Gov. Ralph Northam on Monday issued a limited state of emergency for hospitals stretched dangerously thin amid historic surges in coronavirus caseloads.
The provisions of the targeted 30-day state-of-emergency order will make technical changes to expand capacity and increase staffing at hospitals while they grapple with the pandemic, seasonal flu and a general increase in acuity after patients deferred care.
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“It has been a long 22 months for all of us,” Northam (D) said during a news conference. “It has been a roller coaster, and we are not built for this kind of uncertainty for this long. It has been hard on everyone.”
Gov.-elect Glenn Youngkin (R), who takes office Saturday, could rescind the emergency order, but Northam expects it to have his support.
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“The governor has spoken with the governor-elect, and we’re hopeful he will keep this in place for the full 30 days or as long as necessary,” Northam spokeswoman Alena Yarmosky said Monday. “It’s very important given the fact that the transition’s taking place.”
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Youngkin “supports the use of tailored executive action that removes staffing barriers and provides healthcare providers the flexibility in order to deliver high-quality care and give overworked medical professionals the relief they need,” spokesman Devin O’Malley said in a statement Monday.
The order waives certain regulations to increase bed capacity, allows providers with active licenses and in good standing to practice in Virginia, including through telemedicine, and allows physicians assistants with at least two years’ clinical experience to practice without written agreements. It grants more flexibility regarding vaccine administration and activates price-gouging protections for at-home antigen test kits.
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Virginia’s hospital crisis is in line with the rest of the region, which is seeing widespread surges. A 30-day state of emergency is also in effect in Maryland because of overburdened hospitals, and last week the D.C. Hospital Association called on Mayor Muriel E. Bowser (D) to reinstate D.C.’s public health emergency.
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Bowser said Monday that officials were still evaluating the association’s request and said it’s likely D.C. will need to take administrative actions to make sure hospitals can “operate nimbly.” She also expanded testing options: D.C. residents 65 and older can now pick up at-home rapid antigen tests at six senior wellness centers.
Montgomery County, meanwhile, launched a free program Monday for residents to pick up rapid tests at library branches, similar to programs that have been implemented elsewhere in the region. County health spokeswoman Mary Anderson said there were long lines in the morning at some branches, as people started lining up before test distribution began at 11 a.m.
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“But once we got going, it moved very quickly,” she said.
Anderson said she helped hand out about 1,200 tests within a half-hour at the White Oak branch. The Gaithersburg branch ran out before 2 p.m.
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Northam did not on Monday take broader emergency actions reminiscent of the first year of the pandemic, such as imposing an indoor mask mandate like the one currently in place in D.C., because, he said, vaccines offer widespread protection.
“This is not the virus we faced back in March 2020,” he said.
About 90 percent of Virginia adults and 78 percent of all Virginians have had at least one dose of a vaccine. Public health experts have said two vaccine doses plus a booster offer the best protection against the highly contagious omicron variant.
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The biggest challenges facing the state — and nation — are overwhelmed hospitals, and the vast majority of their patients are not fully vaccinated or boosted, Northam said.
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On Friday, Virginia hospitals hit a peak of 3,329 hospitalizations, surpassing the previous record of 3,201 on Jan. 13, 2021, according to the Virginia Hospital and Healthcare Association. In the past month, covid-related hospitalizations are up about 200 percent.
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D.C. Health emergency response leader Patrick Ashley said the District’s hospitals were operating at 83 percent capacity as of Sunday, which he called “not high.” But staffing shortages — as well as an influx of people going to emergency rooms for tests and mild coronavirus symptoms — have exacerbated strains on health-care facilities.
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Pediatric hospitalizations are skyrocketing across the region and nationally. Although omicron does not appear to cause more severe illness than other variants, public health experts say the staggering rate of infection means a record number of children require hospitalization.
“We are seeing very high numbers of children with covid-19, and the best way to keep them out of the hospital is to get them vaccinated,” said Northam, a pediatric neurologist. He said when he returns to private practice Monday he will encourage his patients to get vaccinated.
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Roberta Lynn DeBiasi, chief of pediatric infectious diseases at Children’s National Hospital in D.C., said about three times as many children are being admitted as in previous waves. The high Sunday was 67, including 20 in the critical care unit, she said.
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Seventy percent of children admitted to Children’s National for the coronavirus are under 12 years old. Kids under 5, who are too young to be eligible for vaccination, make up the largest share, followed by those ages 5 to 11, of which only about a quarter nationwide have received at least one vaccine dose, DeBiasi said.
She said the coronavirus is just as contagious in children as in adults, if not more so, but kids as a whole have a lower chance of being hospitalized and a lower mortality rate even if they are gravely ill. Of all children who test positive for the coronavirus, about 2 percent require hospitalization, national data shows.
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Unlike hospitals generally, DeBiasi said, Children’s National is not overwhelmed.
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“We have plenty of beds,” she said. “We’re designed to take care of large numbers of kids with contagious diseases, so it’s not impacted our ability to care for the kids.”
The latest coronavirus variant has taken over as the dominant strain in the U.S. Here’s what we know about omicron. (Monica Rodman, Sarah Hashemi/The Washington Post)
Infection rates have been on the rise across the board for weeks because of the omicron variant. As of Monday, the seven-day average of new daily cases was up 53 percent in D.C., 27 percent in Virginia and 8 percent in Maryland compared with a week ago, according to a Washington Post tracker.
The District on Friday reported that from Oct. 15 to Jan. 7, more than 59,000 rapid antigen test results were submitted to D.C. Health, including 6,728 that were “probable positive cases.” The District also reported 1,928 new confirmed positive cases from lab tests.
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Asked why rapid test results are reported in a separate data set from the lab tests, Ashley, of D.C. Health, said the lab tests carry “a higher degree of confidence” than over-the-counter tests.
“We take a lot of pride in using accurate data that’s reflective of what’s going on in the community,” he said.
Ashley noted that even with the new antigen test kit option, seniors and residents with disabilities are given priority at testing and vaccination sites in the city.
In Montgomery County, Gigi Diriba said there was a short line inside Silver Spring Library on Monday as people rushed to pick up last-minute tests before distribution closed. But the whole process, unlike other recent testing experiences of hers, took no more than 10 minutes.
“I’ve been in several lines and didn’t feel safe waiting,” Diriba said. “I think this is a great policy to give out tests for free.”
Karina Elwood contributed to this report.