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Local experts: Pandemic waning, but it's not over

In Charlottesville and Albemarle County, fueled by relatively high vaccination rates and easing of restrictions, life has started to return to a pre-pandemic normal, with crowds gathering on the Downtown Mall, descending on area lake beaches and generally reveling in the summer sun.

Virginia’s state of emergency for the COVID-19 pandemic expired Wednesday after 15 months, and all the state’s social distancing and capacity restrictions ended before Memorial Day weekend.

But, even though the Blue Ridge Health District is entering a new phase of the COVID emergency, officials said the pandemic is not over.

“We are closer, but it’s not over,” said Ryan McKay, the health district’s COVID-19 incident commander, adding that the state of emergency ending could indicate to people that everything’s back to normal. “… vaccinated or not, the reality is COVID hasn’t gone away.”

Last month, 96 cases were reported in the district, the fewest since March 2020.

For the health district and other agencies, the pandemic response is shifting from an all-hands-on-deck approach to one that more closely resembles normal operations.

The health district has reduced the number of people working on case investigations from about 50 to 15 and is offering fewer COVID testing events, though McKay said they can bulk up later in the fall if needed.

The regional emergency operations center, which coordinates the different agencies involved, also is scaling back its response.

Sonny Saxton, director of the Emergency Communications Center, which houses the regional EOC, said that group will stay active to assist with the COVID-19 emergency for many months and most likely through the beginning of next year.

“The effects are still being felt around the world and even locally,” he said. “… But I would say we’re in a better place than many of us or even myself would have anticipated up to now, and there’s still work to be done.”

Dr. Taison Bell, director of the medical intensive care unit at the University of Virginia Medical Center, said the drop in cases, hospitalizations and deaths is good news.

“We should celebrate the fact that we’ve turned a corner when it comes to how the pandemic is going in the United States,” he said.

But Bell cautioned that communities have to be “humble,” as the virus has shown the ability to exploit any weakness, and be prepared for things to change.

The delta variant, which was first detected in India and is much more transmissible than other variants, could complicate efforts to stamp out the virus. So far, the approved vaccines have proven effective against the variants.

In response to an increase in cases because of the delta variant, Los Angeles County recently recommended that all residents wear masks when indoors.

According to UVa’s COVID-19 model, the delta variant makes up 13% of sequenced cases in Virginia and that that percentage will likely increase. So far, there’s one confirmed case in the health district tied to the delta variant, according to the state dashboard.

McKay said they are monitoring the delta variant, and that the area’s vaccination rates do create less opportunity for the virus and variants to spread. As restrictions lifted in recent months and schools let out for the summer, McKay said they were bracing for a surge in cases, but that didn’t materialize.

“But I really do think our vaccination rates have really helped with that,” he said. “For the most part, our communities have been really, in general, adhering to the mitigation strategies and the masking.”

Those who are fully vaccinated and living in areas with higher vaccination rates such as Albemarle County and Charlottesville can lead more normal lives, Bell said, adding that he feels comfortable going to businesses without a mask. But if he traveled to somewhere with lower vaccination rates, he’d mask up.

“If you’re vaccinated, and you’re around people that are low risk and also vaccinated, then you can have the sort of summer that we’ve all wanted with being outside and being in close contact with them,” he said.

Local officials agree that the end of the pandemic won’t be definite or like flipping a light switch. Instead, the pandemic will gradually peter out, and the virus will most likely continue to circulate, similar to other infectious diseases.

“It’s not going away; there’s no doubt,” said Christian McMillen, an associate dean for the social sciences at UVa who studies the history of infectious diseases and pandemics. “Diseases don’t generally fade away.”

McMillen said the exception to that trend is smallpox, which the World Health Organization declared eradicated in 1980.

“One of the things that’s most important about this pandemic is it’s clear how interconnected the world is, if it wasn’t clear already,” he said.

Historically, there’s no clear answer to when a pandemic is over. McMillen said that’s because diseases affect places differently.

With hindsight, it can be easier to tell when a pandemic ends. The last outbreak of the bubonic plague occurred in England in 1665, though people didn’t know it was the last one at the time.

“It took a very long time for people to realize, ‘OK, maybe we’re beyond this,’” he said.

