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Virginia coronavirus cases rise by more than 4,000 in a week, hit 11,594

Graphic provided by the Virginia Dept. of Health showing cases on a rate per 100,000 people as of April 23, 2020
Graphic provided by the Virginia Dept. of Health showing cases on a rate per 100,000 people as of April 23, 2020(WHSV)
Published: Apr. 24, 2020 at 9:11 AM EDT
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As of Friday, April 24, the Virginia Department of Health has received 11,594 confirmed tests and clinical diagnoses for COVID-19 across the commonwealth.

New positive results submitted to the department have accelerated rapidly throughout April, with Virginia first crossing 2,000 cases on Friday, April 3; 3,000 cases by Tuesday, April 7; 4,000 cases by Thursday, April 9; 5,000 by Saturday, April 11; 6,000 by Tuesday, April 14; 7,000 by Friday, April 17; 8,000 by Saturday, April 18; 9,000 by Tuesday, April 22; and 10,000 by Wednesday, April 23.

, Virginia was at 7,491 cases.

On Monday, there had been

, but that streak of lower daily totals was broken by

.

Wednesday's update was another jump of 636 cases. Thursday's update saw an increase of more than 730 cases. Friday saw 596 new cases.

Virginia's projected peak, according to UVA data modeling, should be in the coming days.

Researchers are also extremely confident there are many more people with positive cases who have not been tested because they didn't show symptoms, but can still pass the virus on to others. In long-term care facilities in Virginia where the full populations have been tested, large numbers of residents tested positive without displaying symptoms.

Case totals as of April 24

By April 24, the Virginia Department of Health had received reports of 11,169 confirmed and 425 probable cases of COVID-19 across the commonwealth.

Since Tuesday's update to the VDH system, the department now clarifies the difference in cases confirmed by lab tests and "probable" cases, which are cases that were diagnosed by a doctor based on symptoms and exposure without a test.

Those positive test results are out of 69,015 people that have been tested in Virginia, which comes out nearly 17% of Virginians tested for the coronavirus receiving positive results.

At this point, 1,837 Virginians have been hospitalized due to the disease caused by the virus, and 410 have died of causes related to the disease, which marks an increase of 38 recorded deaths in a day.

In

, Dr. Norm Oliver, the state health commissioner, said the data on deaths displayed by the VDH is almost always delayed by a day or several from when the deaths actually occurred.

Although the statewide numbers list 9 deaths in Harrisonburg, the

of coronavirus-related causes.

Those numbers should be reflected in the state dashboard in the days to come.

One death has been reported in Augusta County and one death in Rockingham County as well.

Since April 21, the

has been updated to show a lot more detail by locality, including hospitalizations and deaths for each city or county.

The hospitalization numbers are cumulative — they represent the total number of people hospitalized due to the disease throughout the outbreak and not the total number currently in the hospital. For current hospitalization stats,

.

Local cases

In our area, as of April 24, there were at least 34 confirmed cases in Augusta County, 355 cases in Harrisonburg, 176 cases in Rockingham County, 30 cases in Page County, 65 cases in Shenandoah County, 10 cases in Staunton, 10 cases in Waynesboro, 1 case in Highland County, 87 cases in Frederick County, 31 cases in Winchester, and 5 cases in Rockbridge County, along with 3 in Lexington.

A significant portion, though not the majority, of the Harrisonburg number, which has the most confirmed cases in our region, comes from

, where the Virginia Department of Health and UVA Health collaborated to test every resident and staff member, finding 81 residents and 12 staff members positive by this past weekend

By Wednesday, April 22, the facility had

due to coronavirus.

It's one of several outbreaks across our area, and the most severe one.

The Central Shenandoah Health District has 9 identified outbreaks and the Lord Fairfax Health District has 10.

Health department officials have not specified the majority of the locations of those outbreaks, given that Virginia state code requires permission to be granted by a facility for their information to be released to the media.

The Lord Fairfax Health District is

, as of Wednesday afternoon, but at this point, only one case has been confirmed there.

Of the state's total hospitalizations, at least 39 have been in the Central Shenandoah Health District. Of those, 2 are in Augusta County, 23 in Harrisonburg, 13 in Rockingham County, and 1 in Waynesboro.

In the Lord Fairfax Health District, there have been at least 31 hospitalizations. Ten of those have been in Shenandoah County and eight in Page County.

Just to the east, there have been at least 72 cases in Albemarle County, 45 in Charlottesville, 10 in Greene County, and 7 in Nelson County. There have been 49 hospitalizations there.

In the part of West Virginia we cover, one case has been confirmed

, three cases

, and one case in Grant County.

The numbers provided here are a blend of the data provided by the Virginia Department of Health and case updates provided directly by our local health districts.

What about testing on a local level?

As of April 24, the Thomas Jefferson Health District had reported 2,738 total COVID-19 tests performed. The Lord Fairfax Health District had reported 2,642 tests, and the Central Shenandoah Health District had reported 2,155 tests.

For context, on a state level, of the COVID-19 tests administered, a little more than 15% of people tested have received positive results. Of the tests administered in the Central Shenandoah Health District, more than 27% of people tested have received positive results.

