Testing, Hospital Resources Prioritized As Alexandria Cases Surge

ALEXANDRIA, VA — With high COVID-19 case levels seen in Alexandria amid the spread of the more-contagious omicron variant, testing demand is high while Alexandria's hospital is busy but not close to reaching capacity. Health officials provided an update on the COVID-19 response at Tuesday's City Council meeting and fielded questions from City Council members.

Transmission is currently classified as high in Alexandria, according to Alexandria Health Department director Dr. David Rose. He noted Alexandria only had "a handful of days" where daily cases were over 120, and now the city is averaging 400 to 600 daily cases. The percent positivity average is close to 30 percent, while the average had been 5 percent or below for a significant portion of 2021 after last winter's surge.

While Rose said most cases cause mild illness, the number of cases causes other concerns.

"The sheer number of cases makes us concerned about staffing shortages for essential services and pressure on our area hospitals service capacity," Rose told City Council.

Dr. Rina Bansal, president of Inova Alexandria Hospital, noted the hospital is busy but doing well from a capacity perspective. The hospital is dealing with staffing challenges but is working on it with "creative" recruitment and retention strategies and altering some care models.

"Although we are extremely busy, we are well within our capacity from a bed perspective as well as a resource perspective and caring for communities," said Bansal. "We are actively planning for any surges that we may see in the next few weeks as noted by the predictive models."

Bansal said the 30-day public health order issued by Gov. Ralph Northam helps hospitals by allowing them to increase their licensed bed capacity. It also allows hospitals to have staff-to-patient ratios that are normally not allowed and allows vaccinations to be given by more kinds of health care providers.

Inova Health System also continues to push a message that people should not come to emergency rooms to get tested if they do not need emergency care. People with mild or no symptoms are encouraged to see their primary care provider or visit a community testing site. Inova opened a car-side testing site in the Falls Church area for symptomatic people by appointment.

Testing has been a challenge citywide as demand increases with the recent surge of cases. Natalie Talis, population health manager for the Alexandria Health Department, said the higher positivity rate indicates not only that transmission is high, but also testing supply is not keeping up with demand. One example demonstrating the demand is the distribution of free at-home tests at Alexandria Library. When supplies come in, they usually go quickly.

"We know that it is incredibly hard right now to find those rapid home over-the-counter tests," said Talis. "Many people have been driving around to various pharmacies around our community trying to find them, and unfortunately, they are usually out of stock. It's hard to keep them on the shelves, and that is due to national and international supply chain concerns as well as that growing demand."

Talis said the health department is coordinating with the city to purchase and distribute thousands of free at-home tests. The focus will be on residents who cannot afford to order numerous tests online. When that will happen depends on the supply chain and when those tests can be delivered to Alexandria.

"But as soon as those reach our community we have a plan in place to distribute them particularly focused on our lower resourced residents," said Talis.

The city and health department are also looking at potential large-scale testing events. However, the demand for testing plays into this as well. Talis said Alexandria is competing with other Virginia jurisdictions for a Virginia Department of Health contractor it normally uses. The health department is exploring other vendors to support a large-scale testing event.

Outside of Alexandria, the state has opened new Community Testing Centers near or on the same properties as the Community Vaccination Centers. The testing centers will offer the PCR test, are appointment based, and include locations in Fairfax and Prince William counties. The Fairfax testing center will open Saturday, Jan. 15 by appointment at the Fairfax County Government Center.

Alexandria continues to offer PCR testing kiosks managed by Curative. Talis noted there has been confusion about walk-up availability. Currently, residents should visit curative.com or call the Alexandria COVID-19 Hotline at 703-746-4988 for an appointment.

The health department is also working on an online portal where residents can report positive rapid test results and receive guidance on actions to take after a positive test. Talis said the health department hopes to have the portal live in the next week.

For residents unsure about whether to get tested or whether to get a PCR or rapid test, visit www.alexandriava.gov/COVIDTesting. The website provides testing locations, information on who should get tested and more guidance.

Looking at COVID-19 modeling, health officials are eying the end of January as a time when cases could potentially fall significantly.

"In terms of the cases and modeling, we're looking at something like towards the end of this month, say the fourth week or so, and hopefully according to the model, and according to what had happened in South Africa hopefully a rapid diminution in cases," said Rose. "But in the meantime, it will continue to have those pressures."

Due to the higher numbers of cases, the health department is no longer contacting each person by phone for case investigations and is prioritizing more urgent situations. Rose said the health department is exploring other ways to communicate, including text messaging.

While transmission is high, the health department is emphasizing several strategies: testing, increasing booster vaccination rates, and layered mitigation strategies such as mask wearing. Rose acknowledged Alexandria's high vaccination rate with 80 percent of the population having at least one dose. However, the rate of the population with a booster is lower — below 30 percent for the overall population. Rose said the vaccination rate for children ages 5 to 11 also needs to be higher; it currently stands at 46.9 percent with at least one dose and 35.5 percent fully vaccinated.

"Now everyone 12 years older is recommended to get vaccinated and boosted," said Rose. "So being boosted or up to date is more effective than only attaining the initial course of a COVID-19 vaccine."

At Tuesday's meeting, City Council also extended the local emergency declaration for COVID-19 through June 30, 2022 by request of City Manager Mark Jinks. The emergency declaration will help the city use state or federal assistance that could become available to respond to the COVID-19 emergency.

For the latest coronavirus guidance from the Alexandria Health Department, visit www.alexandriava.gov/Coronavirus.