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Change comes quickly in the midst of a pandemic, and it's hard to keep up with what you need to know. When it comes to keeping abreast of a changing situation, it's best to rely on breaking-news outlets including the Richmond Times-Dispatch and local television stations as primary sources of information, but if you need to dig deeper or you're looking for additional information, here is a sampling of other sites and resources, along with some insights from local experts.
By the Numbers
As of March 20, the Virginia Department of Health reports 114 cases (up from 94 on Thursday) of people in Virginia with confirmed COVID-19; 20 have been hospitalized, and there have been two fatalities statewide. There are five active cases in Chesterfield County, three in the city of Richmond, five in Henrico County, and one each in Goochland and Hanover counties.
Those numbers are expected to rise as testing becomes more widely available and the Department of Health continues investigating possible contacts, according to Danny Avula, supervisor for the Richmond and Henrico Health Districts.
“To some degree, [these case numbers are] what we expected the work of the health department to yield,” he said Wednesday. “When we identify a case and we interview potential contacts and test anybody who is symptomatic, we expect to find spread to other people, so in some ways, this is what the point of contact investigations is, to identify those other cases.”
Richmond Mayor Levar Stoney said at a news conference on Wednesday that the city will begin enforcing a public health emergency order issued by Gov. Ralph Northam and State Health Commissioner M. Norman Oliver on Tuesday that bans more than 10 patrons at a time in restaurants, fitness centers and theaters. Stoney also indicated that city offices are likely to be closed for the remainder of the month amid the pandemic. Learn more about the city's response to the pandemic.
If You're Sick
Don't just show up at your doctor's office, you should call first, according to Tara Wiley, a communications specialist with the Richmond and Henrico Health Districts. Here's her advice:
“If possible, avoid taking public transportation or taxis. If available, wear a face mask to your appointment, or ask for one when you arrive. Be prepared to self-quarantine at home if your symptoms are mild, preferably in a separate room from other members of your household or caregivers who may be assisting you. Stay in contact with your provider and alert them if your symptoms worsen or call 911 or go to the emergency room if your symptoms become life-threatening.“
A Doctor's Take
John Port of Internal Medicine Associates of Chesterfield in Midlothian offers the following insights on how the pandemic is impacting the practice of medicine and what to expect:
"This is truly a unique and unprecedented time.
We have resorted to a lot of telemedicine for worried well, some routine issues, and people with mild – moderate infectious symptoms. Although we all would love to be able to test more people, there are not many tests available and testing them puts health-care workers at risk of being out of commission to care for all of the patients with chronic and other acute diseases who rely on us.
We are happy to have five Bon Secours Mercy Health “flu clinics” opening up around town in the next five days where people with infectious symptoms can be tested for flu, strep and hopefully for COVID in a more controlled setting by volunteers such as me who will be wearing full protective gear (which is also in short supply).
We are postponing most routine visits, especially for high-risk patients, including the elderly .
Unfortunately, I suspect most of us will be exposed to this virus over the next 3 months (maybe longer), but as long as we all don’t get exposed at once, the medical system may be able to care for those who get it and get really sick from it, while also caring for those who are sick from other diseases.
Hopefully most people who are exposed will barely get sick or have mild symptoms. Unfortunately, some will die. This is going to be very difficult indeed.
Stay healthy!"
What to Expect at the Hospital
Feras Khan, a physician with the intensive care units at HCA Chippenham Hospital, provided the following information on some of the protocols that are followed at his facility:
“In general, the patients I take care of have been admitted to the hospital. For those particular patients with respiratory complaints such as fever and cough, who also have hypoxemia [low oxygen level in the blood] and difficulty breathing that require admission to the hospital, we are screening them for COVID-19. Using a detailed history and supplemental tests such as chest X-rays and lab work, we try to identify those patients most likely to have COVID-19. We usually test for influenza and other common viruses in addition to potentially testing for COVID-19. In addition, we are still seeing high influenza activity in the area. We use testing through the Virginia Department of Health and have the ability to test via private laboratory. The specimens are collected on site via a nasal swab or sputum from a cough but are then sent to the VDH for testing.
If patients have mild symptoms or no symptoms but may have been exposed to someone with COVID-19 or recently traveled to an area with a large outbreak, the VDH is recommending those individuals practice social distancing and staying at home for 14 days or until symptoms resolve. If someone is feeling extremely fatigued, weak or is having shortness of breath, they should call their primary doctor for advice and can go to the nearest emergency department for evaluation. I would recommend calling ahead prior to arriving to aid triage protocols to protect staff if possible. Those patients who are immunocompromised or elderly with possible symptoms should speak to their primary care provider to determine if coming in for testing is beneficial.
In terms of what we are doing, we are putting a major focus on preventing spread of the virus while continuing to provide excellent care to those who have a number of more common complaints. We are restricting visitation hours in addition to advocating for social distancing in order to "flatten the curve" or decrease the number of daily infections to make it more manageable for the local hospital systems. We have made preparations for handling a surge of patients who may require critical care in the near future. This is a day-to-day evaluation based on the number of cases we are seeing locally.