According to Dr. Greene, with the Lord Fairfax Health District, those testing numbers reported by the Virginia Department of Health may not include all the tests that have actually been conducted. He said tests performed by private labs aren't always reported to the state if they came back negative, so advised that those numbers generally don't show the full picture.

Dr. Forlano, the state's deputy health commissioner, said in a Wednesday briefing that the state data is meant to give at look at overall trends more than it's meant to show every single case.

Recovery

Wondering about the number of people who have recovered from COVID-19 in Virginia? Recovery information is not required to be sent to the Department of Health, so there is no accurate way to track that data for every single confirmed case.

But there is a way to track the number of patients who were hospitalized due to COVID-19 and have since been discharged – effectively tracking how many people have recovered from the most severe cases.

The Virginia Hospital & Healthcare Association updates their own dashboard of data each day on hospital-specific statistics, including bed availability, ventilator usage, and more. Their

indicates that, as of April 24, at least 1,672 COVID-19 patients have been discharged from the hospital.

Unlike the VDH data that reports cumulative hospitalizations, their data on hospitalizations reflects people currently hospitalized for COVID-19 (whether with confirmed or pending cases), and that number is at 1,399.

The data used by the VDH to report

cumulative

hospitalizations is based on information reported in hospital claims. On the other hand, the numbers reported by the Virginia Hospital & Healthcare Association are based on a current census from hospitals, which provides a separate data set.

Timing of VDH data

The

is updating with the latest statewide numbers at 9 a.m. each day.

The numbers that appear on that list are based on the cases that had been submitted to the department by 5 p.m. the previous day, so there is always some lag between when local health districts announce positive test results and when the department's numbers reflect those new results.

Reporting by local health districts

Our Virginia counties are primarily served by the Central Shenandoah Health District, which covers Augusta, Bath, Highland, Rockbridge and Rockingham counties, as well as the cities of Buena Vista, Harrisonburg, Lexington, Staunton and Waynesboro; and the Lord Fairfax Health District, which covers Shenandoah, Page, Frederick, Warren, and Clarke counties, as well as the city of Winchester.

Where are all the confirmed cases in our region?

According to the Virginia Department of Health's April 24 breakdown, 64,518 people in Virginia had been tested for the virus, with 10,998 positive results. The number of total tests, which had been growing, has plateaued recently, but of those tests, cases keep increasing.

The department's breakdown and location map, available to the public

, shows the number of cases confirmed each day, number of people tested, total hospitalizations, total deaths, and demographic breakdowns, as well as breakdowns by health district.

Here's a breakdown of cases for our region as of 9 a.m. on April 24. You can find the breakdown for the entire state in the chart below our list.

Central Shenandoah

• Augusta County - 34

• Buena Vista - 5

• Harrisonburg - 355

• Highland County - 1

• Lexington - 3

• Rockbridge County - 5

• Rockingham County - 176

• Staunton - 10

• Waynesboro - 10

Outbreaks:

9, with 2 in long-term care facilities, 1 in a healthcare setting, 4 in congregate settings, 1 in a correctional facility, and 1 in an educational setting

Lord Fairfax

• Clarke County - 7

• Frederick County - 87

• Page County - 30

• Shenandoah County - 65

• Warren County - 36

• Winchester - 31

Outbreaks:

10, with 2 in long-term care facilities, 3 in healthcare settings, and 5 in congregate settings

Thomas Jefferson

• Albemarle County - 72

• Charlottesville - 45

• Fluvanna County - 72

• Greene County - 10

• Louisa County - 38

• Nelson County - 7

Outbreaks:

3, with 2 in long-term care facilities and 1 in a correctional facility

Rappahannock Rapidan

• Culpeper County - 90

• Fauquier County - 73

• Madison County - 14

• Orange County - 22

• Rappahannock - 1

Outbreaks:

1 in a healthcare setting

The statewide situation in Virginia

On Friday, April 24, Gov. Ralph Northam

, based on testing, PPE, and hospital capacity requirements. The governor also announced that he was delaying May's local elections by two weeks.

, but Tuesday saw an increase of more than 600 cases that quickly broke that trend.

On Thursday, April 23, Gov. Ralph Northam

, bringing the expiration dates of those orders more in line with other statewide orders.

Last Friday, Northam

to allow more medical providers to practice in Virginia during the state of emergency, and talked about the federal guidelines for reopening the state.

Last Wednesday, he

, which closed many non-essential businesses and banned gatherings of more than 10 people. That order is now set to run through at least May 8.

The previous Friday, he

, proposed the release of inmates with less than year left in their sentences, and emphasized a need for volunteers.

On April 8, he

to November by the General Assembly.

On March 30, Gov. Northam

by signing

, effectively instructing all Virginians to stay home except for essential needs.

Virginia remains under a state of emergency until June 10, and Northam's order that closed many non-essential businesses,

, remains in place until at least May 9.

That order is enforceable by law, so someone who hosts a gathering of more than 10 people can be charged with a Class 1 misdemeanor. You can learn more about what police enforcement of Northam's executive orders looks like

.

The latest updates from Gov. Northam's April 20 briefing
Testing plans

The governor started Monday's briefing by emphasizing that the ability to run a large number of tests is key to any plan to ease restrictions on businesses or gatherings.

