One of Virginia’s top health officials is warning medical providers about a growing number of COVID-19 outbreaks in state hospitals.
Health Commissioner Dr. Norman Oliver released a new clinician letter on Friday, writing that reported COVID-19 infections in hospitals have “increased substantially” since August.
“The largest monthly number of hospital COVID-19 outbreaks since the pandemic began was reported in October,” he said. Data from the Virginia Department of Labor and Industry, obtained by the Mercury through a Freedom of Information Act request, shows that more than 10 different hospitals reported COVID-19 cases or hospitalizations among employees between August and October.
Some of those facilities, including Bon Secours St. Mary’s Hospital in Richmond and Sovah Health in Martinsville, were also the subject of employee complaints for not following the state’s emergency COVID-19 safety regulations. Dozens of private health care practices — including dental offices, ear, nose and throat specialists and eye doctors — also reported cases or received complaints.
Sarah Lineberger, manager of the Virginia Department of Health’s health care-associated infections program, said COVID fatigue is likely contributing to the spread in hospitals and health care facilities, which have been on the frontline of the pandemic for months.
“With the increase in community transmission, we think we just really have to get to the basics of infection prevention and control,” she said. “We’re seeing issues with personal protective equipment and the need to remind staff to make sure everyone is social distancing and and following public health guidelines before and after work.”
The fact that many hospital employees were furloughed over the spring and summer and are still getting reacquainted with COVID-19 procedures also complicated efforts to control the virus, Lineberger said. Some hospitals have also relaxed visitor restrictions or may still be operating under emergency protocols when it comes to distributing personal protective equipment.
“Our messaging right now is that if a facility’s supply chain has evened out, we should be going back to normal PPE use,” she said. “Not this emergency use, where there’s been reuse of PPE or really extended use.”
The rise in hospital-related COVID-19 infections — which in some cases were specifically identified as work-related transmissions, according to DOLI data — has led some facilities to take additional precautions. Dr. William Petri, an infectious disease specialist at the University of Virginia, said the UVA health system recently decided to implement universal testing for all admitted patients after one came in with no coronavirus symptoms but later tested positive, exposing several health care workers and forcing them to quarantine.
“The tricky part is that providers are going to get COVID-19,” he said. “But the real issue is that if you have an inadvertent exposure, you’re losing a lot of manpower in the hospital because those workers will then have to quarantine.”
Oliver called the rise of outbreaks in hospitals especially concerning because the state is also seeing an increase in infections related to multidrug-resistant organisms — bacteria and other germs that don’t respond to antibiotics or other treatments.
“Simultaneous transmission of COVID-19 and multidrug-resistant organisms is occurring in several hospitals and other healthcare facilities across Virginia,” he wrote. Lineberger said that both hospitals and long-term care facilities in Virginia have seen co-occurring outbreaks of the virus and other infections such as Candida auris, a multi-drug resistant fungus that hasn’t been historically common in Virginia.
But recently, the state has been seeing an increasing number of cases, she added — underscoring the need for health care facilities to review and stringently implement infection control procedures.
“We’ve been working with facilities to focus on the basics and make sure they’re thinking about other organisms, not just COVID-19,” Lineberger said. “These are issues that we really tried to drive home with nursing homes and are now coming up in hospitals.”
The warning comes amid a growing number of COVID-related hospitalizations in Virginia, including an uptick in patients admitted to the ICU. The increase is especially large in the southwest region of the state, where local health systems are calling on residents to comply with safety guidelines in the face of dwindling bed capacity.
On Friday, the Bristol Herald Courier reported that Ballad Health — which serves much of Southwest Virginia and northeastern Tennessee — has treated more than 900 COVID-19 patients in the past few weeks. Cases are also growing exponentially near Roanoke, leading one local health director to call for a stop to high school sports.
According to Oliver, Virginia saw 70 confirmed outbreaks of COVID-19 in late October, its highest weekly number since the start of the pandemic. COVID-19 cases increased by 1,568 on Friday, according to data from the Virginia Department of Health — a significant number given that the state’s previous peaks in May and August saw a seven-day average of roughly 1,200 daily new cases.
In his letter, he warned hospitals about the need to focus on safety guidelines within their own facilities, including social distancing between employees in common areas such as break rooms and cafeterias. Lineberger said facilities also needed to focus on environmental cleaning and screening both patients and visitors for the disease.
Hospitals and private practices across Virginia have reported an unprecedented decline in patient volume since the start of the pandemic, which forced many to close their doors or temporarily halt elective procedures. Despite the reported rise in infections at health care facilities, most doctors have spent months implementing new safety protocols and working to convince patients to come in for preventive care.
Pediatricians first raised the alarm in April when they noticed child vaccination rates plummeting across Virginia. Lineberger said VDH is also stressing the importance of flu shots, especially as hospitals work to contain both COVID-19 infections and multidrug-resistant organisms.
“They’re already balancing a lot, so we don’t want to see influenza transmission in our facilities, as well,” she added. Oliver wrote Friday that flu vaccination rates in Virginia increased more than 35 percent between July 1 and October 15 compared to the same period last year.