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Va. COVID-19 cases rise to 16,901 as health department methodology changes

A graph provided by the Virginia Department of Health showing the overall curve of cases in Virginia
A graph provided by the Virginia Department of Health showing the overall curve of cases in Virginia(WHSV)
Published: May. 1, 2020 at 9:13 AM EDT
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As of Friday, May 1, the Virginia Department of Health has received 16,901 confirmed tests and clinical diagnoses for COVID-19 across the commonwealth.

New positive results submitted to the department 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; 10,000 by Wednesday, April 22; 11,000 by Friday, April 24; 12,000 by Sunday, April 26; 13,000 by Monday, April 27; 14,000 by Tuesday, April 28; and 15,000 by Thursday, April 30.

This past Sunday and Monday saw declining daily case totals, but a rise of 804 from Monday to Tuesday broke that streak. From Tuesday to Wednesday, cases rose by 602, and from Wednesday to Thursday, cases rose by 885. Then, from Thursday to Friday, cases rose by 1,055.

A spike in numbers and a change in methodology

That was the highest single-day rise in cases reported yet in Virginia, and it appeared to correlate to another surprising number: 15,000 new tests appearing in the state's reporting system from Thursday to Friday, which would have been a shockingly large increase of testing for Virginia, which, earlier this week,

for total tests given per capita.

But that spike in testing numbers was partially due to a change in methodology by the health department, health commissioner Dr. Norm Oliver explained in the

.

Essentially, while the health department used to report testing numbers based on the total number of people tested, they now report the total number of tests administered.

Dr. Oliver said the number of tests from Thursday to Friday was actually about 5,800, which was still a significant increase in testing from where Virginia had been earlier this week.

But the overall testing number on the state website was adjusted on Friday to include tests that hadn't previously been included in the total, due to the change in methodology, causing it to show 15,000 new tests, though not all were from the previous day.

According to Dr. Oliver, previously, it was not uncommon for a sick patient to get tested, get tested again in the hospital, and potentially get tested again going to a skilled nursing facility, and that would all display as one test on Virginia's system. Now, the system will indicate every single test, rather than just the total number of people tested.

The rationale behind the change, according to Northam's staff, is because every test administered uses testing supplies, reagents, and PPE that is critical to the state response.

They estimated about ten percent of people positive for COVID-19 received more than one test, causing the increase in Friday numbers.

It also is one explanation for why Virginia's testing numbers had been so low, compared to surrounding states.

Dr. Oliver said the discrepancy from the new methodology was a one-time change and won't cause errors in the future. He also quickly rebutted a reporter who asked if it artificially inflates Virginia's numbers, saying it instead more accurately shows the tests Virginia has delivered.

Where Virginia stands

One month ago, as we began April, Virginia

. A month later, reported cases have multiplied more than 11 times.

Virginia's projected peak, according to most data modeling, should be this week, but it's been difficult to gauge when, until Friday, less than one percent of Virginians had been able to receive lab tests for the virus.

Last Friday, Gov. Ralph Northam

, based on comprehensive testing, a steady supply of PPE, and requirements on open hospital capacity.

Those guidelines, based on federal guidance from the White House, call for 14 days of declining daily case totals before Virginia can enter Phase 1. The governor

that the benchmark is based on a 14-day trend downward – not necessarily broken by one or two days with an increase – but we're not at that point yet, especially as the commonwealth works to ramp up testing, which will continue to cause increases in case numbers.

But as testing increases, the rate of tested Virginians who received positive results is starting to slowly drop.

Statewide case totals and testing numbers as of May 1

By May 1, the Virginia Department of Health had received reports of 16,109 confirmed and 792 probable cases of COVID-19 across the commonwealth.

"Probable" cases are cases that were diagnosed by a doctor based on symptoms and exposure without a test – also known as clinical diagnoses.

Those positive test results are out of 105,648 people that have been tested in Virginia, which is a jump of nearly 15,000 tests from the 90,843 tests that had been reported by Thursday.