He ran through a timeline of how testing has gone throughout the COVID-19 pandemic, starting with the beginning, in which Virginia, like all states had to rely on CDC tests and ship them to Atlanta to receive any confirmation of results. Following that, the state lab developed the ability to perform in-house testing, and after that, as capacity increased on the state lab level, hospitals, private labs, and universities developed their own tests and well and steadily scaled up capacity.

That included tests developed by UVA and VCU.

Governor Northam said that, thanks to the efforts of all those facilities developing in-house testing, initial backlogs of tests have largely been reduced.

The governor said the state lab can now perform 300 tests a day, and, with equipment sent from Altria this week, will be able to run 400 tests a day by next week.

That only represents part of the tests being run each day across the commonwealth, though, with so many tests performed at health care systems and private labs that have been boosting their own testing capacity.

But, with Virginia, like all states, competing for testing supplies from federal stockpiles and corporations, the governor said the process has faced delays.

Until shortages of key supplies needed for testing, like the swabs used for tests and container to safely store tests, are addressed, the governor said capacity will face problems.

Testing work group

To help the state face the problems affecting testing, Gov. Northam said he had established a new testing work group, headed by Dr. Lillian Peake, the state epidemiologist, and Dr. Karen Remley, the former Virginia Department of Health commissioner.

Northam said the testing work group would focus on expanding test sites and testing criteria to get more tests utilized across the state.

According to Dr. Remley, their group will try to move Virginia's testing plan into a new phase, coordinating with doctors, private labs, and others to make sure everyone is aware of their role in a statewide plan for testing.

Dr. Remley said coordinating those efforts will help open up more testing for more people and help better manage supplies on a statewide level.

As of Monday, testing criteria in Virginia focused on patients hospitalized with symptoms, emergency responders, people exposed to known cases, and also people who are being admitted to long-term care centers.

State health officials said in Monday's briefing that the key strategy is not just on increasing the number of tests a day, but focusing increased testing capacity in a helpful way to address patients in the most need of them.

Clinical diagnoses

Governor Northam said the initial lack of testing supplies, especially near the beginning of outbreaks in Virginia, resulted in a lot of clinical diagnoses – doctors determining that a patient had COVID-19 based on symptoms without performing a test.

The governor said a large part of that was because of the original testing plan, which could take a week to 9 days for test returns to come back, so doctors would make quicker decisions for their patients.

Now, according to Dr. Norm Oliver, the state health commissioner, the Virginia Department of Health will be sending a clinician's letter encouraging every doctor who made a clinical COVID-19 diagnosis to test those patients to receive verifiable results.

White House governors' call

Northam said he had been on the White House call with governors earlier on Wednesday.

In that call, the governor said Vice President Mike Pence told governors that states would be getting more flexibility to develop their own testing criteria.

He said one of the main focuses was on the availability or lack thereof of swabs needed for testing across the country.

According to Northam, Vice President Pence said the Defense Production Act would be soon utilized to increase production of swabs to send out across America.

When can we ease restrictions?

Governor Northam said he knows the biggest question on many people's minds is when we'll be able to open businesses back up and ease restrictions on gatherings.

But he said the commonwealth has been following CDC guidance that was put out through the White House's 3-phase guidelines for reopening America.

Those guidelines state that states need to have 14 days of declining new case totals before phase 1 can be implemented, and Virginia is not at that point yet.

Dr. Remley, helping lead the new state testing group, said getting to the point where we can have accurate numbers to reflect that decline will depend on testing and coordination, as their group works to make sure everyone knows how they fit into the statewide plan for testing.

Although Virginia has seen lower totals in new cases reported over the past three days, the commonwealth has still seen increases of about 500 cases a day. Northam said the 3-day statistic could be misleading, and that he and state health officials are waiting to see the peak in the curve for Virginia cases, which is projected for late this week, according to UVA modeling.

When asked about the discrepancy between Executive Order 53 running until May 8, appearing to mean that non-essential businesses can reopen then, but the Stay-at-Home order requiring people to only leave home for essential reasons running until June 10, the governor said his administration is working to develop plans to make guidance on reopening non-essential busineses clearer.

He said when they have that, they will make it as clear as concise as possible.

Expanded data

The governor said he and his team have made every decision so far in this pandemic based on science and data.

To reflect that and let people see more of the data that they see every day, he said the Virginia Department of Health, starting today, will start sharing more in-depth data on their

.

Statistics breaking down cases, hospitalizations, and fatalities will be provided by each locality and each health district, along with demographic information by district.

Until today, hospitalization and fatality numbers have not been available by locality.

What about rapid testing?

New tests have been under development across the nation and the world to test people for antibodies to determine if they contracted COVID-19. The tests, in theory, should provide much quicker results than current testing and should be able to determine if someone has had the virus in the past.

However, according to Dr. Remley, Virginia is awaiting federal validation, which has not yet been provided for any of the commercially available antibody testings, before using any on a widespread scale.

Several universities and private labs, like Granger Diagnostics, have been working on developing their own tests in Virginia, but none have yet been approved and made widely available.

Food processing plants

In response to a question about workers concerned about their safety at food processing plants, Dr. Norm Oliver said that many similar facilities across the country have been sites of outbreaks and confirmed that several in Virginia have been as well.

