Virginia will relax pandemic restrictions for the first time in months amid declining cases, hospitalizations

Virginia will lift some of its pandemic safety restrictions as COVID-19 cases decline and access to vaccines slowly continues to expand, Gov. Ralph Northam announced Wednesday.

Spokeswoman Alena Yarmosky described the changes as a “gradual step-by-step” easing — one that offers a rare ray of optimism nearly a year into the ongoing pandemic. But efforts to reopen the state are also complicated by a slower-than-anticipated vaccine rollout and new variants that are more infectious than earlier forms of the virus that have circulated across the state.

“That’s something we’re continuing to watch closely, and I think it’s why we’re taking a really measured approach to this,” Yarmosky said. 

Starting March 1, the size limit for outdoor gatherings will increase from 10 to 25, and outdoor entertainment venues will be permitted to admit up to 1,000 people or 30 percent of their total capacity — whichever is lower. Previously all public venues, both indoor and outdoor, were limited to 250 patrons or 30 percent of their capacity depending on which number was lower.

Alcohol sales at restaurants, currently cut off at 10 p.m., will be extended to midnight. And while dining establishments will still have a midnight curfew, the governor is ending the 12 a.m. to 5 a.m. stay-at-home order first announced in early December.

“We do expect to be able to expand things further if positive trends continue,” Yarmosky said of the relaxed restrictions, which will also allow overnight summer camps to open on May 1. 

There will be no changes to the governor’s current mask mandate or guidelines for indoor gatherings and businesses. Yarmosky said those remain some of the riskiest spaces for spreading and contracting COVID-19. The governor’s decisions are based on the state’s pandemic metrics, but also on disease modeling, which can estimate the risk of encountering the disease in different settings.

In late 2020, models from the Biocomplexity Institute at Virginia Commonwealth University showed that the risk of COVID-19 exposure is significantly lower at a gathering of 25 people than a gathering of 250.

“I think starting with outdoor venues is a good way to take a baby step toward loosening restrictions and seeing what happens,” said Dr. Taison Bell, an infectious disease expert at the University of Virginia. “Of all the sorts of activities we do, those outdoors are the lowest risk. Just because there’s nothing better than outdoor ventilation.” 

The administration plans to keep the new measures in place for at least a month before making further changes. But if the state’s metrics improve, Yarmosky said there are hopes of gradually lifting restrictions in a phased approach similar to the Forward Virginia plan launched in May of last year.

Still, the unpredictability of the virus and risk of future surges have scuttled previous efforts to roll back restrictions, both in Virginia and across the country. Even as much of the state reopened, Northam announced targeted restrictions in late summer and early autumn as cases in the Hampton Roads region soared. And health officials across Virginia were disconcerted as infections rose statewide even before the winter holidays — prompting the governor’s latest round of safety measures in December.

The state’s metrics have improved significantly since January, when cases and hospitalizations surged to an all-time high. Roughly two weeks after New Year’s, Virginia was reporting an average of more than 6,000 new cases a day (with one single-day increase of more than 9,000). Hospitalizations peaked around the same time at more than 3,000 a day, according to data from the Virginia Hospital and Health Care Association.

Those numbers have sharply declined since the post-holiday surge. As of Wednesday, Virginia reported an average of 1,908 daily new COVID-19 cases, according to the Virginia Department of Health. Hospitalizations declined to an average of 1,624 a day, and the state’s percentage of tests that return positive — a measure that can gauge the amount of testing being conducted and the scale of the disease — dropped to 8 percent (down from a high of roughly 17 percent in January). 

But not all regions are seeing the same uniform improvements. Health officials in the Richmond area recently reported five new cases of Multisystem Inflammatory Syndrome in Children, or MIS-C — a relatively rare condition that can affect children after being infected or exposed to COVID-19.

“The increase in cases of MIS-C coincides with the surge in cases of COVID-19 in the metro area,” officials from the Chickahominy Chesterfield, and Richmond-Henrico health districts wrote in a Tuesday news release. “Other states have also reported increases in MIS-C concurrent with increases in COVID-19 cases.”