As far as the takeaway, we are in the early stages of the pandemic for the Central Virginia area. We expect to see a spike in [the] total number of cases as more people get the virus and more testing is made available. We are learning from our colleagues in other parts of the country and over the world who have had to provide critical care for COVID-19 patients. The goal is to provide supportive care to the sickest patients to allow time for them to recover. Furthermore, there are potential treatments that are being investigated as we speak that will hopefully help us treat the sickest patients.
In general, we are telling patients to protect themselves from getting the virus. Some of the advice we are giving patients include: staying 6 feet away from one another; covering your mouth or nose when you sneeze or cough; wash your hands often with soap and water or hand sanitizer; avoid touching your eyes, nose, and mouth; and stay home if you are sick.”
Going Mobile
Bon Secours in metro Richmond is setting up local flu clinics if you have symptoms of flu, such as a fever, sore throat, aches and a cough. The first local clinic is in Petersburg at 50-B Medical Park Blvd., at Southside Regional Medical Center.
A mobile testing site has been set up at Dorey Park off Darbytown Road in Henrico County. WRIC 8 reports that you can't just show up: You need to be in contact with the health department first (call center number is 804-205-3501) and see if you meet the criteria based on your symptoms and exposure to receive an appointment for use of the service.
Learn More
Get updates on VCU Health operations.
A Richmond-region coronavirus hotline has been established by the Virginia Department of Health: 877-ASK-VDH3
There's also a Richmond and Henrico virus hotline: 804-205-3501
VDH also has an extensive coronavirus FAQ.
Some Final Words
A statement from Tara Wiley, communications specialist with the Richmond and Henrico Health Districts:
Each of us has a very real and important role to play in limiting the spread of COVID-19. Every time you wash or sanitize your hands, every time you choose to stay home when you would prefer to go out, every time you call an elderly relative or share facts instead of rumors, you are joining together with people throughout our region and around the world to fight this pandemic. We can only do this together, and every preventive step we take matters.
Wash your hands and stay home.
Hand washing and social distancing advisories are everywhere for good reason. The basics of disease prevention are our best defense as individuals when faced with the spread of any virus. Wash your hands frequently with warm water and soap for 20 seconds or use hand sanitizer. Avoid touching your face. Cough into a tissue and then throw the tissue away, or cough into your upper arm or elbow. Sanitize all frequently used surfaces frequently: countertops, keyboards, phones, sinks, etc.
If possible, arrange to work from home, and avoid gathering with friends and family, especially if they are over 65 or have chronic health challenges. Visit the grocery store and pharmacy as infrequently as possible and consider curbside pickup or grocery delivery services if those are available to you. When in public, try to maintain 6 feet of distance between yourself and other people.
Stick to trusted sources.
Along with the coronavirus outbreak we are experiencing an infodemic: Every day we are inundated by countless news stories, opinions, memes, videos and social media posts about COVID-19. Identify a few trusted sources that are sharing reliable facts and practical steps that are useful for your life. Centers for Disease Control and Prevention (CDC) and Virginia Department of Health update their websites daily, and Johns Hopkins University has established a helpful dashboard that tracks cases across the U.S. and globally. Don’t trust or share advice or rumors that are posted online but not published by a reputable news source or attributed to a medical or public health authority.
If you have symptoms, seek help.
If you have respiratory symptoms and a fever, contact your provider or an urgent care facility and let them know that you have symptoms consistent with COVID-19 before visiting their office. If possible, avoid taking public transportation or taxis. If available, wear a face mask to your appointment, or ask for one when you arrive. Be prepared to self-quarantine at home if your symptoms are mild, preferably in a separate room from other members of your household or caregivers who may be assisting you. Stay in contact with your provider and alert them if your symptoms worsen or call 911 or go to the emergency room if your symptoms become life-threatening. For more information, call Richmond and Henrico’s Coronavirus Hotline at 804-205-3501 or Virginia Department of Health at 877-ASK-VDH3.
Wherever you are, take time to rest and space to breathe.
This is a very stressful time, and stress can take a toll on your health. Many people are working from home while also caring for and teaching children who are out of school. People who are over 65 or have chronic health challenges are self-quarantining and may feel lonely or depressed. Business owners are concerned about lost revenue. Health care providers are working extremely hard with limited resources and facing new challenges they have never experienced before. Life is harder for all of us right now, but there are steps we can take to cope.
The days ahead will be more manageable if you are well-rested, hydrated and eating regular, healthy meals. Talk about your feelings with a trusted friend, family member or coworker. Stay connected with friends and family via phone, video chat or social networking. Take a screen break each day and moderate the amount of news you consume. Remember that fresh air and exercise are still possible while practicing social distancing — just maintain space from others while walking in a park or on a trail by the river.