However, as previously noted by Dr. Oliver, information on which facilities in Virginia have had outbreaks can only be provided if the facilities agree to the sharing of their information.

In our area, even with multiple confirmed outbreaks, most affected facilities have not identified themselves or agreed to the health department identifying them.

According to Dr. Oliver, local health departments have been working with plant managers at affected food processing facilities to provide personal protective equipment, provide testing, and trace the contacts of anyone with confirmed cases.

He said they're also providing suggestions and finding ways to contain the spread at those facilities, hoping to make sure workers are as safe as possible.

What does Gov. Northam have to say to 'ReOpen Virginia' protesters?

As the Republican Party of Virginia doubled down in an official statement on Monday backing President Trump's tweet to "liberate Virginia," the governor said he wants to remind Virginians of a message Vice President Mike Pence told governors in their Monday call: "one team, one mission."

The governor said that his administration has been following the White House guidelines on waiting for a 14-day downward trend in cases, so then seeing tweets from the president calling to "liberate" the state sends mixed messages.

Northam said he is just as anxious as anybody else to see restrictions eased and that he "doesn't really need protesters to remind" him that the economy needs business to open back up.

He described looking out the windows of the governor's mansion during a protest last week and seeing groups of children inches apart on blankets and about 50 adults gathering without wearing masks.

"We're all trying to get through this together," Northam said, adding that, based on his experience as a doctor, he finds the most frustrating thing to be that protesters are putting themselves at risk, all of us at risk, and putting health care providers and their families at risk.

"This is not the time to play politics," Northam said, saying it's instead a time to work together to get through the situation.

Relevant updates from Gov. Northam's April 17 briefing
Gov. Northam signs Executive Order 57

The governor announced that he had signed

on Friday as a way to help hospitals and long-term care facilities respond to the ongoing pandemic.

The order eases licensing restrictions on nurse practitioners and doctors licensed in states other than Virginia to allow them to respond in Virginia.

“While we are seeing promising signs in our ongoing fight against COVID-19, we must continue to prepare for all scenarios, and that includes making sure we have to the necessary staff to confront a potential medical surge,” said Governor Northam. “This pandemic is placing extraordinary demands on our doctors, nurses, and nurse practitioners, and these policies will enable us to expand our health care workforce so more trained medical professionals can step in and help.”

The order adds physician offices and other health care facilities to the section in Executive Order Fifty-Two allowing hospitals, nursing facilities, and dialysis facilities to have out-of-state licensees provide in-state care.

It allows Virginia-licensed nurse practitioners with two or more years of clinical experience to practice without a collaborative agreement. It provides additional flexibility to hospitals in the supervision of interns, residents, and fellows, and allows hospitals to use fourth year medical students in the provision of care.

Executive Order 57 also allows for expanded use of telehealth. Physicians with licenses from another state who have current Virginia patients may continue to treat their patients via telehealth, which will help ensure Virginians who live in border communities to not have to travel out-of-state for care.

The response to long-term care centers

Gov. Northam said that his administration has waived a number of regulatory rules around staffing so that long-term care centers across Virginia can recruit staff and volunteers quickly.

The governor said Virginia's Medical Reserve Corps is being mobilized to long-term care centers to help respond to outbreaks, like

, which Dr. Norm Oliver, Virginia's health commissioner, specifically mentioned in his part of Northam's Friday briefing on the rise of cases in the past day.

State health administrators said the National Guard is also being utilized to help train staff at long-term care centers on proper practices for using personal protective equipment.

They also announced that Virginia's expanded testing criteria, which should be announced publicly on Friday or Monday, will include people about to be admitted to congregate settings, like long-term care centers, and not just people who are already rsidents there.

Northam said any facility with an outbreak should be able to test every resident and employee, with help from several of the state's medical systems, including UVA, VCU, and the state lab.

Reduction of population in jails

The governor also discussed moves his administration has made to lower the population at jails across Virginia. You can learn more about those reductions

.

Unemployment

Northam acknowledged the recent statewide numbers of 410,000 total claims for unemployment in Virginia over the past month, and said those numbers don't even include the number of newly eligible workers under the CARES Act, including self-employed and gig workers.

He said the Virginia Employment Commission has received payroll records for about 80% of all people who have applied for unemployment benefits, and that an online portal will go live Friday night for people to submit that documentation if theirs has not yet been received.

The governor also said the VEC will be able to provide backpay for anyone who's faced delays receiving unemployment insurance benefits due to issues with the system and massive response overwhelming it.

Fifty new employees have been hired at the VEC headquarters, and they've set up at least two more call centers across the state to handle the large volume of calls.

A private call center is also being established to start running next week.

Responding to President Trump

A reporter asked the governor about his response to

to "LIBERATE" several states from COVID-19 restrictions, including Virginia.

Northam said he and his team are busy fighting a biological war and that he doesn't have time to involve himself in a Twitter war.

The governor said earlier in the press conference that he wants to get back to a place where all Virginia businesses can be open again, but that we have to get there using science and data available. Otherwise, he said, the sacrifices being made by health care professionals and first responders would be for nothing if we ignored the data, reopened too early, and caused another surge of cases.

