Dr. Danny Avula, the state’s former vaccination coordinator, was recently appointed commissioner of the Virginia Department of Social Services. (Photo by Zaid Hamid)
Dr. Danny Avula, who served as the state vaccination coordinator under former Gov. Ralph Northam, has had a busy couple of years. In addition to running the state’s efforts to vaccinate millions of Virginians during the COVID-19 pandemic, Avula also practices clinically as a pediatric hospitalist.
Avula recently stepped down as state vaccination coordinator. In early February, he was appointed commissioner of the Virginia Department of Social Services by Gov. Glenn Youngkin. Avula spoke with Richmond magazine about his experiences and lessons learned over the last two years, and his qualified optimism that the end of the pandemic is within sight.
Richmond magazine: How has the pandemic changed your daily job as a health care professional?
Dr. Danny Avula: For those of us who work in public health, COVID-19 completely subsumed anything we did before. In 2020 and 2021, we were completely focused on COVID. As in many aspects of our lives, other priorities had to take the back burner.
The health department still traces other communicable diseases. We still do restaurant inspections. But the degree to which we’ve been able to offer some services has been scaled down, as staff has been redirected to combating COVID.
I think that soon we’ll be at a point where we’re able to prioritize those other aspects of our job again.
RM: What lessons have been learned in the medical community from the COVID-19 pandemic?
Avula: There are a bunch, and there are some that will continue to emerge.
Since 9/11, one of the roles that federal funding has given local health departments is the ability to distribute medical countermeasures — flu shots, pills, medication. We practice that every year with the flu, and that practice has certainly helped. One of the things that went extraordinarily well last year was vaccine distribution.
What we didn’t anticipate was the impact social media would have on patient behavior and patient trust, especially in relation to the vaccine. Now we recognize that there are a lot of forces at play, and that social media is a powerful shaper of opinion on health issues.
In the future, we have got to leverage our voice as a health department and use social media effectively. That can only be so successful — government social media platforms are not going to compete with a celebrity like Nicki Minaj. So we also have to have nurses and doctors engaging the public in a broader sense — doing interviews with media, using our own social media platforms, showing up to city councils. There are a lot of intentional efforts on social media to provide information that can lead people astray, and we need to counteract that intentionally.
Another lesson is about the makeup of our workforce.
Our workforce needs to reflect the communities we hope to serve. For almost a decade now, we’ve done a lot to expand our programming in that area, but COVID showed we still need to augment that part of our workforce.
RM: What specific recommendations would you make now to prevent infection?
Avula: The most important thing to understand is that vaccination is the best way to protect ourselves. What we’ll see is that with each new variant, the ability to protect oneself varies. Even fully vaccinated people are getting omicron at a high rate, but vaccination [protects] you against severe disease. That’s the main goal — keeping people out of the hospital and keeping them from dying.
We also know that there are habits and behaviors we’ve learned over the last few years that we need to practice when there are high case rates in our community. Before COVID, people would go to work and school with head colds all the time. But COVID is a different breed, and if we have cold symptoms, we need to get tested for COVID, and quarantine if we are positive. And when we are at work, in school and in public settings, wearing a mask is a helpful addition to vaccination.
RM: The Spanish flu ended when a more contagious, less deadly variant became dominant. How does the emergence of omicron compare to that scenario?
Avula: The Spanish flu spanned a couple of years, and over time the pandemic petered out. But the flu is still around, and it evolves each year. That’s why you need a new flu shot each year — each year brings a new mix of mutations.
Because omicron is so contagious, the combination of immunity from the vaccine plus the immunity from this round of infection will start to limit the number of people susceptible to future disease.
COVID isn’t going to go away. But it will become an endemic, not a pandemic. Between natural immunity and immunity from the vaccine, I think we’re getting really close to that point.
