Essex County Virginia

Three Rivers Update 10-19-2020

Posted on 10/20/2020


Three Rivers Health District COVID 19 Update                    10/19/2020


Pandemic Status:  Three Rivers Health District decline in new cases

COVID 19 new cases across the United States are increasing rapidly; the 7-day moving average is about 60,000, and over half the states are reporting higher case rates.  We have had over 8.1 million cases in the United States, and we have over 220,000 deaths.   In Europe, cases are increasing across the continent.

In Virginia, the 7-day moving average of cases by date reported is 1037 on 10/19.  The 7-day average percent positivity of tests is currently 4.8%.  Community transmission extent in the Central region is substantial (high).  Community transmission extent is moderate in the Eastern, Northwest, Southwest regions, and Northern regions.  The moving 7-day average of people hospitalized for COVID 19 is 985 on 10/20.  We have good hospital and ICU capability across the state. 

In Three Rivers, according to the UVA Biocomplexity Institute’s modeling, we have moved from a decline in new cases to a plateau.  Seven of our jurisdictions are above 10 cases/100,000 moving 7 day average (Northumberland, Richmond, Westmoreland, Mathews, Gloucester, King William, King and Queen), Middlesex, Lancaster and Essex are between 5-10.  We had 126 cases reported last week across our jurisdictions.  We continue to have outbreaks, which are indicators of enhanced viral spread.  The main source of community transmission continues to be individual exposures during private, unregulated events.

Virus update:  Phase 3 clinical trials paused for two US Vaccines; Evidence supporting masking as effective protection against COVID 19 increases

Johnson and Johnson, Moderna, Pfizer and AstraZeneca all have vaccines in phase three trials in the U.S.  The AstraZeneca trial remains suspended in this country.  On October 12, Johnson and Johnson paused its trial to investigate an adverse reaction in a volunteer.  Pauses such as these often happen in clinical trials, and should not be a cause for concern.  Rather, these pauses reassure us that safety remains a highest priority in this vaccine development effort.  Novavax, a Maryland based company, has a vaccine in phase three clinical trials in South Africa and the UK, and plans to launch in the U.S. later this month.  The company could deliver 100 million doses by early next year if the vaccine is successful.  The VDH has developed a very comprehensive draft COVID 19 Vaccination Plan that is being refined continuously.

Masking continues to be a controversial topic for some.  VDH Central Office personnel reviewed the world’s published literature last week to look at evidence concerning masking effectiveness during the COVID 19 pandemic.  Articles published in journals such as Health Affairs, Lancet, The Journal of Infectious Diseases, Travel Medicine and Infectious Diseases, The Journal of General Internal Medicine, and the Emerging Infectious Diseases Journal all offer evidence that masking is effective in reducing COVID 19 infections.   There is no doubt that masking helps us all stay safer in this pandemic.   Masking, social distance, good hygiene and surface decontamination, good ventilation, and avoidance of indoor crowded spaces appear sufficient to reduce viral transmission by personal contact, respiratory droplet, or airborne modes.

Executive Order Compliance:  Businesses continue to comply with executive orders

We continue to investigate concerns and complaints and enforce executive order compliance to the best of our ability across the district, often in collaboration with the Department of Agriculture and Consumer Services and the Department of Labor and Industry.  Thus far, even though we have had outbreaks in business settings, we have not identified any discrete sources of viral spread in any business or restaurants that have served as a major source of ongoing community transmission.

Last week we had a large increase of cases in Westmoreland County due to an outbreak in a congregate setting.  This was travel related, and was detected and contained immediately.  This outbreak does not have the potential to spread farther into the community, and is more an indicator of enhanced viral transmission elsewhere than in our jurisdictions.

Testing:  Three Rivers Health District continues community testing

Virginia has received a large shipment of Abbott BinaxNOW card tests.  The federal government purchased 150 million of these rapid antigen test cards, aimed primarily at nursing home use.  They are primarily useful in clinical settings to identify positive COVID 19 cases and in vulnerable facilities such as nursing homes.  The VDH health districts may receive some of these rapid tests for local use.  We are developing plans for using these testing resources if we obtain them.