That projection, based on UVA's modeling that the governor's team uses for Virginia planning, has been mentioned in each of the governor's briefings this week. Essentially, the model shows that Virginia hits a peak of coronavirus cases in late April or early May, but also shows if restrictions on social distancing and gatherings were to be lifted suddenly and early, Virginia would see a second surge of cases that would not peak until August. You can learn more about the Virginia modeling

.

Why aren't numbers available on outbreaks?

A reporter asked the governor to explain why, as with Accordius Health in our area and other facilities with outbreaks in other areas, the Virginia Department of Health continues to treat facilities like people and will not release any detailed information, like the number of confirmed cases at facilities.

Dr. Oliver said it's a statuary requirement of Virginia code the department cannot release information on a facility without the facility's permission.

When asked if he could override that part of the Virginia code, Gov. Northam said that is something that legislators would have to do.

What about more recovery data

The state of Maryland has established an online registry where people can report if they have recovered from COVID-19 while self-quarantining with a confirmed case or with symptoms and a clinical diagnosis without a positive test result.

Dr. Oliver said academic institutions in Virginia, including UVA, Virginia Tech, and more are establishing their own version of a registry like that to help Virginia's numbers.

New screening criteria

At a briefing earlier this week, Dr. Forlano, Virginia's deputy commissioner of public health, said that Virginia was working on a new criteria for testing across the state.

She said on Friday that the criteria will include a focus on long-term care centers, allowing people about to enter those facilities to be eligible for testing, and will continue to include a focus on health care workers, including symptomatic health care workers and workers at centers facing confirmed COVID-19 treatment.

State administrators said they want to get to a point of significantly higher testing levels per day and are exploring how to do that while facing national shortages of testing equipment and PPE needed to boost that capacity.

Dr. Forlano said the new testing criteria will be released on Friday or Monday for public review.

Gov. Northam said it's up to every state and every governor to establish their own testing guidance and protocols on where to use supplies because no national testing guidance has been established.

Response to protesters

Asked for a response to the

on Thursday, the governor said they were putting themselves at risk, but more importantly, "putting all of us at risk."

The governor called for all Virginians to unite to "be a part of the solution." While acknowledging that everyone has the right to protest, he said joining together as a team could help Virginia face the crisis together.

Relevant updates from Gov. Northam's April 15 briefing
Business closures extended

As of March 24,

ordered non-essential services, including all recreation and entertainment services, to close, as well as any non-essential businesses, like hair salons and massage therapists, that can't feasibly social distance.

is also the order that banned gatherings of more than 10 people in Virginia and limited restaurants to takeout and delivery, rather than in-house dining.

On Wednesday, Gov. Northam announced that he was extending the end-date of

by two weeks. It initially took effect for 30 days, set to expire on April 23. Now, the order is set to expire on May 8.

That means, effectively, that until May 8, gatherings of more than 10 people are banned and all businesses that had to initially close due to the order have to remain closed until May 8 at the earliest.

“As we have seen from our data and models, social distancing is working, and we are slowing the spread of this virus,” said Governor Northam. “But it is too early to let up. By extending this order to keep certain businesses closed or restricted, we can continue to evaluate the situation and plan for how to eventually ease restrictions so that our businesses may operate without endangering public health.”

The Stay at Home order, which was issued through Executive Order 55, remains in effect until June 10, as it was originally set.

The governor said he and his team will continue to monitor health data over the coming weeks to determine what happens next, after the May 8 expiration date.

Executive Order 53 covers three categories of businesses:

1. Recreational and entertainment businesses, like bowling alleys and theaters, which must close their doors by midnight on Tuesday.

2. Non-essential retail stores, which are allowed to remain open so long as they can limit patrons to 10 at most, maintain social distancing of at least 6 feet, and follow CDC guidelines on sanitation.

3. Restaurants and food service establishments, which can remain open for carry-out, curbside pickup, or delivery, but not in-house dining.

Hair salons, barbers, massage therapists and similar non-essential services who can't feasibly carry out social distancing were required to close.

Dining and on-site alcohol establishments are allowed to keep operating through delivery and takeout services, but had to close on-site dining to the public. That includes restaurants, food courts, farmers markets, breweries, distilleries, vineyards, and tasting rooms.

Grocery stores, health services, businesses in supply chains, and other essential businesses will be able to remain open no matter what. Virginia ABC stores are also considered an essential service, Northam clarified in response to a reporter's question.

The construction industry and construction supply stores are also considered essential services.

Here's a comprehensive list of businesses considered essential that may remain open during normal hours:

• Grocery stores, pharmacies, and other retailers that sell food and beverage products or pharmacy products, including dollar stores, and department stores with grocery or pharmacy operations;

• Medical, laboratory, and vision supply retailers;

• Electronic retailers that sell or service cell phones, computers, tablets, and other communications technology;

• Automotive parts, accessories, and tire retailers as well as automotive repair facilities;

• Home improvement, hardware, building material, and building supply retailers;

• Lawn and garden equipment retailers;

• Beer, wine, and liquor stores;

• Retail functions of gas stations and convenience stores;

• Retail located within healthcare facilities;

• Banks and other financial institutions with retail functions;

• Pet stores and feed stores;

• Printing and office supply stores; and

• Laundromats and dry cleaners.

All essential businesses must still adhere to social distancing as much as possible and implement enhanced sanitation practices.

