Richmond Times-Dispatch

Northam warns of strain on hospitals

Governor says if trends continue, more public restrictio­ns could follow

- BY MEL LEONOR AND MICHAEL MARTZ

Gov. Ralph Northam on Wednesday warned Virginians of capacity and staffing strains among some of the state’s hospitals due to the latest surge of COVID-19, and suggested that if trends continue, more public restrictio­ns could be on their way.

Northam’s comments came as

Ballad Health, a hospital system that serves Southwest Virginia and Tennessee, announced that it will halt nonemergen­cy elective procedures, starting Monday.

On Wednesday, the Virginia Hospital and Healthcare Associatio­n reported that the number of hospitaliz­ed COVID-19 patients statewide had reached a new high: 1,669. Coronaviru­s hospitaliz­ations in Virginia previously peaked at 1,573 in early May.

Statewide, occupied beds remain below total capacity and well below the state’s surge capacity, but Northam said that the situation is perilous.

“In some parts of the state, if you get this virus and need to go to the hospital, there is not a bed for you, near your home,” Northam said during a news conference Wednesday. On hospitals statewide, Northam added: “Right now, the capacity exists, but let’s not put that to the test.”

Virginia is expected to start receiving its first doses of COVID19 vaccine before the end of the year, but the number of promised vaccines falls well short of the amount needed for the health care workers and nursing home residents who are first in line to get it.

Northam, a pediatrici­an, said he is watching the state’s trends to gauge whether further public restrictio­ns are needed to stem the surge of the virus, which his administra­tion largely chalks up to social gatherings and weariness among the public to continue to follow health guidance.

“I continue to closely monitor the numbers, and we’ll evaluate whether further mitigation steps are necessary,” said Northam,

pointing specifical­ly to the effects of Thanksgivi­ng gatherings.

Over the past week, Virginia has reported an average of 2,311 cases per day, while the positivity rate has climbed to 8.3%. (The positivity rate is the number of positive COVID-19 test results among everyone tested on a given day. The World Health Organizati­on suggests that the number should remain below 5%, a signal that the spread of the virus is under control.)

Virginia’s positivity rate moved past 5% on Oct. 13 and has been on the rise ever since. All of the state’s regions are experienci­ng surges, most notably Southwest Virginia, where health care resources were already limited before the pandemic.

Northam said the state’s contact tracers report that much of the spread is taking place in community and social settings — at small gatherings, churches and schools.

“What all of these settings have in common is that people are getting together, often indoors in places where they feel safe, and they let their guard down,” Northam said.

“Virginia, you know the truth: If you don’t wear a mask, and you don’t socially distance, and you think your right to ignore public health advice trumps your neighbors’ right to not get infected by you, these cases will just continue going up. It’s just selfish.”

Preparing for a vaccine

Northam said the state is working diligently to prepare for the delivery of the first doses of the COVID-19 vaccine. Under guidance from the federal government, the doses will first be distribute­d to health care workers and nursing home residents — a group that comprises about 500,000 people, health officials say.

The state confirmed that it will receive 70,000 doses of the vaccine from Pfizer as part of the company’s first wave of distributi­on, which is expected to take place before the end of the year. The state also is expecting an as-yet-undisclose­d number of doses from Moderna.

There likely won’t be enough initial doses to serve all health care workers and nursing home residents, and the state is working to decide who should go first. The next round of priority groups will include essential workers and people at higher risk of complicati­ons from the virus.

Health Secretary Dan Carey said it could be months before the state serves its priority groups, meaning that wide public access to the vaccine is still at a distance.

“It’s a significan­t number of folks who are simply over 65, and those that have chronic conditions and essential workers and infrastruc­ture workers, et cetera,” Carey said. “It’s millions of folks, so it’ll be a ways before we get to the general public.”

Northam sought to dispel fears about the vaccines, vouching for the federal regulatory process that would approve them and promising that his health department would do its own review of available vaccine data.

“Scientists know how to create vaccines that work and, most importantl­y, that are safe. As a doctor, I amconfiden­t that all protocols have been followed and no corners have been cut, as I expect the FDA review will show,” Northam said.

Budget concerns

Virginia faces a potentiall­y big bite in its general fund budget to pay for distributi­on of one or more vaccines as early as mid-December.

State officials expect the federal government to pay for the vaccine doses, but distributi­on will be an expensive challenge, especially as more doses become available for the wider population beyond health care workers and long-term care residents and employees.

“We’re going to have to fill some gaps,” Secretary of Finance Aubrey Layne said in a recent interview.

Layne won’t say how much the state expects to budget for distributi­on until Northam proposes a new two-year budget on Dec. 16.

The General Assembly money committees expect distributi­on to cost $99 million to $121 million over two years, depending on whether the number includes the cost of communicat­ions, messaging and ongoing disease surveillan­ce through contact tracing.

Currently, those costs represent “priority spending” for the $46.1 billion general fund budget, which relies on state taxes to pay for core government services such as education, public safety and health care.

“The important thing is to make sure the citizens of the commonweal­th are taken care of,” House Appropriat­ions Chairman Luke Torian, DPrince William, said Wednesday.

Timing is a major challenge for paying those expenses.

Federal money from the CARES Act cannot be spent beyond Dec. 30, unless Congress and President Donald Trump agree to extend the deadline, as Virginia Attorney General Mark Herring and 48 other attorneys general asked earlier this week.

“It would be wonderful if they would extend the deadline,” Torian said. “That would be extremely helpful, not only for Virginia, but also states all across the country.”

However, Layne said the budget that legislator­s approved in special session last month and Northam signed on Nov. 18 restricts the governor’s ability to spend CARES Act money or other emergency funding without General Assembly approval.

“It’s tied up in the budget,” Layne said. “It has to be appropriat­ed.”

The next budget is likely not to take effect before April at the earliest, he said.

At the same time, Virginia is waiting on Congress to decide whether to approve additional emergency relief, either in another COVID-19 stimulus package or a stopgap relief bill.

Sen. Mark Warner, D-Va., and a bipartisan congressio­nal group, including Rep. Abigail Spanberger, D-7th, proposed a framework Tuesday for an interim package to provide

$908 billion in additional funding through March. (Northam said he would confer with the state’s congressio­nal delegation Wednesday evening.)

The White House and Senate Majority Leader Mitch McConnell, R-Ky., showed no interest in the bipartisan proposal, according to news reports, which suggested a smaller relief package could be part of a broader resolution for funding the federal government beyond Dec. 11.

Otherwise, Congress could wait for President-elect Joe Biden to take office on Jan. 20 before acting on emergency relief.

“Assuming there is another stimulus package, it won’t be addressed anytime soon,” Layne said.

 ??  ?? Northam
Northam
 ?? DEAN HOFFMEYER/ TIMES-DISPATCH ?? Gov. Ralph Northam said
Wednesday that the state’s contact tracers report that much of the spread is taking place in community
and social settings— at small gatherings, churches and
schools.
DEAN HOFFMEYER/ TIMES-DISPATCH Gov. Ralph Northam said Wednesday that the state’s contact tracers report that much of the spread is taking place in community and social settings— at small gatherings, churches and schools.

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