May 5, 2020 Health Department Situational Briefing for Accomack BOS Current Accomack Case Count: 463

We continue to learn more about this virus every day. It looks like it can attack many systems in the body, and its worst expression remains the Severe Acute Respiratory syndrome for which it is named. Many questions remain about the effectiveness of immunity after infection, but early experience with immune globulin therapy is encouraging. Patients with the disease can continue shedding viral particles for weeks and remains unknown whether these individuals with prolonged shedding can infect others or not. Early research indicates viral cultures can not be grown beyond 9 days. This is encouraging. We all hope the virus proves to be less active in the summer months, which will help us stay safer as we reopen our economy.

This week, initial results of clinical trials were released by the NIH that indicates the antiviral agent Remdesivir has benefits to shorten the course of disease and might help survival as well. Remdesivir is becoming the standard of care for COVID 19, and it is likely more antiviral therapies are on the way. Vaccine development continues in multiple countries at an unprecedented rate.

Shortages of PPE/testing capability have improved but still need work. We have better testing ability now, and we are performing large scale testing in facility settings when indicated. Outbreaks in long-term care facilities, correctional facilities, and congregate settings remain a prominent feature of this phase of the pandemic. We are learning that the virus is capable of working its way through these vulnerable facilities very quickly.

What are we doing?-We have primary resources directed at case investigations, clinic planning, testing follow up planning and community mitigation. We have absorbed resource assistance from Three Rivers Health District, Regional VDH folks and Central Office to assist in response. Testing of plant workers at both facilities is currently ongoing and being done by private contractors. Results expected sometime next week. The Health Department has scheduled a testing clinic for this Friday and Saturday with a total of 1500 kits available. We are targeting our clinic messaging to our more susceptible populations. We will be finishing all planning for that event later today or early tomorrow as we work out some final details with state and local law enforcement, VDOT and the VA National Guard. The idea behind the community event is to help us establish data to inform us on the prevalence rate of the virus in the community. Almost all testing to date has only been done on those exhibiting symptoms. Complete testing at the plants along with our community event will provide data on those who are asymptomatic and may be shedding virus without knowing. This will help to establish best next steps.

CDC-How do they fit and what are they doing?-CDC is here in an advisory capacity. They have provided an Industrial Hygienist (IH), three Epidemiologists, a Lab technician, an Outreach Specialist and their team lead, Dr. John Dreyzehner, Director of CDC Center for Preparedness and Response. Their initial efforts were focused on the poultry plants and they did a walk through inspection of each last week. They did not identify glaring issues with either plant. Reports from the IH are forthcoming. This week they have helped with data analysis and community risk assessment and testing plan.