The Virginia National Guard is available to help with focused testing events at vulnerable facilities across the Commonwealth.  The Virginia Department of Health (VDH) has also contracted with two companies (BakoDX and Mako Medical Laboratories) to provide testing services for all Health Districts, Regional Emergency Offices and any other office under the Virginia Department of Health. 

Our testing team in the Three Rivers Health District is actively conducting testing events across our jurisdictions.   Upcoming events during October include:

  • Tuesday, 10/20: King William Health Department (Appointment Only) 172 Courthouse Rd, King William, VA 23086
  • Monday, 10/26: Essex Fire House 10am-12pm620 Airport Rd, Tappahannock, VA 22560
  • Wednesday, 10/28: Westmoreland Health Department (Appointment Only) 18849 Kings Hwy, Montross, VA 22520

We are offering 150 – 250 tests per event, there is no charge for the testing, and all events are open to the public.  Our overall test positivity rate for these community events is currently about 1.9%.

Flu Vaccination Campaign:  Paving the way for the COVID 19 vaccine

We have held several drive-thru flu vaccination events thus far in Three Rivers Health District.  We are providing flu vaccines to persons 10 years of age and older, free of charge. 

Our next drive through flu vaccination event is:

  • Thursday, 10/22: 11am-1pm, Beale Memorial Baptist Church, 19622 Tidewater Trail, Tappahannock, VA

The Three Rivers Testing Team, the Medical Reserve Corps (MRC), and the Community Emergency Response Teams are collaborating to hold these events, which are preparing us for the upcoming large COVID 19 vaccination effort.  It is more important than ever to get our flu vaccine, to reduce flu case rates, ease the burden on our health care system, and help lessen confusion with COVID 19 cases, which may look just like flu.  It is possible to have flu and COVID 19 at the same time; it is best to avoid both.

Pandemic Containment:  Three Rivers continues case investigation and contact tracing

Our Three Rivers case investigation and contact-tracing capability remains excellent.  To date we have hired 11 case investigators, 10 contact tracers, and one team supervisor.  It appears that we are entering a period of increased viral transmission across the country, commensurate with increasing indoor congregate activity and a probable fall/winter COVID 19 pandemic surge.  We will respond to contain outbreaks where and when they occur. 

K-12 School Status:  Three Rivers Health District is working with schools closely

School systems with fully remote learning are making plans to bring vulnerable children and K-3 students back into the schools and begin in-person operations, guided by current community transmission extent.  It is important to remember that many cases of COVID 19 among children are asymptomatic or minimally symptomatic, children rarely suffer severe complications from COVID 19 infection, and long-term health effects among children remain unknown.

We continue to experience COVID 19 cases among school faculty, staff and students in multiple Three Rivers Health District jurisdictions.  All of these have been community acquired, and we have still seen only one case of viral transmission that actually occurred in the school setting.  Thus far, our schools have been able to pay diligent attention to social distancing, masking, and hygiene.  This, in combination with early detection, case investigation and contact tracing appear to be working together to prevent large outbreaks in our schools. 

Our objective remains to prevent cases from occurring in schools, contain any COVID 19 cases that do occur, minimize outbreaks and prevent further community spread.  There is absolutely no question that the lower the level of community transmission, the safer we all will be, the better our economy will be, and the safer it will be to send our children in person to school.  We must work together to decrease virus transmission as much as possible.

