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2 million COVID case count causes pause for reflection

The number of COVID-19 cases reported in Virginia topped two million this week and University of Virginia Medical Center officials say that milestone has caused them to stop and reflect on the past two years.

“It provides an opportunity for reflection. I think everybody is working hard to figure out how we can do these things better. From tragedy comes learning opportunities,” said Dr. Reid Adams, interim chief medical officer for the UVa Medical Center. “Emerging infectious diseases are going to become a constant issue for us in the foreseeable future. Just look at what’s happened in the last couple of months to a few years.”

“One of my thoughts is, that is a vast undercount of the number of cases that have actually occurred. That’s really accelerating because there are more and more people who have COVID but we just don’t know it because [of] the home testing, and maybe they just don’t have symptoms or are asymptomatic,” said Dr. Costi Sifri, hospital epidemiologist at UVa Health.

“It’s really astounding with a disease we didn’t even recognize until December 2019,” he said. “It’s difficult not to be saddened by it and to wonder how we can be better prepared, how we can do this better in the future.”

UVa Medical Center’s number of COVID-19 patients has remained steady for the past few weeks and much of the summer, with about 35 patients with a COVID-19 diagnosis in the hospital. Of those, 27 are in the adult acute care section and four are in intensive care, Adams said. The hospital has three pediatric patients being treated for the virus, including two in pediatric intensive care.

Adams said frontline care providers are looking back at the past two years to determine what they can do better. He said that’s the reason for the U.S. Centers for Disease Control announcing a reconfiguration of the agency.

Among the key moves at the CDC is having the Division of Laboratory Science and the Office of Sciences report directly to CDC Director Dr. Rochelle Walensky, a shift aimed at making them more accountable and speeding the results of their work to the public.

The agency will also create a new office of intergovernmental affairs to interact with state health departments and other federal agencies.

“For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations,” Walensky said earlier this week.

Former U.S. Health and Human Services Deputy Secretary Mary Wakefield will join the CDC to oversee the reorganization and Walensky will convene an executive council to set agency priorities, track progress and advise on budget decisions.

The agency will also start a new equity office which aims to increase diversity both in the CDC’s workforce and add that lens to its public health activities.

Adams and Sifri noted that, as part of the review of pandemic response, the CDC has issued slightly different guidelines for isolation and quarantine times for those who are diagnosed or self-diagnosed with COVID.

According to the CDC’s website, anyone with COVID or who suspects they have COVID-19 should isolate themselves for at least five days, including isolating from others in the household as people are likely most infectious during these first five days.

Isolation may end after the fifth day if someone is free of fever for 24 hours sans medications or if symptoms are improving.

“Regardless of when you end isolation, avoid being around people who are more likely to get very sick from COVID-19 until at least day 11,” the CDC website states. “Remember to wear a high-quality mask when indoors around others at home and in public and not go places where you are unable to wear a mask.”

Both Sifri and Adams said they expect bivalent COVID boosters to be available this fall. That means booster shots will help provide antibodies to two COVID strains, similar to influenza vaccines.

“We do think that a reformulated booster – a bivalent booster – that’s targeting not only the original Wuhan strain but also an omicron strain – probably a BA.5 strain – will improve vaccine responses,” Sifri said.

He said it’s expected that such a vaccine will be offered to those eligible for booster shots this fall. He also warned that a busy influenza season in the Southern Hemisphere could mean a return of the flu bug to the Northern Hemisphere this winter.

“We’re concerned that it could be a busy flu season this year because we haven’t had a significant flu season for the last couple of years,” Sifri said.

Adams said UVa Health officials are preparing to offer COVID boosters, even if the shots are not available until influenza vaccines are distributed.

“Our teams are deep into planning in terms of how we’re going to roll out and provide vaccinations when the boosters become available,” he said. “We’re doing the same in terms of getting ready for the flu vaccination. It will be a little more complicated this year because we may roll them out at the same time.”


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