COVID-19 Peaks in SW Virginia, No Cause for Panic Elsewhere

Written for Bacon’s Rebellion by James A. Bacon

Spread of the COVID-19 virus is gaining momentum as the weather cools, and news reports from around the country are raising the alarm that hospitals are at risk of being swamped by a fresh surge in patients. Here in the Old Dominion, the situation is reaching a “crisis point” in far Southwest Virginia, according to the leading hospital system, Ballad Health.

So, how bad are things getting? Are we experiencing a re-run of the spring when public policy was driven by panic that the United States might see a repeat of the hospital overcrowding in Italy and then in New York City?

When viewed from a statewide level, there appears to be no imminent threat of hospitals getting overwhelmed. According to the latest Virginia Hospital and Healthcare Association data, hospitals are treating 1,313 patients confirmed or suspected to have COVID-19. That compares to 3,063 inpatient beds available, and another 3,695 additional beds licensed under Executive Order 52.

Another important measure is the number of ICU beds, which are needed for sicker COVID patients. Combining the licensed complement of ICU beds and “surge” beds, ICU occupancy is only 54%. In other words, Virginia hospitals are holding more than 1,100 ICU beds in reserve.

Only 29% of ventilators are being used, leaving more than 2,000 on hand, And not a single hospital is reporting any difficulty replenishing personal protective equipment.

All things considered, Virginia’s hospitals are far better prepared than they were this spring to handle a run-up in the number of COVID patients.

That conclusion is subject to one important caveat. Those are statewide numbers. They don’t tell us what is happening regionally. Some regions have more capacity to spare than others, and some are being harder hit by the virus than others. Here are the regional trends in confirmed cases.

Hampton Roads: The seven-day moving average in confirmed cases, which spiked in July, is way down.

Central Virginia: Cases have been stable since spiking and declining in May, although they have been creeping higher in the past month.

Northern Virginia: Cases are way down from their May peak, but have been inching higher in the past month.

Northwest: Cases hit new highs in September and have not backed off substantially since then.

Southwest: The virus largely bypassed this largely rural region early in the epidemic, but cases have been trending steadily higher and peaked in late October/early November.

Bacon’s bottom line: Hold steady, folks. No need to panic. First, let us remember that “confirmed cases” does not translate into “hospitalizations.”  Here is what is happening to hospitalizations in Southwest Virginia:

Not as spikey as the number of confirmed cases, is it?

If hospitals are approaching capacity in the far Southwest, they can voluntarily suspend elective procedures as long as the emergency lasts. Perhaps temporary restrictions on restaurants, bars and public gatherings are temporarily justified. There is absolutely no cause for a statewide ban on elective procedures, as occurred earlier this year. Fortunately, Governor Ralph Northam has shown a propensity in recent months for measures tailored to local conditions.

Here’s how I interpret the patterns we are seeing. The large metropolitan areas were hit by the virus early and hard. Lots of people were infected, and lots of people developed antibodies. Those regions haven’t reached “herd immunity,” so the virus is still spreading. But it might be fair to say they achieved “herd resistance.” Enough people have antibodies now to slow the propagation of the virus. COVID-19 skipped past Southwest Virginia earlier this year, so the population there never developed herd resistance. Now the Southwest is getting slammed like other regions did.

In the absence of a vaccine, it’s a safe bet that almost everyone would catch the virus sooner or later. Only those willing to isolate themselves indefinitely would avoid it. The aim of public policy now should be to slow the spread of COVID-19 until a vaccine is available for the general population by next spring — without shutting down the economy. That means applying narrowly targeted restrictions as local conditions warrant.

And everyone, please wear your masks when you run your errands.