Special topic:  COVID 19 safety during Halloween

Maintaining a sense of normalcy when possible is imperative during this pandemic.  This is especially important to children; celebrating holidays and special occasions helps with this.  When celebrating Halloween, remember any activity that places people in close proximity to each other increases the risk of an exposure significant enough for viral transmission to occur.  Wearing a mask, practicing social distancing, limiting the time spent in close proximity to others, and proper hand washing reduces the risk of transmission.  The VDH developed guidance stratifying the following activities to lowest, moderate, or highest risk categories:

Lowest Risk:

• Carving or decorating pumpkins with members of your household and displaying them

• Carving or decorating pumpkins outside, at a safe distance, with neighbors or friends

• Decorating your house, apartment, or living space

• Doing a Halloween scavenger hunt where children are given lists of Halloween-themed things to look

for while they walk outdoors from house to house admiring Halloween decorations at a distance

• Having a virtual Halloween costume contest

• Having a Halloween movie night with people you live with

• Having a scavenger hunt-style trick-or-treat search with your household

members in or around your home rather than going house to house


Moderate Risk:

• Participating in trick-or-treating with distancing strategies in place (e.g. treat-givers provide

individually wrapped goodie bags lined up for families to grab and go while continuing

to social distance (such as at the end of a driveway or at the edge of a yard)

• If you are preparing goodie bags, wash your hands with soap and water

for at least 20 seconds before and after preparing the bags.

• Stopping only at houses where individuals are wearing masks, and it is easy to

maintain six feet of distance between the host and other trick-or-treaters.

• Attending a small, outside event such as trunk-or-treat, where social

distancing can be maintained and everyone is wearing a mask.

• Visit pumpkin patches or orchards, where wearing masks is encouraged and

enforced, and people are able to maintain at least six feet of physical distance


Highest Risk:


• Trick-or-treating to a large number of houses or visiting multiple neighborhoods, where participants go door to door

• Trick-or-treating at houses where individuals are not wearing a mask, and where

six feet of physical distance is not maintained between individuals.

• Attending parties or events that may become crowded and social distancing is difficult to maintain.

• Going on hayrides or tractor rides with people who are not in your household.

• Going to indoor haunted houses where people may be crowded together and screaming.


Trick or treating, our most traditional Halloween activity, deserves special mention.  The VDH guidance states:


Trick-or-treating involves increased risk for transmitting COVID-19, due to the potential for close proximity to many people and the difficulty for children trick-or-treaters to follow mask use and social distancing recommendations. If you do choose to trick-or-treat, it is important to protect yourself using the following recommendations:

1. If you have COVID-19 symptoms, have tested positive for COVID-19 in the past ten days, or

have been in contact with someone with COVID in the past 14 days, follow VDH guidance

to stay home and away from others. If you are self-isolating or self-quarantining, do not

participate in trick-or-treating this year, and look for other virtual options to celebrate.

2. Be sure to maintain at least six feet of distance between yourself

and others who do not live in your household at all times.

3. Wash your hands before going trick-or-treating or handing out candy. Hand sanitizer should be

used while trick-or-treating or handing out candy when soap and water aren’t available.

4. Wear a cloth mask. Halloween masks may not fit snugly against the face and may not

cover the nose and mouth. Halloween masks with gaps and holes do not protect against

inhaling respiratory droplets from other people. Cloth masks should be worn under

costume masks to keep a close fit over your nose and mouth. Ensure that any cloth

mask worn under a costume mask does not inhibit the ability to breathe easily.

5. If you hand out candy, consider setting up an area outside, like a folding table or chairs, to set

out candy. Space out the placement of treats so that multiple people do not have to reach into

the same bowl or find contactless ways to deliver treats, like a candy chute that is more than six

feet long. For trunk-or-treating, create distance between cars by parking in every other space.


Our best defense remains prevention of disease by social distance, masking, staying out of crowds, hygiene and sanitation

To repeat our most important message, this virus repeatedly demonstrates its ability to transmit briskly if given the opportunity.  We all hope for an effective vaccine, and we all hope for better medications to treat this virus.  Our best defense remains to prevent virus exposure and disease through social distance, masking, avoiding crowds, washing our hands, and practicing good sanitation methods.  Our secondary line of defense is containment activity with extensive testing, case investigation and contact tracing, intended to control spread of active infections that we are unable to prevent.   

If you are sick at all, even if your symptoms do not feel like COVID 19, stay at home, consult your health care provider, and do not hesitate to seek testing.  The virus can masquerade as many other diseases, and can fool us all.  Again, difficulty breathing remains a sign of possible serious disease; if this develops, please seek help very quickly.