COVID-19 It’s still here, isn’t going anywhere, but transmission is low

Dr. Noelle Bissell, Director of the New River Health District, had good and bad news Monday evening for the Pulaski County Board of Supervisors.

The bad news: COVID-19 is still here, and it is not going away any time soon. However, the good news is people have learned to deal with it and transmission of cases is very low in the NRV.

Noelle Bissell
Dr. Noelle Bissell

“As you all know COVID is still here. It hasn’t gone anywhere. It’s been around 6 or 7 months,” Bissell said in beginning her update on the pandemic for the board.

“I think people have settled into kind of learning to live with COVID, which I think is a good thing. It’s not going to go anywhere anytime soon,” she said.

“It’s not going to go away until we have a vaccine,” Bissell said. She noted that the word that is getting out now is we’ve been a little bit overly optimistic to expect that a vaccine is going to happen anytime soon.

She said spring of 2021 is more realistic, with the first rollout being for our highest risk individuals that are healthcare providers, first responders and folks in nursing homes and long care facilities.

She expects vaccines for everyone else won’t be out until next summer or fall.

“So, until then we do expect that we will continue to see some sustained transmission,” Bissell predicted.

“When we first started this back in March, when the governor put out the order to stay at home with restrictions and closed businesses and what not, we really weren’t in a position at that point to need that drastic measure. We really didn’t have cases,” Bissell said.

“So, we were just in this position of waiting and waiting and waiting until it got here. And COVID has followed pretty much followed the path of every infection like flu season. Every year, it comes straight down the I-81 corridor or straight up the I-77 and 81 corridor so in Southwest Virginia we know what’s coming our way,” Bissell explained.

“We know how this thing spreads. I mean, it’s a serious disease for sure, but we know how it’s spread. And there are simple things that we can do to protect each other and to protect ourselves. And that’s watching our distance, wearing our masks and washing our hands. And those are the three big things,” said Bissell.

“Everyone gets really worried about the surface contamination and disinfecting, but if you touch the surface and you touch your face, that’s how you transmit it. If you touch a surface and you wash your hands, you’re not going to transmit it. So those three things are very, very protective,” stated Bissell.

She added that focusing on those three strategies – social distancing, wearing masks, washing hands – “protect our community and I think they empower our community to realize that they really do have some control. I feel that uncertainty and lack of control has led to a lot of fear and I feel people are starting to settle down now and realize that we can navigate life with COVID.”

“We are at the lowest level of sustained transmission,” Bissell said.

After spikes in COVID-19 following the arrival of students at Radford University and Virginia Tech, the number of cases in both Radford and Blacksburg has completely come back down and Bissell said “we know that all of our localities are now in that low level of transmission.”

“I think Pulaski County today (Monday) there were zero cases and within the last seven days there were like three or four cases and just under 250 cases since the start of all this. The county has had five deaths and all those involved people older than 65 with multiple morbidities. That’s not unexpected,” Bissell said.

“We’ve kind of settled into continuing to do our testing. When we first started out, we had a lot of people who wanted to be tested just to know. Now I think most people have figured out that if I’m not doing high risk things then I don’t really need to be tested because I’m not going to have it,” Bissell said.  “So testing is for people who are symptomatic, or people who have been in contact with someone who has it and that’s actually a good thing. That’s the way it should be.”

“My team is working really hard. As soon as we get a positive case, we interview that person within 24 hours of seeing the case. Every interview we do is a risk assessment. We want to know where they’ve been, what they’ve done, who they’ve been with, how they traveled. Our goal is always to look at where they intersect with the higher risk population – whether its been in nursing homes, hospitals or mental health, law enforcement, in the jail or schools and that’s what we prioritize when we deal with contract tracing,” Bissell said.

Bissell said the health district has set up programs with area nursing facilities and the jails, and so far in the NRV Health District has been very successful in keeping COVID out of those facilities.

“People are really cooperating with us. Just like everything else we deal with, this has become very stigmatized and it almost has that negative spin to it that if you have COVID you know you’re a bad person. We don’t judge anyone. We know you can get it through all kinds of reasons,” Bissell said.