The following list of businesses were required to close to the public as off 11:59 p.m. when Executive Order 53 was issued:

• Theaters, performing arts centers, concert venues, museums, and other indoor entertainment centers;

• Fitness centers, gymnasiums, recreation centers, indoor sports facilities, indoor exercise facilities;

• Beauty salons, barber shops, spas, massage parlors, tanning salons, tattoo shops, and any other location where personal care or personal grooming services are performed that would not allow compliance with social distancing guidelines to remain six feet apart;

• Racetracks and historic horse racing facilities;

• Bowling alleys, skating rinks, arcades, amusement parks, trampoline parks, fairs, arts and craft facilities, aquariums, zoos, escape rooms, indoor shooting ranges, public and private social clubs, and all other places of indoor public amusement.

Professional businesses not in any of the above lists must utilize telework as much as possible. Where telework is not feasible, such businesses must adhere to social distancing and other CDC guidelines.

Businesses violating the governor's order can be charged with a Class 1 misdemeanor.

Republican leaders in Virginia's House of Delegates – including House Republican Leader Todd Gilbert, R-Shenandoah, Republican Caucus Chair Kathy Byron, R-Bedford, and Republican Caucus Whip Jay Leftwich, R-Chesapeake – issued the following statement in response to the governor's executive order extension:

Regional coordination

According to Gov. Northam, he and his office have been talking regularly with leadership in Maryland, North Carolina, and Washington, D.C. to make sure each of the states in the region is moving forward in a coordinated way for what they determine is best for the health and safety of the public.

Why did Virginia see an increase of 41 deaths in one day?

According to

provided on Virginia's confirmed COVID-19 cases, hospitalizations, and deaths, 195 people have died of confirmed COVID-19-related causes.

That number reported by the VDH on April 15 was a jump of 41 deaths from the day before, which marked the biggest recorded one-day rise in deaths in the commonwealth.

Gov. Northam and his staff were asked what contributed to that number, and the response essentially was that a lot of the data reported to and confirmed by the state is delayed.

According to Dr. Norm Oliver, Virginia's state health commissioner, much of the data on deaths lags several days behind when the deaths actually occurred.

That's because, on the local level, due to the many steps in the process of local health districts entering data into the state system, the process can take a few days.

Dr. Oliver mentioned how the same people in local health districts responsible for tracing hundreds of people anyone with a confirmed case had contact with are the ones who have to handle data entry into the VDH system.

Often, he said, they are focused on that critical contact tracing part of their job, so data entry may not happen for a day or two, which causes the state numbers to lag behind.

Essentially, he said the numbers released at 9 a.m. each day on the VDH site reflect prior history, and not necessarily what happened on the day before.

As for the conditions of those who died, state health officials said many were elderly and had pre-existing conditions that made them especially vulnerable populations.

Testing capacity

Data reported by Johns Hopkins University on testing across the country shows Virginia having the 2nd lowest rate of testing for COVID-19 in America, behind only California.

While Virginia has tested significantly more people than a number of other states, when the numbers are considered as a factor of population, the rate of testing is under half a percentage point.

State health officials said they are working to address the lack of capacity by trying to optimize testing capacity in Virginia's state labs and commercial labs, as well as at medical centers like VCU, UVA, and Carilion.

They acknowledged that many health care providers have often been caring for patients with presumed cases of COVID-19 without necessarily confirming the diagnosis with a laboratory test, and said they're working to get more of those patients tested.

Officials said the Centers for Disease Control (CDC) has three categories of cases, and Virginia has been focusing on people hospitalized with symptoms and health care workers. They are now adding those in long-term care facilities to the list of patients who get priority for available tests.

They also said they're evaluating with medical providers to broaden the criteria of who can get tested to get a better sense of exactly what's happening, with goals of outbreak intervention and public health surveillance.

Overall, it was acknowledged that more testing clearly needs to be made available, but that the goal of testing for diseases like COVID-19 is to understand the virus' trend – not necessarily to count every single cases.

Dr. Forlano said they key word in epidemiology is "trend" and that counting every single case of a disease is only possible for extremely rare diseases, like Ebola in the U.S., and that the goal is to understand overall trends for COVID-19 in Virginia.

Clinical diagnoses

Dr. Norm Oliver acknowledged that many medical providers have made clinical diagnoses of COVID-19 – doctors saying that a patient has the virus based on symptoms without having a laboratory test to confirm their diagnosis.

He said that those diagnoses have been reported to the Virginia Department of Health and that the department has encouraged medical providers to do so.

But while they're collecting that information, until a national guideline is established defining what counts as "suspect" coronavirus case, based on clinical diagnosis instead of lab testing, those numbers are not being reported to the public with the rest of the VDH data.

When will we go back to normal?

UVA modeling data indicates that even if Northam's Stay at Home order is lifted on its current date of June 10, if all activity returns to pre-coronavirus levels, Virginia would likely see another spike of coronavirus cases that wouldn't peak until August.

However, Gov. Northam said, as of now, he has no intention of extending the Stay at Home order.

In fact, he said that what he would like to be able to do is move that date back, if at all possible. That is dependent on people following the executive orders and following the CDC's social distancing guidelines in a way that decreases Virginia's curve of cases.

