The two coronavirus briefings, separated by about 100 miles, were nearly contemporaneous Wednesday.
“We will see more cases and things will get worse than they are now,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, in response to questions from a congressional committee on Capitol Hill.
In the Patrick Henry building here in Richmond, Gov. Ralph Northam concluded his news conference on coronavirus preparations by showing off his new elbow bump (in lieu of a handshake) greeting.
"One of the things I'm doing is I've stopped shaking hands with people. Please don't be offended," Northam said.
— Mel Leonor (@MelLeonor_) March 11, 2020
The overall thrust was that, with a growing number of confirmed Virginia cases of the virus, state officials are doing lots of planning on how the pathogen might affect everything from hospitals, nursing homes and schools to transportation systems and private businesses.
“I know you have heard a lot about the ways different states are responding to this situation,” said Northam, a pediatric neurologist. “Virginia’s response is unique to our commonwealth and to our situation. … We are planning for every scenario. While we have not declared a state of emergency, we are prepared to do so if needed.”
There was little approximating Fauci’s blunt assessment. And it left some wanting.
“I have never heard so much talk where so little has been said,” as one commenter on Facebook aptly put it.
Our neighbors to the north, in Maryland, declared a state of emergency last week after the state’s first cases were discovered. Meanwhile, New York City has postponed the St. Patrick’s Day Parade, an annual event which predates the United States, the New York Daily News reported, the latest in a long list of high profile postponements or cancellations of mass gatherings.
The NBA has suspended its season.
In Ohio, the Republican governor, Mike DeWine, said he’ll be issuing an order restricting mass gatherings.
We are doing the things we are doing because we have the potential to become like Italy. We are taking the actions we are taking now to try to avoid that. The situation will get bad before it gets better, but it is in our hands to determine what the outcome will be.
— Governor Mike DeWine (@GovMikeDeWine) March 11, 2020
In Kentucky, Gov. Andy Beshear has called on churches to cancel services: “I believe God gives us wisdom to protect each other and we should do that,” he said, per The New York Times.
“Cancel everything,” a writer for The Atlantic implored this week.
“The coronavirus could spread with frightening rapidity, overburdening our health-care system and claiming lives, until we adopt serious forms of social distancing,” Yascha Mounk wrote. “This suggests that anyone in a position of power or authority, instead of downplaying the dangers of the coronavirus, should ask people to stay away from public places, cancel big gatherings and restrict most forms of nonessential travel.”
For now, Virginia seems to be playing it cooler, at least publicly.
“The potential public health threat posed by COVID-19 is high, both globally and to the United States. But individual risk is dependent on exposure. For the general American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low,” the Virginia Department of Health says on its website.
The operative phrase there is “at this time.” And maybe also “the general American public,” since the elderly and infirm are particularly at risk of dying and the spread of the virus among healthier people endangers them.
That’s why the most urgent voices are pushing us to wash our hands, “socially distance” ourselves and stay away from crowds: not necessarily because the coronavirus poses an existential threat to humanity but because it could be particularly deadly for certain people. Just ask the families of the people at the Life Care Center, in Kirkland, Washington, where the virus had killed 19 as of Wednesday.
Virginia officials say there’s no evidence the virus is spreading in the community and the cases flagged so far are limited to people who traveled overseas or the Washington church service that may have exposed hundreds of parishioners to the virus.
“We would suspect community spread if a number of people were diagnosed in one community and we could not identify how or where they became infected,” Dr. Lilian Peake, the state epidemiologist said in an email in response to questions about whether the virus might be spreading undetected.
“The cases in Virginia have not been clustered in one community. Among the nine cases, seven are travel-related and one was a contact to a known confirmed case in Washington, D.C. We are still investigating potential exposures for one of the cases associated with the Department of Defense. We are working with state partners and local health departments are working with their community partners to prepare in case there is community spread in Virginia.”
But strict criteria on who can get tested still remain in place at the state lab, with officials recommending doctors refer patients who don’t meet those thresholds to testing by private labs. That means, to some degree, we don’t know what we don’t know. And it’s not a dynamic unique to Virginia, spurring fears that the virus is spreading undetected and could explode in the United States as it has in Italy, for example.
Dr. Gonzalo Bearman, chief of infectious diseases and director of infection prevention at Virginia Commonwealth University School of Medicine, told me Wednesday that it was “essentially inevitable” that community transmission will occur here, if it isn’t already happening.
There are likely undiagnosed cases in Virginia, as the pattern of the outbreaks in Washington and New York has demonstrated, he added. But with a limited number of tests available, getting a handle on the true number of U.S. cases has been difficult.
“I think the state is doing every thing it can within its powers to respond as decisively and quickly as possible,” he said. “The major issue is the availability of the testing kits. … Essentially the threshold for testing will decrease as there’s greater disease activity in the community.”
There’s lots of troubling nonsense out there about this virus. Social media reaction seems to pinball between all-out panic and hostility to the notion that it’s something to worry about. Some conservatives commentators are spinning it as a media-manufactured crisis ginned up to damage President Donald Trump.
“COVID 19 poses a real and legitimate threat to the health of Virginians,” Bearman told me. “It’s not something to be minimized.”
You can still also get a flu shot, Bearman added, which, while it won’t protect you from the novel coronavirus, might prevent you from clogging up the health care system and creating more bandwidth for hospitals, nurses and doctors to come to grips with COVID-19, a battle that seems likely to escalate.
Limiting the spread of the virus and buying our health care system time, given that our federal government has badly fumbled the crucial early stages of its response, is now a job for all of us.