Coronavirus spread will test the strength of Virginia’s health care infrastructure

March 9, 2020 12:01 am

This illustration, created at the Centers for Disease Control and Prevention (CDC), shows a coronavirus virus virion, or virus particle, including the spikes that adorn the outer surface, which impart the look of a corona surrounding the virion. (CDC Public Health Image Library)

About 800 people have perished in the past year in Virginia from the flu. Other than the standard precautions (flu shots, wash your hands, stay home when you’re sick), influenza is regarded as it historically has been – a difficult fact of life.

COVID-19, the precise name the medical community has given to a new, highly contagious, deeply debilitating and even deadly pathogen known commonly as the coronavirus, has killed no one yet in Virginia, though the first confirmed cases have appeared here in the past few days.

Yet it has rocked our world in remarkable ways.

Airlines are cutting hundreds of flights indefinitely, particularly to overseas hotspots.

It convulsed the skittish markets, sending the Dow Jones Average on its worst one-day dive ever and then reversing course with an even larger upward one-day spike. The Federal Reserve, goaded by a president preoccupied with re-election, lowered its prime lending rate by one-half point in a failed bid to calm the volatility.

The National Collegiate Athletic Association has not ruled out the prospect of holding its capstone sports tournament – college basketball’s March Madness – in empty arenas silent except for the sound of squeaking sneakers and the dribbling ball.

Even James Bond has been stymied by the contagion in ways that all of Spectre’s evil masterminds combined not could have devised, forcing a seventh-month delay in the theatrical release of the latest 007 spy thriller, prophetically titled “No Time to Die.”

Unheard of just a few weeks ago, COVID-19 has spread to nearly every corner of the globe since it mutated and made the jump from animals to humans in China. Since then, it has made a folly of efforts by one nation after another to contain it.

Is Virginia ready?

Overall, yes – at least compared with other states. Gov. Ralph Northam, a doctor by profession, proclaimed as much in a news conference last week. The state has set aside $3.6 million to help prepare for widespread outbreak.

There’s also a report released last month by the Trust for America’s Health that assessed each state’s readiness to protect their residents from “diseases, disasters and bioterrorism.” Virginia was among 25 states and the District of Columbia ranked in the top tier.

In one telling measure of the report, Virginia was among only 17 states and the District of Columbia with a perfect 100 percent participation rate in regional coalitions of health care organizations that collaborate in preparing for and responding to “medical surge events.”

Virginia also was among 39 states where public funding for health care increased or at least was unchanged from 2018-2019. It also ranked in the top quartile among states with the highest proportion of residents who get seasonal flu vaccinations (54 percent), a metric of health consciousness.

But rural residents face challenges that people in urbanized areas or those fortunate enough to live near major university medical centers such as the University of Virginia or Virginia Commonwealth University do not.

Nationally, hospitals in flyover country have had a hard time remaining open. Since 2005, 163 hospitals in rural areas have closed nationally, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, which tracks health care in underserved communities. That’s particularly difficult for rural populations who are older, poorer and more isolated and have persistently higher mortality rates. In rural areas, hospitals are smaller and fewer, dispersed over a much wider geography, and lack many of the resources of big-city hospitals.

Virginia has gotten off easy with only two rural hospital closures — one in Lee County and one in Patrick County — in recent years, said Julian Walker, vice president of communications for the Virginia Hospital and Healthcare Association.

They are, however, feeling the strain, Walker said. More than half of the state’s 105 hospitals experienced declines in their operating margins in 2017, the most recent year for which complete data are available. But in rural areas, it was much worse, with 57 percent of hospitals operating in the red for that year.

The rapid onset and spread of the disease has the entire medical world playing catch-up. The first challenge is getting good data on who has the disease. In most cases, the disease is identified when patients show up at hospitals suspecting they’ve contracted the flu.

As The Mercury’s Kate Masters reported, Virginia’s Division of Consolidated Laboratory Services announced just two weeks ago that it was finally able to test samples from Virginia patients, eliminating the need to send them to the U.S. Centers for Disease Control and Prevention in Atlanta and cutting the diagnosis time down to a day or two.

However, the state agency last week had only enough test kits, distributed by the CDC, to diagnose 50 to 60 people and can only order one kit at a time from the federal agency. Should Virginia experience the sort of high-volume outbreak that Washington state is struggling with, the state would have to get inventive very quickly.

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Bob Lewis
Bob Lewis

Bob Lewis covered Virginia government and politics for 20 years for The Associated Press. Now retired from a public relations career at McGuireWoods, he is a columnist for the Virginia Mercury. He can be reached at [email protected]