By Carol Vaughn —
The Virginia Department of Health announced it now recommends indoor visitation may be permitted for residents of nursing homes, assisted living facilities, and similar health care settings except under certain circumstances.
The March 10 announcement came after the Centers for Disease Control and Prevention released updated health care infection prevention and control recommendations in response to COVID-19 vaccination progress.The Centers for Medicare and Medicaid Services at the same time released updated guidelines and revised visitation recommendations for nursing homes, according to a press release from the VDH.
The changes come as the number of new cases reported in Virginia nursing homes has consistently gone down since mid-January.
“VDH is currently observing the lowest weekly case counts since early summer 2020,” the release noted.
Additionally, as of March 11, nearly 280,000 vaccine doses had been administered to residents and staff in Virginia long-term care facilities.
While relaxing restrictions on visiting nursing home residents might increase the risk of transmission, Virginia’s progress in vaccinating residents and staff “can mitigate some of these risks, and public health officials understand that expanding visitation has substantial benefits to residents,” according to the release.
VDH recommends that indoor visitation can be permitted for all long-term care facility residents except in the following cases:
Indoor visitation for unvaccinated residents should be limited to only compassionate care situations if the county’s positivity rate is over 10% and under 70% of the facility’s residents are fully vaccinated; or for vaccinated and unvaccinated residents with SARS-CoV-2 infection, until they have met criteria to discontinue precautions; or for vaccinated and unvaccinated residents in quarantine until they meet criteria to be released from quarantine.
Facilities with COVID-19 outbreaks should follow guidance from the local health department and CMS on when visitation should not be allowed.
Additionally, VDH recommends visitors should be counseled about their potential to be exposed to the virus in the facility.
Facilities should continue to vaccinate new residents and staff and adhere to federal guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing, according to VDH.
The release went on to say “that it is critical that facilities, healthcare personnel, residents and visitors remain vigilant by continuing to follow infection control recommendations such as wearing a well-fitted cloth mask or face mask, physical distancing (maintaining at least 6 feet between people), hand washing, staying home when sick, and wearing appropriate PPE.”
Vaccine Update from Dr. Danny Avula
As of March 12, 2.5 million vaccine doses have been administered in Virginia, accounting for 19.5% of the commonwealth’s population, Virginia vaccine coordinator Dr. Danny Avula said in a press briefing Friday.
Virginia is averaging around 55,000 doses per day now and is ranked number four in the United States in doses given and twelfth in number people fully vaccinated.
After the initial rollout of a third vaccine from Johnson & Johnson — with 69,000 doses received in Virginia and used in the past week for mass vaccination clinics — Virginia expects to receive 9,600 doses weekly for the next two weeks. Production is then expected to increase dramatically by the end of March, with potentially up to 100,000 doses weekly allocated for Virginia.
“Given these predictions, I think it is very realistic that we will get through our (Phase) 1b demand by mid-April. In some parts of the state, that’s going to be sooner,” Avula said.
As supply increases, more of the 16-64 age group with underlying medical conditions are receiving vaccinations than in earlier stages of Phase 1b.
Different parts of the state will be allowed to move into Phase 1c as they are ready, he said.
Avula said people being scheduled for vaccination “will always know what type of vaccine will be given” at events.
Virginia should “easily” meet President Joe Biden’s goal of having all Americans eligible for vaccination by May 1, Avula said, predicting all Virginians who want a vaccine should be able to be vaccinated by the end of May.
So-called “herd immunity,” which experts put at around 75% of the population being vaccinated, “is absolutely within reach,” Avula said.
National surveys show around 65% of adults now are “ready and willing” to get a vaccine, he said, adding the final 10% or so, who may still be hesitant, could be reassured as more vaccine supply goes to private providers.
“I think people do really rely on their doctors and nurses for guidance and advice,” Avula said.
Vaccine hesitancy nationally has dropped significantly since December, including among Black and Brown people, he said.
Vaccinations for children ages 12 and up could start to happen this fall, Avula said, noting Moderna and Pfizer currently are conducting vaccine trials for ages 12 to 15, but are just starting to recruit for trials with children under 12, making it unlikely a vaccine will be approved for those ages before the first quarter of 2022.
Moderna has started formulating a booster to address virus variants, he said.
Data show the three available vaccines are strongly effective against identified variants, in particular the variant first detected in the United Kingdom, which the CDC predicts could become the dominant strain by the end of March or beginning of April, Avula said.
“I do think it’s possible, and maybe even likely, that similar to the way that the flu vaccine is reconstituted every year…that we will have a booster dose that incorporates some of the newer strains moving forward,” he said.
I’ve Been Vaccinated — What Now?
The CDC earlier this month issued recommendations for what are considered safe activities for fully vaccinated people.
People are considered fully vaccinated for COVID-19 two weeks after they have received the second dose in a 2-dose series, or two weeks after they have received a single-dose vaccine.
Fully vaccinated people can:
Visit with other fully vaccinated people indoors without wearing masks or physical distancing
Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
Refrain from quarantine and testing following a known exposure if asymptomatic
For now, fully vaccinated people should continue to:
Take precautions in public like wearing a well-fitted mask and physical distancing
Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
Avoid medium- and large-sized in-person gatherings
Get tested if experiencing COVID-19 symptoms
Follow guidance issued by individual employers
Follow CDC and health department travel requirements and recommendations.
Most experts say masks, social distancing, and hand washing are likely to be part of the “new normal” life for some time.