COVID-19 Testing Update November 20, 2020 Situation Report Summary and Key Trends Updated 11/19 This Situation Report contains insights from data collected by the VDH Testing Unit. The below integrates insights from across the weekly Situation Reports to highlight key trends and data points of note.

Statewide Snapshot Commonwealth and Locality Trends Community Testing Events (CTE) Virginia’s 7-day positivity rate continues to increase and is currently at 7.1%. The number of tests conducted per day continues to exceed VDH’s Positivity rate has • 21 health districts reported 95 CTEs in increased from daily targets. REDCap this week and 59% of those 6.2% to 7.1% events were in the Southwest region. • 8 districts reported CTEs targeting • Across the Commonwealth, an average of 19,200 PCR tests vulnerable populations this week. were conducted per day – exceeding the daily target of Hospital 17,500 tests per day. capacity is at 78% VA National Guard (VANG) • Supported seven CTEs. • Commercial lab turnaround times have increased over the past • Supported nine point prevalence Effective Reproduction three weeks; their average TAT now exceeds two days. survey events at long term care Number (Rt) facilities (5), educational settings (2), 1.15 and correctional facilities (2).

• 25% of localities (33 of 133) are reporting positivity rates higher Laboratory Community testing than 10%. events held this week Average 95 Turnaround Time (TAT) increased 1.59 Total PCR tests to date from 1.39 to days 2,983,430 • Russell is reporting the highest 14-day positivity rate in the state, at 25.8%. • TATs at commercial labs and the On target to meet the November PCR public lab have increased over the testing projection past week.

2 Statewide View: High-Level COVID-19 Metrics, Cumulative Updated 11/18 Key Metrics, as of 11/18

Total Cases: Total Hospitalizations: Total Deaths: Total PCR Tests: 208,833 13,707 3,860 2,983,430

Daily New Cases 2,000 Tests and Positivity Rate 25,000 25.0%

1,500 20,000 20.0%

15,000 15.0% 1,000

10,000 10.0% 500 5,000 5.0%

0 - 0.0%

Daily Cases Daily PCR Tests (7-Day Average) Daily Cases (7-Day Average) PCR Positivity Rate (7-Day Average)

Data sources: VDH Website [PublicUseDataset-Cases, Tests_by-LabReportDate], rt.live, NCHS 2018 Population Estimates 3 Statewide View: PCR Tests Conducted – November Updated 11/18

The current 7-day average PCR tests per day is 19,200 exceeding the daily target of 17,500. Virginia is on track to meet the November projection of 525,000 total tests.

Daily Statewide Number of PCR Tests Conducted: November1 Progress Toward November PCR Testing Projection 30,000 November daily testing projection Daily PCR Tests (7-Day Average) 2 25,000 November Projection 525,000

20,000 Tests to Date 256,530 (49%)

15,000 Projection to Date3 227,500 (43%)

10,000

5,000 2. Testing projections are informed by The UVA Adaptive Fit Scenario, the Harvard Global Health Institute, and the goal to - increase testing capacity across the state. 11/1 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11/11 11/12 11/13 3. Projection to Date (as of 11/13) represents the number of tests that should have been completed by this time in the month to track to the amount needed as projected. 1. To account for delays in adding more recent data, a 3-day buffer is applied to lab data. The latest day of full data as of this report is 11/13.

Data sources: VDH Website (Tests_by-LabReportDate), UVA Adaptive Fit Scenario, Harvard Global Health Institute 4 Locality View: Positivity Rate Updated 11/18

14-Day Positivity Rate by Locality Localities with 14-Day 1 (October 31, 2020 to November 13, 2020) Winchester Positivity Rates over 10% Clarke Highland 10.3% Roanoke City 10.4% Buchanan 10.4% Botetourt 10.4% Highland Roanoke County 10.6% Buckingham 10.8% Giles 11.0% Bath Prince George 11.1% Culpeper Clarke 11.2% Covington Tazewell 11.5% Grayson 11.5% Alleghany Winchester Tazewell 11.5% Botetourt Wythe Buchanan Wythe 12.4% Bath Norton 12.5% Smyth Giles Smyth Roanoke City 12.6% Dickenson Norton 13.6% Lee 13.8% Wise Franklin Buckingham Henry 13.9% Charles Pulaski Charles City 14.0% Covington 14.0% Alleghany 14.0% Roanoke County Wise 14.0% Washington 14.3% Lee Russell Washington Carroll Prince George Galax City 14.7% Henry Galax City Pulaski Scott Patrick 15.4% Patrick Bristol Grayson Quick Facts 16.0% Culpeper 16.2% Dickenson • Virginia’s 7-day positivity rate of 7.1% is 2.9 percentage points below the national average of 10%. 16.3% Scott 17.7% • 30% of localities (40 of 133) have 14-day positivity rates less than 5%. Carroll 18.1% Bristol 18.4% • 25% of localities (33 of 133) have positivity rates above 10%, and the locality with the highest 14-day positivity rate is Russell Franklin County 19.9% (25.8%). Russell 25.8%

