“We also encourage continued efforts to further improve vaccination rates and efforts to maintain other mitigation measures to address this increased disease burden on our community,” the health directors said in a joint letter to area government leaders.
As of Tuesday, the five major localities in Northern Virginia were all in the “substantial”category, which the Centers for Disease Control and Prevention defines as 50 or more total new cases per 100,000 people in the past week. “High” transmission is 100 or more total new cases per 100,000 people in the past week. Only about a dozen counties in the state are below this standard, including Madison and Rappahannock.
D.C. Mayor Muriel E. Bowser (D) reimposed a mask mandate in the District last week — which is classified as having substantial transmission — but Virginia Gov. Ralph Northam (D) and Maryland Gov. Larry Hogan (R) have not done so, instead reiterating the CDC guidance.
David Goodfriend, the health director in Loudoun County, called the surge in Northern Virginia “troubling.”
While not as bad as in the winter, the continued increase in new infections across the region — to a seven-day average of 1,888 as of Wednesday compared with 253 one month ago — points to a larger burden on the local health-care system if it continues, he said.
New hospitalizations are still low, averaging about 71 daily admittances in the region this week, but that could change if people continue to gather without wearing masks, particularly those who haven’t been vaccinated, he said.
“The real challenge is, when you’re on the curve for covid-19, you don’t know where exactly the curve will top out,” he said. “We don’t want our health-care delivery system to be overwhelmed.”
Alison Ansher, the health director in Prince William County, said the low rate of new hospitalizations in that county — 0.2 percent for every 100,000 residents — may change as newly infected people fall ill.
Fairfax County was the last major locality in the region to hit substantial transmission — turning from yellow to orange on the CDC map — a change Jeffrey C. McKay (D), the chairman of Fairfax’s Board of Supervisors, said was inevitable in a region where people may travel through multiple counties in a day.
The change also underscored the fact that there are thousands of schoolchildren younger than 12 in the county of 1.1 million who are not eligible to receive the vaccine, putting them at higher risk for serious illness, McKay said.
“They are the ones that have me the most worried right now,” McKay said.
Last month, Fairfax County Executive Bryan J. Hill began evaluating how to implement a policy to require the county’s 12,500 employees to either be vaccinated or submit to a weekly coronavirus test.
Alexandria officials are considering vaccination requirements for public employees, but localities cannot implement widespread mask mandates without Northam’s say-so.
In the meantime, public health and elected officials have experienced pushback, especially on social media, from residents urging more — or less — action, sometimes back-to-back.
“I had residents say, ‘Oh there you go again sowing a panic and getting everyone freaked out,” Alexandria Mayor Justin Wilson (D) said, “and then, a couple hours later saying, ‘I can’t believe you’re not taking everything more seriously. Why are you not shutting everything down?’ ”
The city’s acting health director, Anne Gaddy, said about a third of city residents who tested positive in June and July reported recent travel — a reality that reflects the challenges of containing the virus when people are eager to resume normal activities.
“Covid doesn’t follow the lines on a map,” she said.
Although Virginia’s hospitals are not yet as crowded as harder-hit parts of the country, positivity rates of patients are on the increase.
“We’re not super busy but covid is part of our day in the emergency room,” said Michael Silverman, chairman of emergency medicine at Virginia Hospital Center in Arlington. “It’s definitely back.”
Silverman, who writes a widely circulated weekly Facebook update about the pandemic, said three to four weeks ago doctors and nurses were beginning to return to “business as usual,” but the respite was short-lived.
He attributed the increase in infections in Northern Virginia to pockets where people are unvaccinated and the delta variant, which he called an “entirely different animal” from the base strain of the virus.
“It’s more likely to infect you if you’re unvaccinated, but even if you’re vaccinated the possibility of you getting it now is higher compared to other variants,” he said.
While Northern Virginia had “substantial transmission” as of Wednesday, almost every bordering county, where many residents commute to Northern Virginia, had “high transmission” and some had lower vaccination rates.
That’s the case in rural Page County, where area health district nurse manager Leea Shirley said people question masking guidelines because they say federal, state and school district guidelines are always changing.
“Who are you supposed to believe? They tell us yes, they tell us no. Why should I get vaccinated if I have to wear a mask anyway?” she said people say.
Some will never change their minds, others may be swayed with education, she said.
“You’ve got to break that barrier to make people understand. It’s hard,” Shirley said.
A team of Federal Emergency Management Agency volunteers went door to door, but stopped when residents distrustful of the vaccine complained they were being coerced even though the volunteers carried only literature, she said.
However, Shirley said their visits to businesses and events, and expanded availability of the shots, have lead to an uptick in vaccinations, from a handful to as many as 10 to 15 daily.
Brandy Darby, a Virginia Department of Health veterinary epidemiologist working on the covid response, said vaccinations are the best way to prevent infection and severe disease.
“Masks are great but they’re not bulletproof. Vaccines add another layer of protection,” she said.