Overall, considering testing numbers and positive results, a little less than 16% of Virginians who have been tested have received positive results. The increase in testing has already brought that percentage point down from over 17%.

At this point, 2,416 Virginians have been hospitalized due to the disease caused by the virus, and at least 581 have died of causes related to the disease.

The hospitalization and death numbers are the totals confirmed by the Virginia Department of Health, which are always delayed by several days due to the logistics of medical facilities reporting information to local health districts, when then report it to the state health department.

The

shows a lot of detail by locality, including hospitalizations and deaths for each city or county, and will soon be updated to break the data down by zip code as well.

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 May 1, there were at least 44 confirmed cases in Augusta County, 456 cases in Harrisonburg, 249 cases in Rockingham County, 104 cases in Page County, 120 cases in Shenandoah County, 12 cases in Staunton, 13 cases in Waynesboro, 2 cases in Highland County, 115 cases in Frederick County, 41 cases in Winchester, and 7 cases in Rockbridge County, along with 4 in Lexington.

Local outbreaks

Part 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 Tuesday, April 28, the facility had

due to coronavirus.

A separate outbreak in Harrisonburg,

, has resulted in at least 25 positive cases, according to the Virginia Department of Corrections.

Another involves

as of April 30. The health district has not publicly identified LCS as an outbreak site, but the number of cases they have confirmed to employees meets the VDH definition of a congregate setting outbreak.

In Page County, which went from 30 cases last Friday to 100 as of Thursday, a large part is accounted for from an outbreak at

, where 59 residents tested positive for the virus amid an outbreak.

The facility has 115 residents total. According to Dr. Colin Greene, with the Lord Fairfax Health District, about 10-15 percent of staff members there have tested positive as well.

The Central Shenandoah Health District currently has 11 identified outbreaks and the Lord Fairfax Health District has 12.

Dr. Colin Greene, the director of the Lord Fairfax Health District, told WHSV on Thurday that they're looking into three other "significant outbreaks" in their area, including two at workplaces and one at a long-term care facility, though he does not have permission from the facilities to share their identities.

Those outbreaks are a major factor behind the increase of cases across their district since last week.

Health department officials have not specified the majority of the locations of our outbreaks, given that Virginia state code requires permission to be granted by a facility for their information to be released to the media. Many have been identified in congregate settings, which could include workplaces, apartment complexes, churches, gyms, or any setting with a group of people in one place.

Hospitalizations

Of the state's total hospitalizations, at least 44 have been in the Central Shenandoah Health District. Of those, 2 are in Augusta County, 26 in Harrisonburg, 15 in Rockingham County, and 1 in Waynesboro.

In the Lord Fairfax Health District, there have been at least 41 hospitalizations. Twelve of those have been in Shenandoah County and 11 in Page County.

Deaths

As far as deaths, there have been two reported in Shenandoah County, one in Page County, one in Augusta County, 11 in Harrisonburg, and one in Rockingham County.

Although the statewide numbers still list 11 deaths for Harrisonburg, the

of coronavirus-related causes.

While the state-listed number remains for Rockingham County has remained at one, WHSV has confirmed with Cargill

of COVID-19.

Dr. Norm Oliver, the state's health commissioner, has said that it often takes several days before local health districts are able to enter death information into the state database. Dr. Laura Kornegay, director of the Central Shenandoah Health District, told WHSV that deaths first have to be reported to them by medical facilities, which is a major cause for the delay on the numbers reported for our area.

Dr. Kornegay also explained that if someone has tested positive for COVID-19, that's what goes on their death certificate. Those death certificates have a space to list secondary causes of death, and that's where ongoing health issues like heart disease and cancer are listed – the same process is how flu deaths are reported.

Other local updates

Just to the east, there have been at least 103 cases in Albemarle County, 58 in Charlottesville, 10 in Greene County, and 8 in Nelson County. There have been at least 59 hospitalizations there.