Vaccination rates

Vaccines are critical to ending the pandemic, and the health district and community partners are now focused on ensuring that communities hit hard by the pandemic are protected. About 53% of the vaccine-eligible population in the district is fully inoculated.

“We’re tremendously fortunate to have multiple effective vaccines that are widely available,” Saxton said. “… There’s still a lot of work to be done in ensuring that we have equitable vaccine distribution.”

The COVID-19 vaccines are not yet available to children 11 or younger, which is one reason the pandemic can’t be considered over, McKay said. Additionally, the rate of vaccinations is not uniform across the health district, commonwealth, country and globe.

Albemarle County leads the state in the percentage of the COVID vaccine-eligible population who have been fully inoculated, at 60%. In Charlottesville, 51.6% are fully vaccinated. Louisa County lags in the health district, with only 42% fully vaccinated.

Meanwhile, in Amherst County, only 38.3% are fully vaccinated. In several counties throughout southern Virginia, less than 45% of the population has received one dose of the vaccine.

“While the daily count of COVID-19 cases in Virginia and the nation have fallen to numbers not seen since the earliest days of the pandemic in March 2020, this global pandemic is not over,” said Logan Anderson, a public information officer with the Virginia Department of Health. “This is true in the commonwealth, the United States and the world.”

Anderson added that the World Health Organization determines whether a disease outbreak should be classified as a pandemic, which refers to an event affecting the entire world.

For Bell, the pandemic won’t be over until there’s greater vaccination rates across the globe.

“This has become a two-tiered pandemic, where the have countries are doing relatively well and the have-nots are still waiting for their protection and are still very high risk,” he said. “If anyone is high-risk abroad, then we’re high-risk here, as well.”

Locally, Bell is keeping an eye on case counts, the test positivity rate and hospitalization data to gauge the state of the pandemic.

McKay said he would feel more comfortable when younger children have access to the vaccine and if 70% of the district’s population was fully vaccinated.

“… And then continuing to see that same level of cases probably over the next six months,” McKay said.

Case counts

Since the COVID-19 vaccine was opened up to all adults and 16- and 17-year-olds in April, local cases have plummeted. The district reported 1,206 new cases in April and then 225 cases in May. Last month, just 96 cases were reported, the fewest since March 2020. By the end of June, the district was averaging three new cases a day.

For comparison, at the height of the pandemic — in January — the district’s seven-day average of new daily cases hit 147. That month, 3,242 new cases were reported.

Despite much lower case counts, people have continued to be hospitalized and die from COVID-19 in the district. Last month, 29 people were hospitalized, bringing the district’s total to 678. Three more deaths were reported in June. Overall, 227 people in the district have died from the virus.

Saxton said that it’s important to keep in mind that each new case is a person affected.

“Regardless of what happens, it’s a life impacted, and so as long as the disease prevalence is anything more than zero, we’ve got a lot of work to do,” he said.

Saxton said the regional EOC’s work won’t end when there are zero cases. The pandemic response includes helping people and businesses rebuild, similar to natural disasters, and that aspect has been under way for many months.

“… We’ve got to at least put things back to where they were or better,” he said. “That is a long arc. That arc extends way past when you have zero disease prevalence.”

Saxton said the pace of requests handled by the regional EOC has slowed in recent months, highlighting the changing nature of the local emergency.

“It just has more of an operational feel, if you will, rather than that emergency request feel that we had there in the beginning and for the last year and a half,” he said.

Meanwhile, calls to the 911 center, which he also oversees, have returned to pre-pandemic levels. During the initial stay-at-home orders and for much of the last year, call volume dropped by about 30%. In June 2021, the center received an average of 695 calls a day, which is a little bit more than June 2019’s average of 680.

At the health district, planning for the next six months is focused on the mobile vaccination effort and providing access to the vaccine at the health departments throughout the area, McKay said.

The change of pace has allowed staff to resume other projects and focus on other public health issues, such as back-to-school vaccinations for other viruses and testing for sexually transmitted infections.

“There has been an increase in STIs, particularly syphilis,” McKay said. The district is “getting back to those things, so that we’re not missing those things and creating other public health issues that we have to sort of scramble to meet.”


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