But he emphasized that decisions have to be made on current data, and the data changes every day, which requires decisions to be made on a day-to-day basis.

While acknowledging that that's frustrating, the governor said his team is focusing on how to help Virginia's economy, which was booming up through March, recover.

But he said it's key for people to realize, based on the science, that we won't just one day go back to "being normal again," at least in the near future.

So long as we don't have a vaccine and don't have a treatment, it's difficult to say when people can go back to normal life, Northam said.

Wearing a mask and social distancing, as well as other CDC-recommended measures, will have to continue for our society on a day-to-day basis until more is learned about the virus and we have those options for treatment and prevention available, the governor said.

While things will not go back to exactly how they were before, he said state leaders and everyone are figuring out together how to build a new normal, with tools like tele-working, social distancing, small gatherings, and more.

"We have to weigh what we want versus what we need," Northam said.

He pointed to health care workers, grocery store employees, volunteers, and more who are risking their health every day, saying that their sacrifices are helping to slow the spread of the virus, but that "we're in all this together" to help protect those workers' families.

On the topic of families, the governor also announced that Virginia is receiving $70 million through the CARES Act to help provide childcare for children of essential workers.

Relevant updates from Gov. Northam's April 13 briefing
The latest modeling

Northam said that he and his staff have been watching national models throughout the COVID-19 pandemic to make key decisions like closing schools for the rest of the school year, issuing a Stay at Home order, and closing non-essential businesses.

Those models included the University of Washington and CHIME models, which have been heavily relied upon.

The governor noted how those models change on a daily basis and said that Virginia leadership wanted to take into account Virginia-specific data, including data on how Virginians have responded to the coronavirus.

In response, researchers with the University of Virginia have developed a specific model for the commonwealth.

It will change each day based on behavior in Virginia, but the modeling has been designed as of April 13 and was demonstrated to many reporters just before the governor's 2 p.m. briefing.

The new UVA model shows that social distancing measures are working to slow the spread of the coronavirus, Northam said, and also show that Virginia hospitals have sufficient capacity to handle the expected surge in patients.

However, the model also shows that if the Stay at Home order and other restrictions are lifted too soon, cases across Virginia would surge and threaten the available capacity at medical facilities.

Specifically, the models suggest another wave of illness in mid-July or August if we don’t slowly ease back into normal life.

"And we can't afford that," Northam said.

He reiterated that modeling data shows that the key is for "us to keep doing what we're doing" and stopping any time soon would put Virginians in danger.

Continuing education

As K-12 schools remain closed throughout Virginia until the end of the school year, teachers and school division leaders have been working hard to adapt to the situation to keep providing educational opportunities for their students.

Gov. Northam said they're all doing their best to address inequities in education to ensure all students are able to keep learning, but to help them, the state is making additional education resources available.

That includes expanding "Virtual Virginia," which is a statewide online learning system, to allow every public school teacher in Virginia to host line classes through June 30.

For students who don't have internet access, Virtual Virginia content can be loaded onto devices and used offline as well.

In addition, Northam highlighted the new

program, through which four public media TV stations have partnered with the Virginia Dept. of Education to provide education over the air.

The department also convened a task force on continuity of education to develop guidance on how to ensure that there are no gaps between who gets an education as the pandemic wears on.

Long-term care facilities

The governor said, along with budget amendments he approved by the state constitutional deadline over the weekend, was an amendment to increase rates given to long-term care facilities by $20 per Medicaid recipient per day to assist the facilities' responses to COVID-19.

The governor also said that they are looking into using Virginia's reserve corps of volunteers to help provide more staffing at nursing homes and long-term care centers facing staffing shortages, as many across the country have in the face of coronavirus.

According to the task force established last Friday on long-term care facilities across Virginia, there have been at least 554 COVID-19 cases and 34 deaths identified across the state.

Data on the number of identified outbreaks, including if they were in these especially vulnerable facilities, is now available on the

.

Dr. Laurie Forlano, the deputy commissioner for public health at the Virginia Department of Health who's been heading the task force, said that, over the weekend, when a new outbreak was identified at one long-term care center, which she did not identify, the health district reported it immediately and worked hand-in-hand with the task force to respond to the situation. She said UVA offered testing kits and increased testing capacity to test residents at the center.

She said they will continue to work with their local partners across the state to sustain that kind of response in the future.

While Dr. Forlano did not identify the specific facility or health district, the Central Shenandoah Health District reported a new outbreak in a long-term care facility this past weekend. They have declined to identify the facility to WHSV or other media outlets.

Budget amendments

Governor Northam said, among the bills he signed by the state constitutional deadline Saturday night, was the state budget, to which he and his team proposed more than 100 amendments.

According to the governor, 49 of those amendments are language amendments that would give agencies greater flexibility as to how they conduct business during the pandemic. Another 83 of the amendments, he said, would unlock new discretionary spending for state agencies to continue their response.

Challenges

When asked about a statement by President Donald Trump on hospitals doing well amid the crisis, Gov. Northam said we're nowhere near where we want to be in supplies. While Virginia hospitals remain prepared in terms of bed capacity, when looking at modeling on surge data, he said they're facing challenges on staffing, PPE, and ventilator supplies, like many hospitals across the country, and that those challenges need to be addressed in terms of reality.

