results from the CDC. Seventeen patients have been tested for the virus, with 14 negative results and three pending.
What isn’t clear is how the state will respond if testing needs increase dramatically over the coming weeks or months. DLCS Director Denise Toney said the lab is currently relying on two test kits sent out by the CDC, which each have the capability to test between 50 to 60 people. The state has requested additional tests, but can only order one kit from the agency at a time.
That’s left health officials reliant on a limited number of results as they assure Virginians that COVID-19 hasn’t spread within the state. Roughly 10 of the 17 patients tested for the disease qualified because they had traveled in mainland China, said Health Secretary Dr. Daniel Carey. Since then, the state has tested some patients based on the CDC’s expanded criteria, which allow patients to be tested if they’ve traveled to other high-risk areas or show symptoms of respiratory illness that aren’t explained by another diagnosis.
Of the 17 tests, 14 were negative and three are still pending — one in Northern Virginia and three in central Virginia. Peake said the situation is different in Virginia than it is in Washington, the epicenter of the U.S. outbreak, where experts say the disease likely spread undetected for weeks.
“The testing that’s been done, we have not had any positive cases,” she said. “In Washington state, they had a positive case very early on.”
Dr. William Petri, an infectious disease specialist at the University of Virginia, said community spread is often detected after patients are hospitalized and later test positive for COVID-19. There are patients in Virginia who have been hospitalized for flu or respiratory conditions, Petri said — a common occurrence in the middle of flu season — but none have tested positive for coronavirus.
“To me, that’s reassuring,” he said. “Yes, there may be some unrecognized transmission, but there can’t be a lot of it because we’d be catching these patients in the hospital.”
Petri described Virginia’s state lab in Richmond as “state of the art,” but said that UVA is one of several academic hospitals in the process of developing their own coronavirus tests.
There are ongoing concerns that coronavirus estimates in the United States remain unreliable. But Virginia officials are continuing to emphasize the state’s preparedness, including designated funding to monitor and control potential spread.
Secretary of Finance Aubrey Lane said the state will dedicate $3.6 million over the next three months to prepare for the potential spread, with most of the spending going toward outreach, personnel and protective gear for medical workers. The state is prepared to nearly double the funding if the virus spreads throughout the spring and summer.
Both the Virginia Department of Health and Virginia Hospital and Healthcare Association have launched websites with information on COVID-19. Peake said the state already has a comprehensive plan for responding to pandemic flu, which appears to spread similarly to COVID-19.
A respiratory disease, COVID-19 appears to be less transmissible than the flu but has a higher death rate, based on rough estimates from cases around the globe. Northam, a pediatric neurologist, said Virginians could take simple steps to prevent transmission by washing their hands, covering their mouths and noses when sneezing and not touching their faces.
Virginia isn’t the only state to face concerns over testing capabilities or criteria. There have been multiple reports of patients across the United States who were found to have coronavirus after delays in testing based on the CDC’s original guidelines. One patient in Florida was hospitalized for five days before doctors tested him under the agency’s expanded criteria.
As federal agencies announce plans to expand testing capabilities, Carey said it’s important to use the state’s existing resources only on the most high-risk patients as a way to monitor the potential spread of the disease.
“With a limited number of kits, you want to use that resource where it has the most important impact,” he said. “Impact on the individual that you’re taking care of, as well as yielding information on which to base public health decisions.”
Federal health officials grilled over response to virus
In Washington, U.S. senators criticized federal officials and the Trump administration over the initial botched test kits and the handling of the virus outbreak, saying they want officials to be more transparent.
A Senate panel with oversight on health issues heard from top public officials Tuesday from the Centers for Disease Control, the National Institutes of Health, and the Food and Drug Administration.
“Our obligation is really simple here,” Sen. Bob Casey (D-Pa.) said at the hearing. “Every one of us is charged with working constructively to at least do the following: slow the spread of the virus, support state and local preparedness efforts and provide complete and accurate — always, always accurate — information to the public to address their concerns about this challenge.”
