Virginia Health Commissioner Dr. Norm Oliver, flanked by Gov. Ralph Northam, left, also a doctor, and Secretary of Health Dr, Daniel Carey, right, spoke at a news conference on Capitol Square in March. (Ned Oliver/Virginia Mercury)

Virginians took a scolding on Tuesday as Gov. Ralph Northam linked rising COVID-19 caseloads, particularly in the Hampton Roads region, with a failure to obey the state’s mask order and other social distancing guidelines.

“They’re occurring when people are gathering, especially in areas around a bar,” Northam said at a press briefing where he announced plans to ramp up enforcement of the mask mandate. 

In Virginia, though, more specific details remain elusive, even in communities facing rising cases. Westmoreland County, a rural region in the Northern Neck, has seen a dramatic increase in cases since July 1, which its district health director, Dr. Richard Williams, attributed to two recent outbreaks in “congregate settings.” But The Free Lance-Star reported that Williams refused to disclose more detailed information about where the outbreaks occurred, only confirming that they took place in a 10-county area including the Northern Neck and Middle Peninsula.

Four months into Virginia’s COVID-19 pandemic, detailed information on transmission is still hard to find and often inconsistent. Last month, after weeks of bipartisan criticism, the Northam administration reversed course and began releasing the names of nursing homes and assisted living facilities with outbreaks of the virus. The data was accompanied by measures to protect patient-specific medical information, including suppressing case counts at facilities with numbers below a certain threshold. 

The reversal came despite earlier insistences from state health officials that Virginia privacy laws prevented the disclosure. And so far, the expanded transparency hasn’t translated to other areas. Last week, in response to a Freedom of Information Act request from the Mercury, the Virginia Department of Health said it would not provide similar information on COVID-19 outbreaks at poultry processing plants, which have made up the majority of cases in some health districts. 

Earlier this week, VDH also declined to provide a detailed breakdown of cases in schools. As of Tuesday, there have been 20 outbreaks in Virginia linked to “educational settings,” according to the state’s COVID-19 dashboard. But the department refused to specify how many of those outbreaks occurred in preschools, colleges, or K-12 schools.

“The outbreak setting categories we have available on our website are what we are able to share at this time,” a member of VDH’s epidemiology team wrote in a statement provided by spokeswoman Tammie Smith. 

The Northam administration has emphasized that reopening schools this fall is a local decision, with districts free to ignore the state’s lengthy safety guidelines as long as they send a plan to the Virginia Department of Education. 

It’s still unclear what’s driving the decision-making behind the administration’s interpretation of patient privacy laws — and whether that interpretation will change, especially as officials urge Virginians to avoid activities that carry a high risk of transmission. 

Northam spokeswoman Alena Yarmosky has previously stated that the governor’s interpretation of state privacy laws was “based on guidance from the Virginia commissioner of health, in consultation with the Office of the Attorney General.” But on Tuesday, Northam and Health Commissioner Dr. Norman Oliver said it was up to the state’s legislature to clarify how much information could be released under the current code — or to change existing regulations to allow more transparency (several lawmakers have announced their intention to do just that during a reconvened General Assembly session planned for August).

But Oliver independently made the decision to release the names of nursing homes and assisted living facilities under a section of Virginia code that allows the state’s health commissioner to release potentially sensitive information “if pertinent to an investigation, research or study.” 

“We released information about nursing homes because the extended outbreak had gotten quite expansive,” Oliver said Tuesday. The decision was also driven by the facility-specific data released in early June by the U.S. Centers for Medicare and Medicaid Services, which was riddled with errors and — in some areas — directly contradicted numbers from the state.

While state law gives him the authority to release information, Oliver said it wouldn’t always serve a public health purpose. So far, the state hasn’t released information on an outbreak connected to a specific restaurant or public setting, but Oliver said a release in that case might be helpful “when you can’t track everyone down.”

“But you take a situation like a poultry plant where everyone is known — we can identify all the cases, we can identify all the contacts,” Oliver added. “Releasing information about that particular outbreak doesn’t advance the investigation.”

Both legislators and legal experts have repeatedly expressed confusion over current interpretation of the state’s privacy laws.