Gov. Ralph Northam at a press conference in October. (Ned Oliver/Virginia Mercury)

Faced with the approaching holiday season and surging Virginia COVID-19 case numbers — the highest at any point during the pandemic so far — Gov. Ralph Northam reminded Virginians Tuesday about basic public health steps: hand-washing, masks and taking precautions with gatherings. 

“I’m not saying don’t celebrate Thanksgiving, but if you’re planning to gather with people outside of your household, think about ways to do it more safely,” he said during a news conference. “Consider how the space is ventilated. Or think about ways to have gatherings outdoors — especially if the weather is like it is today.”

However, he said he won’t impose any new restrictions, unlike neighboring Washington, Maryland and North Carolina.

The message — delivered during what Northam said was likely his last public briefing until after Thanksgiving — came in response to growing questions about what Northam’s administration is doing to curb new cases of the virus continue as numbers climb in many areas of the state.

As of Tuesday, Virginia had a seven-day average of 1,462 daily new cases — higher than it’s been at any point during the eight months of the ongoing pandemic. Infections are increasing across the state, but the surge is particularly critical in Southwest Virginia, where most health districts are seeing more than 10 percent of all tests return with positive results.

Virginia’s overall percent positivity rate has risen from five to 6.2 percent over the last few weeks, according to data from the Virginia Department of Health. Health systems, too, are sounding the alarm over rising hospitalizations. 

Last week, Ballad Health — which serves much of Southwest Virginia and Northeast Tennessee — reported that its ICU was at nearly 92 percent capacity. The Bristol Herald Courier reported in late October that the system was implementing a temporary moratorium on elective procedures as COVID-19 patients threatened to overwhelm hospital resources. 

But over the past several weeks, Northam has continued to emphasize messaging over mandates as his preferred strategy for combating the spread. 

“I’ve said all along, this is not about carrying a stick around,” he added Tuesday. “This is about carrots. And I really encourage Virginians to follow the guidelines — not just for themselves but for the people that are working in our hospitals. And frontline workers in our grocery stores.” 

Physicians with the Carilion Clinic in Roanoke, Virginia wear enhanced personal protective equipment inside the health system’s facilities (Photo courtesy of the Carilion Clinic).

As the virus continues to spread across Virginia, the state is also expanding its laboratory network to support what Northam described as high-priority COVID-19 testing campaigns — including community testing in surge areas and screening for nursing homes and other congregate care facilities.

He announced that the Virginia Department of Health and Department of General Services, which oversees the state’s public health lab in Richmond, finalized contracts with Virginia Tech, the University of Virginia Medical Center, and Sentara Healthcare in Norfolk to boost capacity to 7,000 tests a day by the end of the year. 

DGS spokeswoman Dena Potter said Tuesday that each lab received one-time funding of $400,000 to purchase new instruments and supplies “to ensure the commonwealth has a diversity of testing equipment to mitigate future supply chain issues.” The labs will be reimbursed up to $100 per sample, with an initial goal of completing 200 tests a day per facility.

That will increase to 600 a day by Dec. 1, but Potter added that the “actual number of tests will depend on the number of samples we need to test for public health purposes.”

According to Northam, the expansion was based less on Virginia’s growing outbreaks than it was on the need for high turnaround testing in crucial investigations where fast results are especially important for limiting the spread of the virus.

“The availability of testing right now and what we’ve been using mainly in Virginia are the PCR tests,” he said. “And we’ve gotten the turnaround time to one day, sometimes two, sometimes three. But what’s really important is the overall need to be able to do more testing.”

Over the last several weeks, the state has also been distributing an initial order of 200,000 rapid antigen tests — purchased through a multi-state collaboration — and more than 52,000 Abbott BinaxNOW antigen tests delivered by the federal government. Roughly 50 percent of the state-ordered tests were prioritized for clinics serving vulnerable populations, including low-income or uninsured residents, and for congregate care facilities such as nursing homes, assisted living facilities, prisons and group homes, according to VDH spokeswoman Erin Beard.

Another 40 percent are prioritized for “critical infrastructure” testing, including educational settings like preschools and K-12 schools. The remaining tests are dedicated to surge response in COVID-19 hotspots and validation studies to measure their performance.

Later this week, Beard said VDH will distribute another 300,000 BinaxNOW tests. The Virginia Hospital and Healthcare Association will receive 100,000 tests, as will institutes of higher education and local health departments across the state “to meet the needs of vulnerable populations,” she added.

Northam’s focus on education and messaging, including a recently launched public health campaign in Southwest Virginia, comes as state models predict a growing spike of cases into December and January. As cases continue to grow across the country, other state and local leaders have announced new restrictions to curb the spread of disease, including curfews for bars and restaurants and testing requirements for incoming visitors.

Virginia’s guidelines currently allow for indoor dining — as long as restaurants can follow six-foot social distancing rules — and gatherings of up to 250 people. Some local health officials are skeptical that more restrictions will help curb outbreaks in some parts of Virginia, which have largely been traced to small gatherings of friends and families.

Dr. Karen Shelton, the director of the Mount Rogers Health District in the far corner of Southwest Virginia, said in an interview last week that the current political climate has also been a challenge when it comes emphasizing compliance with the current statewide mask mandate and other public health guidelines.

“Especially in the last few weeks with the election — that makes it hard,” she said. “You have certain people who don’t wear masks and certain people who do wear masks and they don’t always have a lot of common ground. But we’re hoping that once a lot of this turmoil dies down, there will be more unity on both sides.”

Northam, who has grown more vocally critical of the Trump administration’s response to the pandemic, said Tuesday that President-elect Joe Biden would make a key difference in emphasizing the importance of public health guidelines to reduce the spread of the virus.

“We need to continue to be able to figure out why our numbers are rising, and right now they’re rising because people are gathering and they’re not wearing masks,” he said.

“That starts with leadership,” Northam added. “And I’m going to continue to do everything I can to get that message out. And it’s good to see we’re going to get that messaging out of Washington, as well.”