![\"\"](\"https:\/\/www.vdh.virginia.gov\/content\/uploads\/sites\/134\/2022\/05\/Letterhead-Oliver-2019-1.png\")
<\/p>\n<\/p>\n
COVID-19 Update for Virginia<\/strong><\/p>\n November 6, 2020<\/p>\n Dear Colleague:<\/p>\n As the COVID-19 pandemic continues, please visit the Virginia Department of Health (VDH) website<\/a> for current guidance and epidemiologic data.\u00a0 COVID-19 cases and hospitalizations are on the rise across the Commonwealth, and the number of reported outbreaks (70 confirmed outbreaks) for the week ending October 24 is the highest weekly number of outbreaks reported since the start of the pandemic.\u00a0 I want to highlight the following updates:<\/p>\n VDH Interim COVID-19 Antigen Testing Recommendations<\/strong><\/a>\u00a0 <\/u><\/strong><\/p>\n Although VDH considers RT-PCR to be the \u201cgold standard\u201d for diagnosing COVID-19, VDH developed interim antigen testing recommendations for COVID-19 that summarize current recommendations about the use, evaluation, and interpretation of antigen tests.\u00a0 Test results should be interpreted with consideration of pre-test probability of infection, including the patient\u2019s recent exposures and presence\/absence of signs and symptoms.\u00a0 The table on Page 4 of this letter summarizes result interpretation for symptomatic and asymptomatic persons. VDH also updated the antigen and molecular testing algorithms<\/a> for healthcare personnel.<\/p>\n By law, all positive and negative COVID-19 test results from diagnostic testing or screening must be reported electronically to VDH within 24 hours, regardless of the test type<\/strong>.\u00a0 VDH\u2019s<\/a> Reporting Portal for Point-of-Care (POC) Test Results<\/a> may be used to meet this rapid reporting requirement for POC tests and allows for aggregating negative results for high-volume sites.<\/p>\n COVID-19 Transmission in Acute Care Hospitals<\/strong><\/p>\n Since August 2020, the number of reported COVID-19 outbreaks in Virginia hospitals has increased substantially.\u00a0 The largest monthly number of hospital COVID-19 outbreaks since the pandemic began was reported in October.\u00a0 Increases in the number of hospitalizations and ICU bed utilization also have been observed<\/a>.\u00a0 Recent investigations have highlighted the need to reiterate the infection prevention and control (IPC) procedures listed below.\u00a0 In addition, simultaneous transmission of COVID-19 and multidrug-resistant organisms (MDROs) is occurring in several hospitals and other healthcare facilities across Virginia, further highlighting the need to focus on IPC measures across all units.<\/p>\n VDH reminds hospitals and healthcare personnel to:<\/p>\n VDH Tools for Evaluating a Child with COVID-19 Symptoms or Exposure<\/strong><\/a><\/p>\n VDH updated an algorithm <\/a>to assist parents and guardians, schools and childcare facilities, and healthcare providers in determining when a child should be excluded from the facility; when care and further evaluation for COVID-19 should be pursued; and when the child can return to the school or childcare facility.\u00a0 VDH also developed a guideline \u201cWhen Should a Child Stay Home from School and\/or Child Care\u201d<\/a> to explain key decision points with images and text for parents, schools, and healthcare providers.\u00a0 These materials are available on these websites:\u00a0 K-12 Education<\/a>, Child Care & Camps<\/a>, and Resources and Support<\/a>.<\/p>\n \u00a0<\/strong>Recommendations for Isolation and Quarantine <\/strong><\/p>\n \u00a0<\/strong>As a reminder, VDH recommends a time- or symptom-based strategy, not<\/u> a test-based strategy, for most people diagnosed with COVID-19.\u00a0 This means that people with COVID-19 may be released from isolation if there has been at least 10 days since symptoms appeared (or 10 days since positive test, if asymptomatic), at least 24 hours with no fever without fever-reducing medication, and symptoms have improved.\u00a0 A test-based strategy can be considered for determining either when to end isolation for infected persons who are severely immunocompromised or when to discontinue transmission-based precautions<\/a> for patients in healthcare settings earlier than if the symptom-based strategy were used.\u00a0 Close contacts of people with COVID-19 may be released from quarantine 14 days after their last contact; close contacts who have a negative COVID-19 test still must quarantine for the entire 14-day period. This is because it can take up to 14 days for symptoms to develop.\u00a0 Available VDH tools about isolation and quarantine are posted on the VDH Resources and Support page<\/a> and include VDH Isolation and Quarantine: What’s the Difference?<\/a>, VDH When to End Isolation or Quarantine<\/a>, and VDH Algorithm for Evaluating Non-Critical Infrastructure Workers with COVID-19 Symptoms or Exposures<\/a>.<\/p>\n Vaccination for Flu and Other Diseases<\/strong><\/p>\n \u00a0<\/strong>Influenza (flu) vaccination is more important this year than any other to protect ourselves, our loved ones, and our healthcare system.\u00a0 Without high flu vaccination rates this winter, we can expect increased burden on our healthcare system while treating those sickened by flu and COVID-19. With flu vaccination, we can prevent some of those illnesses or reduce the severity of illnesses to preserve healthcare capacity for those that are sickened by SARS-CoV-2.<\/p>\n I am excited to report that based on doses entered into the Virginia Immunization Information System (VIIS) between July 1 – October 15, 2019 vs. the same time period in 2020, flu vaccination is up over 35%.\u00a0 Please continue to provide flu vaccination to your patients and urge those who have not yet been vaccinated to do so as soon as possible.<\/p>\n \u00a0<\/strong>Routine childhood immunization in Virginia took a deep dive early in the Spring of 2020.\u00a0 Fortunately, over time, routine immunization has increased from its lowest point in April.\u00a0 However, it is still not back to normal.\u00a0 Please join me in this important call to action:<\/p>\n Thank you for all your continued efforts to protect Virginians from COVID-19.\u00a0 Please continue to contact your local health department<\/a> if you have questions about COVID-19.<\/p>\n Sincerely,<\/p>\n M. Norman Oliver, MD, MA<\/p>\n State Health Commissioner<\/p>\n \u00a0<\/strong><\/p>\n \u00a0<\/em><\/p>\n (test as close to symptom onset as possible and as recommended by manufacturer)<\/em><\/td>\n a known COVID-19 case<\/strong><\/td>\n without Close Contact#<\/sup> to <\/strong><\/p>\n a known COVID-19 case<\/strong><\/td>\n<\/tr>\n \u2022\u00a0\u00a0 Prompt isolation until no longer contagious by symptom-based strategy<\/a><\/td>\n \u2022\u00a0\u00a0 Prompt isolation until no longer contagious by time-based strategy<\/a><\/td>\n \u2022\u00a0\u00a0 Prompt isolation while awaiting confirmatory test result<\/p>\n\n
\n
\n
\n
\n
Table 1. Antigen test result interpretation for symptomatic and asymptomatic persons<\/strong><\/h3>\n
\n\n
\n Test Result<\/strong><\/td>\n \u00a0Person Being Tested<\/strong><\/td>\n<\/tr>\n \n <\/td>\n Symptomatic <\/strong>Person<\/strong><\/p>\n Asymptomatic <\/strong>Person with Close Contact#<\/sup> to <\/strong><\/p>\n Asymptomatic Person<\/strong><\/p>\n \n Positive<\/strong><\/td>\n \u2022\u00a0\u00a0 Current infection<\/p>\n \u2022\u00a0\u00a0 Current infection<\/p>\n \u2022\u00a0\u00a0 Presumptive current infection<\/p>\n