In the part of West Virginia we cover, three case have been three confirmed cases

, five cases

, and one case in Grant County.

What about testing on a local level?

As of May 1, the newly updated VDH dashboard, which goes into a lot more demographic detail by locality, no longer shows the overall number of tests administered per locality.

As of April 30, the Thomas Jefferson Health District had reported 3,317 total COVID-19 tests performed. The Lord Fairfax Health District had reported 3,371 tests, and the Central Shenandoah Health District had reported 2,648 tests.

For context, on a state level, of the COVID-19 tests administered, a little more than 17% of people tested have received positive results. Of the tests administered in the Central Shenandoah Health District, around 28% of people tested have received positive results.

Testing numbers for the Central Shenandoah Health District should rise in the coming days as

.

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 30, at least 2,196 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 1,431.

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 May 1 breakdown, 105,648 people in Virginia had been tested for the virus, with 16,901 positive results. The number of total tests increased significantly in recent days, with about 15,000 tests administered from Friday to Monday, falling in line with Gov. Northam's guidelines to focus on comprehensive testing for the state. But from Monday to Tuesday, the daily testing rate appeared to fall back to around 2,000 tests. From Tuesday to Wednesday, about 3,000 tests were registered. From Wednesday to Thursday, more than 5,000 new tests were reported. From Thursday to Friday, around 5,800 new tests were reported, among the about 15,000 total tests that were newly added to the system due to the change in methodology as of May 1.

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 May 1. You can find the breakdown for the entire state in the chart below our list.

Central Shenandoah

• Augusta County - 44

• Buena Vista - 6

• Harrisonburg - 456

• Highland County - 2

• Lexington - 4

• Rockbridge County - 7

• Rockingham County - 249

• Staunton - 12

• Waynesboro - 13

Outbreaks:

11, with 2 in long-term care facilities, 1 in a healthcare setting, 6 in congregate settings, 1 in a correctional facility, and 1 in an educational setting

Lord Fairfax

• Clarke County - 9

• Frederick County - 115

• Page County - 104

• Shenandoah County - 120

• Warren County - 57

• Winchester - 41

Outbreaks:

12, with 4 in long-term care facilities, 3 in healthcare settings, and 5 in congregate settings

Thomas Jefferson

• Albemarle County - 103

• Charlottesville - 58

• Fluvanna County - 74

• Greene County - 10

• Louisa County - 45

• Nelson County - 8

Outbreaks:

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

Rappahannock Rapidan

• Culpeper County - 162

• Fauquier County - 128

• Madison County - 14

• Orange County - 36

• Rappahannock - 5

Outbreaks:

2, with 1 in a healthcare setting and 1 in a congregate setting

The statewide situation in Virginia

Virginia remains under a series of public health orders and executive orders designed to slow the spread of COVID-19 in the commonwealth. The timeline of those measures can be seen below.

On Wednesday, April 29, Gov. Ralph Northam

, letting elective procedures resume on May 1. That also effectively re-opened dentist's offices for regular appointments and veterinarian's offices.

On April 24, the governor

, calling for the commonwealth to see a 14-day trend of declining daily case totals before the process begins.

Executive Order 53, which closed many non-essential businesses and banned gatherings of more than 10 people, is set to last until at least May 8, after

.

, the 'Stay at Home' order signed by Northam on March 30, is set to run through at least June 10, as it has been since its signing. It instructs all Virginians to stay home except for essential needs.

Virginia remains under a state of emergency until June 10 as well.

Of the orders in place, Executive Order 53 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

.

Virginia's

and the

have each been postponed by two weeks as well.

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.

It spreads primarily through respiratory droplets produced when an infected person coughs or sneezes. Those droplets may land on objects and surfaces. Other people may contract the virus by touching those objects or surfaces and then touching their eyes, nose, or mouth.

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.

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.

There is currently no vaccine to prevent or antiviral medication to treat COVID-19. The best way to avoid illness is preventing exposure, which is why governments around the world have implemented Stay at Home orders.

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

and the

.

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