Relevant updates from Gov. Northam's April 10 briefing
Task force to respond to outbreaks at nursing homes

The governor announced in his briefing that he has appointed Dr. Laurie Forlano, currently the deputy commissioner for public health at the Virginia Department of Health, to head up a task force on responding to outbreaks at nursing homes and long-term care centers across Virginia.

The move was especially prompted by the

, where dozens of people have died in recent weeks.

Northam said Dr. Forlano will head up a coalition of public health officials that will work to make sure all facilities have access to testing, PPE, and the cleaning supplies they need to respond to the pandemic.

Dr. Forlano said as staff at all these facilities are dedicated to protecting the people that live there, she and the task force will ensure long-term care facilities are prioritized and get the funding they need, as well as needed information.

The task force will also track data specific to long-term care facilities in Virginia.

For instance, on Friday, Dr. Forlano said the state has identified 45 outbreaks at long-term care facilities in the state, which makes up about 55% of all outbreaks identified in the state.

They've also identified 525 cases among those facilities.

Proposed amendment to make inmates eligible for release

The governor also announced on Friday that he is proposing a state budget amendment to give the Virginia Department of Corrections the authority to release inmates who have one year or less remaining in their sentences.

That's because most correctional facilities across Virginia face serious overcrowding

The authority granted to the department would allow them to release inmates who don't pose a threat to the safety of themselves or anyone else and also meet good behavior standards.

Under the amendment, the Dept. of Corrections would handle re-entry planning for about 2,000 inmates who meet the standard of having a year or less in their sentence.

The department, which has never before had the authority to release inmates, would need to plan for inmates to have somewhere to go upon their release and have necessary medications for at least three months.

The authority would last for the duration of Gov. Northam's executive orders, which are currently set until June 10.

However, for it to happen, the General Assembly will need to approve the amendment at their special session on April 22.

Unemployment changes

According to Governor Northam, more than 191,000 payments went out through the Virginia Employment Commission over the past week.

Next week, through the federal Pandemic Unemployment Assistance program, Virginia's unemployment insurance will offer payments boosted by about $600 a week to everyone who qualifies.

Through the CARES Act, people who previously did not qualify, like gig workers, can also now apply through the VEC and get benefits.

You can learn more about the coming unemployment insurance changes

.

What about hope?

Governor Northam was asked why, while President Donald Trump says "he's a glass half full kind of guy" and hopes to reopen the country soon, he instead provides somber updates.

Northam said while he wants everyone to get life back to normal as soon as possible, "we have to face reality."

The governor, who was a doctor before taking office, said his leadership style comes from his time in the medical field, so he's "a big believer in telling people the truth."

He said he looks at the data every day, looks at admissions to Virginia hospitals, looks at the number of patients now on ventilators, and bases public health decisions on the data and the recommendations of his staff.

"My job as your governor is to keep Virginians safe," Northam said.

He used an analogy of doctors making a treatment plan with a cancer patient, letting them know guidelines to follow and medicines to take. In a situation like that, we know that stopping the plan early just because it seems to be working is not the right course of action, because the cancer returns.

The governor said ending the Stay at Home order or social distancing guidelines because models appear to project peaks earlier would be largely the same, and people need to keep staying home and staying safe to get through this.

"This is a biologic war that we're fighting," the governor said, and Virginians all need to follow the guidelines set based on data.

The governor said we have to get through the health crisis before he sees a path to fully address the economic crisis.

General info on COVID-19
Who gets tested for the virus?

Currently, there are two main reasons someone would be tested for the coronavirus: having symptoms or exposure to an infected person. In our area, requirements for testing include both symptoms and either travel to an affected area or exposure to someone with a confirmed case.

The main symptoms of COVID-19, the disease caused by the coronavirus SARS-CoV-2, are fever, dry cough and shortness of breath. These look a lot like the flu and the common cold, so it takes a physician to determine if testing for the virus is necessary.

How does the coronavirus test work?

For a patient, the process of being tested for the virus is easy and can potentially be done almost anywhere. It typically involves taking a swab from deep in a patient’s nasal cavity to collect cells from the back of the nose.

The sample is then sent to a lab, where it will be tested to determine if the patient’s cells are infected with the virus. The same process is used to collect a sample from a patient who is tested for flu.

What to know about preventing the virus

Most people don't suffer much from COVID-19, but it can cause severe illness in the elderly and people with existing health problems.

The coronavirus that causes COVID-19 can cause mild to more severe respiratory illness. In a small proportion of patients, COVID-19 can cause death, particularly among those who are older or who have chronic medical conditions. Symptoms include fever, cough, and difficulty breathing. Symptoms appear within 14 days of being exposed to an infectious person. COVID-19 spreads primarily through respiratory droplets produced when an infected person coughs or sneezes.

To lower the risk of respiratory germ spread, including COVID-19, the Virginia Department of Health encourages the following effective behaviors:

• Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer only if soap and water are not available.

• Avoid touching your eyes, nose, and mouth.

• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

• Clean and disinfect frequently touched objects and surfaces.

• Stay home when you are sick.

• Avoid contact with sick people.

• Avoid non-essential travel.

For the latest factual information on COVID-19, you're encouraged to check both the

and the

.

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