“Our goal is to really slow the spread, so we don’t judge anybody or give anybody a hard time,” she added.

“Our stores, restaurants and other businesses have opened up and everyone has to assess kind of what their risk tolerance is. Our college kids know, by and large, they are very healthy and they are not going to get really seriously ill. In fact, most of the college kids have no symptoms. So, their risk tolerance is different from somebody who may be older and has a lot of actual problems and is a little bit higher risk,” Bissell said.

She noted that college kids have kept things to themselves.

“They socialize together and they keep to themselves,” she added.

“Things have happened like we expected them to. We expect, moving forward, we’ve hit our peak and we expect to see some more low-level transmission and that will be the way it will be for a while,” Bissell said.

“We continue to urge people – outside is better than inside, physical distancing, wearing your mask especially if you can’t maintain that distancing, washing your hands and just being careful in those ways. And we’ll all kind of get through this together and move forward to when we have a vaccine,” she said.

Supervisor Chairman Joe Guthrie asked if we continue to social distance – or as Bissel said, physical distance – and wear masks, will that be the new normal or will the day come when someone says you don’t need to be socially distanced “and can go back to normal now.”

“I think we’re going to find a middle ground,” Bissel responded.

“The reason for using ‘physical’ distancing is because the mental health consequences of this lockdown have been tremendous. If you look at our amounts of depression and suicide attempts, abuse, substance abuse and overdoses they’re all up throughout the state. And that’s because these people need that support system.”

She noted that the flu still kills tens of thousands of people a year “and we really don’t bat an eye at that.”

Bissell said, with global travel, there will be other pandemics.

“We are very lucky that MERS originated in the Middle East where there’s not that much global travel. SARS originated in Africa and not that much global traffic. This one originated in China. When this one started there were a million people traveling each day between the U.S. and China. All it takes is one person getting on a plane and it’s here,” Bissell said.

She noted the southern hemisphere currently is having a milder flu season and she believes it is because of all the precautions people are taking for COVID.

Guthrie noted that Pulaski County is in the bottom 15 localities in Virginia in number of cases.

Guthrie recalled that early in the pandemic the push was to “flatten the curve” on rising hospitalizations so as to not overwhelm the health system.

“How are we doing in reality as far as the number of cases in hospitals versus our capacity for hospitals to absorb the cases,” he asked.

“COVID is not overwhelming our hospitals at all,” Bissel responded. “I mean, I think as of today, we had six cases between all four hospitals in the valley.”

She recalled that back in March everything was shut down. Now hospitals have started back up and started doing surgeries, so now when people come into the hospital they are coming in sicker.

County Administrator Jonathan Sweet touched on some of the by-products of the pandemic.

Noting the county had the smallest number of hospitalizations in the valley for COVID, Sweet said Pulaski County saw in August 40 overdose hospitalizations. “Emergency room, needing to transport folks to the hospital for overdoses.”

“There are so many right here in the New River Valley who are being hospitalized and harmed indirectly because of COVID, and we need to stay vigilant to that and really understand what it means. When we talk about mitigating COVID and responding to COVID, it is just as important for us to mitigate and respond to all of those comprehensive dynamics and not just talk about wearing face masks and social distancing,” he said.

He mentioned the several programs enacted by the Board of Supervisors to assist small businesses, non-profits and others to help them through the stresses of COVID shutdowns.

Bissel said domestic violence is way up.

“Speaking with our social services agencies, cases are down which is actually very concerning. Schools haven’t been in session up until August and they are where a lot of the child abuse, child molestation and social service reports are made. No one is thinking the numbers are down because they’re just not happening, but rather because schools aren’t open to observe students,” she said.

“Agencies are saying be on alert for 25 to 30 percent increase in cases as schools reopen,” she added.

Food insecurity is another issue, Bissell said, and overdoses are way up.

“Overdoses in the 0 to age 14 group are up by 25 percent, and in the 15 to 19 age group they’re up 19 percent. And those are the kids who weren’t in school, not getting that structure and supervision and many are overdosing and ending up in the hospital.”

“The mental health consequences of COVID are severe,” Bissell said.


Top photo: Dr. Noelle Bissell, Director New River Health District

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