1. Testing data are provided at the locality level with the exception of Covington, Emporia, Lexington, and Manassas Park. Based on how laboratory results are reported, data from these small jurisdictions are not trustworthy on their own. The surrounding localities of Alleghany, Greensville, Rockbridge, and Manassas are displayed instead. (Source: VDH Website) Data source: VA Long-Term Care Task Force Dashboard, Johns Hopkins Coronavirus Resource Center 5 Health and Human Services Support for Community Testing Events Updated 11/19 The Department of Health and Human Services (HHS) has partnered with VDH to increase access to testing for communities across the Central Shenandoah Health District, with a particular focus on colleges and universities.

Partnership Roles & Responsibilities Community Testing Events The Central Shenandoah Health District and HHS play complementary roles to The LHD and HHS have collaborated to plan 18 events in the District. support each event. Date Location HHS provides: Oct 21 James Madison University Oct 26 Rockingham County Fairgrounds ▪ Specimen collection kits Oct 28 James Madison University ▪ Lab services (eTruenorth) and transport courier Nov 2 Rockingham County Fairgrounds Nov 4 James Madison University ▪ Clinical staff to oversee client self-collection (locally hired nurses) Nov 9 Rockingham County Fairgrounds ▪ PPE (surgical masks, gloves and masks for clients) Nov 11 James Madison University Nov 16 Rockingham County Fairgrounds Virginia Military Institute, Washington & Lee University, VDH Central Shenandoah Health District and Partner Agencies: Nov 16 Southern Virginia University (event at VMI in Lexington) ▪ Select, plan, and operate the test site Nov 17 Mary Baldwin University (Staunton) Nov 18 James Madison University ▪ Store HHS supplied collection kits and PPE Virginia Military Institute, Washington & Lee University, Nov 19 ▪ Provide site staffing (leadership, logistics, traffic flow, registration, physical Southern Virginia University (event at VMI in Lexington) set-up) Nov 23 Rockingham County Fairgrounds ▪ Provide site supplies: tables, chairs, tents, traffic cones, signs, clerical items, Nov 30 Rockingham County Fairgrounds ice for specimens, trash collection/waste disposal Dec 2 James Madison University Dec 5 Charlottesville (Thomas Jefferson Health District) Dec 6 Charlottesville (Thomas Jefferson Health District) Dec 16 James Madison University

Data sources: Testing Unit, VDH Recent Community Testing Events at Virginia Universities Updated 11/19 VDH has partnered with VANG and HHS to provide testing for university students, faculty, staff, and the surrounding communities prior to holiday campus closures. Events this week have targeted various university communities, including Mary Baldwin University, James Madison University, Randolph-Macon College, Southern Virginia University, Virginia Military Institute, and Washington & Lee.

Randolph-Macon College Virginia Military Institute James Madison University • Tested 500 individuals (25% of student/staff • Tested 275 students from VMI, Washington & Lee, and • Tested 1,694 individuals at event on 11/18; population) Southern Virginia University on 11/16 additional events planned • Partnered with VANG • 537 individuals registered for event on 11/19 • One of Virginia’s largest single-day testing events • Partnering with HHS • Partnering with HHS

Mary Baldwin University

• Tested 377 students on 11/17 • Partnered with HHS

7 Skilled Nursing Facilities (SNF) & Assisted Living Facilities (ALF) Baseline Point Prevalence Survey (PPS) Project Updated 11/18

SNF/ALF Baseline PPS Project Summary

• Beginning in April 2020, VDH and partners, including the Virginia National Guard and Turnkey providers, offered Point Prevalence Surveys (PPS) in all Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs).

• As part of this effort, VDH coordinated PPS testing events in 249 SNFs and 224 ALFs.

• Specimen collection was conducted primarily by the Virginia National Guard, who collected specimens in 93% of SNFs and 61% of ALFs, as well as Local Health Districts, Turnkey Providers, and one hospital-affiliated facility.

• The COVID-19 Testing Team will continue to provide baseline PPS testing to facilities who previously declined this offer but then express interest.

Skilled Nursing Facilities Assisted Living Facilities

Final status of SNF testing coordinated by VDH: Final status of ALF testing coordinated by VDH

38, 13% 339, 224, Yes No Yes No 60% 40% 249, 87%

n= 287 SNFs n= 563 ALFs

Data sources: National Guard and Next Molecular reporting to VDH 8