The hearing on Capitol Hill came amid increased frustration about whether the Trump administration has been forthcoming about the virus. President Donald Trump appointed Vice President Mike Pence to lead a coronavirus task force, but reports have indicated that the health officials may have to clear statements with Pence.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said the ongoing work on the vaccine is “literally the fastest ever done.”
Researchers have sequenced the virus and are working on a potential vaccine that could go into clinical trials. But even so, a vaccine would have to go in broad trials to make sure it would “do no harm” to healthy people that would be receiving it — which would take at least a year.
“When we hear talk about a vaccine is going to be ready in a couple of months — it won’t be ready to be deployed. That will take a while,” Fauci said.
“I do think it is worth saying that it is pretty extraordinary that we have to have our medical and health professionals counter a message from the president of the United States, that they have to spend their time trying to correct the record,” said Sen. Chris Murphy (D-Conn.).
‘Can the American people count on you?’
Public health officials warned Tuesday that the virus remains a threat.
“In just two months, the outbreak has grown from a cluster of pneumonia cases in China, in one city, to affecting over 70 countries and territories around the world with more than 90,000 cases and about 3,000 deaths,” Anne Schuchat, the principal deputy director for the Centers for Disease Control and Prevention, told the Senate Tuesday.
“We are now, in the United States, seeing in addition to the small number of travel-related cases, we are seeing community transmission in a few areas and a tragic outbreak in a long-term care facility in Washington State.”
Sen. Tim Kaine (D-Va.) criticized the administration’s budget request, which seeks to reduce funding for the World Health Organization, NIH and Centers for Disease Control.
“It does not seem to me that this is a wise time to take a scalpel or a meat axe to our public health infrastructure,” Kaine said.
Republicans on the committee said the issue should not be political, but they also called on officials to be up front with the public.
“Our first goal of the hearing is to provide the American people with accurate information from respected professionals,” said Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate committee.
Sen. Richard Burr (R-N.C.) criticized the slow release of diagnostic tests, given that the government has known about the potential threat of the disease for months.
“I thought we were better prepared for this when it happened, and it doesn’t seem to me that we were,” said Burr.
Public health officials have fast tracked new tests and estimated there will be thousands of test kits sent out by the end of the week, with the ability to test 1 million new cases.
Pence gave lawmakers an update on the virus Tuesday at their closed-door party lunches in the U.S. Capitol. The House and Senate are each working on emergency response bills that would allocate billions of additional dollars for research and treatment of the disease.
Trump also spoke about the virus Tuesday at a National Association of Counties’ conference in Washington, D.C., and at the National Institutes of Health Vaccine Research Center in Bethesda, Md.
“We’re really working hard on it,” Trump said, according to CBS news. “Six weeks ago, eight weeks ago, you never heard of this. All of a sudden it’s got the world aflutter … things happen that you never would even think would happen.”
Congress is working on an emergency $8.3 billion spending package for state, local and federal efforts to prepare for the spread and treatment of the virus. It passed the House Wednesday and will head to the Senate.
“Once this bill is signed into law, Virginia will immediately receive $13.3 million in federal funding from the Centers for Disease Control and Prevention to cover some of the costs of preparing for this public health emergency,” Kaine and Sen. Mark Warner, D-Va., said in a statement. The senators have also called on the fealth insurers and federal and state officials “to eliminate cost burdens that could disincentivize people with coronavirus symptoms from seeking testing and treatment for the contagious illness,” citing the man in Miami who was hit with a $3,270 bill after he returned from China and sought treatment.
“We are moving quickly to protect our citizens from the coronavirus epidemic. With greater funding, our federal, state, and local health officials can do to more to address the scale and seriousness of this global health threat,” U.S. Rep. Don McEachin, D-Richmond said in a statement.
Allison Winter, a reporter in the States Newsroom Washington bureau, contributed.