Growing reports of COVID-19 variants have also worried health officials. In late January, Virginia confirmed its first case of the United Kingdom coronavirus variant, which is more highly transmissible and can more easily infect children than other versions of the virus. Preliminary research from the U.K. suggests that the variant could increase the death rate from the virus, though it’s still unclear why that may be occurring.

Last week, VDH announced the state had confirmed its first case of the South African, or B.1.351, variant in an adult from Southwest Virginia who recently returned from international travel. 

That variant is also known to be more infectious and could decrease the effectiveness of some COVID-19 vaccines (though all of the currently available and upcoming shots, including the Johnson & Johnson one-dose vaccine, offer strong protection against severe cases and deaths). But the rapid spread has led to global calls for faster vaccination and enhanced personal safety measures including double-masking.

Bell said it’s encouraging that cases in Virginia have continued to decline even with the presence of variants. Still, modeling from UVA’s Biocomplexity Institute indicates that infections could spike if mitigation and personal hygiene efforts lag as more infectious variants continue to circulate across the state.

Northam has urged Virginians to continue social distancing, hand-washing and consistent mask usage, which is currently required in almost all indoor settings and outdoors when social distancing isn’t possible. But state health officials have stopped short of issuing new safety recommendations in response to the variants.

“What’s we’ve got to do to prevent is all of the things that we know work — wear our masks, stay home when we’re sick, social distance, wash our hands,” Dr. Danny Avula, the state’s vaccine coordinator, said at a news briefing in late January. “But what the data tells us right now is also that we can rely on the vaccine protecting us.”

After a rocky start, Virginia currently ranks 19th among all 50 states and Washington, D.C., when it comes to the number of doses administered per 100,000 residents, according to the U.S. Centers for Disease Control and Prevention. State data shows that as of Wednesday, 13.5 percent of Virginians had received at least one dose. And Virginia is administering an average of nearly 30,000 doses a day — better than Northam’s short-term goal of 25,000 daily doses.

Vaccines are also gradually becoming available at a growing number of pharmacies. Northam said that the Federal Retail Pharmacy Program had added several new networks in Virginia, including Walgreens, Walmart, Kroger, Safeway, Giant, Food Lion and Food City, a chain of supermarkets headquartered in Abingdon.

Health officials did not identify the 140 new pharmacy locations that would begin to receive vaccines. But those new partnerships are expected to bring an additional 52,000 doses into the state, which will be prioritized for residents over 65 and — eventually — those who have already preregistered for the shots.

“VDH is working with eligible pharmacies to schedule appointments using Virginia’s centralized pre-registration system, as possible,” the department wrote in a release on Wednesday. “Beginning this week, the Vaccinate Virginia call center is making calls to individuals on the pre-registration list to schedule appointments for Walmart and Giant vaccination events, while other pharmacies have agreed to use pre-registered individuals to schedule their own appointments.”

Still, the governor has acknowledged that he’d like the state to improve, particularly in regions where administration is lagging or local health departments haven’t received as many doses. U.S. Sens. Tim Kaine and Mark Warner (D-VA) announced Monday that Virginia would be receiving just over $179 million in federal funding to support vaccine distribution, which Yarmosky said would include mass vaccination sites.

But the usefulness of that funding is limited by the restricted supply of vaccine. State allotments have improved over the past few weeks, from roughly 105,000 weekly doses in Virginia to 160,000 doses (excluding shots distributed through the federal pharmacy partnership). Northam said Wednesday that emergency approval of the Johnson & Johnson vaccine, expected by the end of the week, could bring around 50,000 additional doses to the state.

That’s still not enough to quickly vaccinate a large percentage of the state’s population — a crucial step in curbing the virus.

“Clearly we have more demand than supply, so the job’s not going to be done until people are vaccinated,” Bell said. “But I think what we’re doing a good job at is coordinating at a higher level.”

“The switch to the state registration system — I think that’s a good thing,” he continued. “I think it takes some of the burden off local health districts so they can focus on distribution.”