Misplaced Priorities at VDH

by Carol J. Bova

The Virginia Department of Health (VDH) announced January 19 that it has launched a COVID-19 Outbreaks in Virginia Higher Education dashboard. The department included a disclaimer that the dashboard reports only “outbreak-associated cases and not the total number of cases at the college or university.” For more information on COVID-19 numbers, the dashboard points to a separate website hosted by eleven schools which contains information about their cases at www.covid19.va.education.

The VDH rationale for a new dashboard with incomplete information? “This dashboard helps to provide awareness of the spread of SARS-CoV-2, the virus that causes COVID-19, in colleges and universities statewide.”

This new VDH dashboard does not show the true extent of COVID-19 in colleges and universities. It is a waste of time and resources. Having this information at the beginning of the fall semester might have been useful. Citizens are already acutely aware of the spread in their communities, and efforts need to be redirected to the state’s older population.

For example, since November 1:

Colleges and universities have had 13 outbreaks involving 556 cases and no deaths.
Long term care facilities have had 490 outbreaks with 12,024 cases and 1,012 deaths.
Totals for higher ed: 55 outbreaks, 3,026 cases, zero deaths.
Totals for LTCF:  806 outbreaks, 24,935 cases, 2,795 deaths.

On November 17, 2020, the Centers for Medicare and Medicaid Services (CMS) recognized 1,092 nursing homes with half or more of their staff who completed CMS training to help control COVID-19 in their facilities. There were only 32 nursing homes in Virginia on that list.

Over 125,000 of approximately one million staff from 7,313 nursing homes completed the training. That means 254 Virginia nursing homes were among the 8,000 others in the country whose staffs did not complete the training.

Long term care facilities, including the state’s 286 nursing homes, are responsible for 94.5% of Virginia’s COVID-19 outbreak deaths, and 48% of all Virginia COVID-19 deaths.

In November, I asked Brenden Rivenbark, senior policy analyst, office of the commissioner at VDH and a member of the Governor’s Long Term Care Task Force, if the task force had taken any action encouraging nursing homes to take part in these CMS training modules.

In his reply, he said:

“The Task Force and our partners continue to encourage facilities to participate in the Targeted COVID-19 Training for Nursing Homes for clinical staff and management. In addition, our local health departments provide infection control guidance to long-term care facilities. Lastly, [Virginia Commonwealth University] and George Mason University are implementing the Project ECHO (Extension for Community Health Outcomes) model for Virginia’s nursing homes to connect facilities with subject matter experts across Virginia for knowledge exchange.”

Since November, almost 500 LTCF outbreaks, 12,000 cases, and more than 1,000 deaths show that encouragement, guidance, and experts for knowledge exchange have not reduced the overall nursing home cases and deaths.

CMS classes can help only if nursing home staff take them. Instead of creating dashboards that have limited information and do nothing to save lives, VDH should refocus on getting nursing homes to get more staff members to take the free CMS online training to control COVID-19 in their facilities. 

If that’s not to VDH’s liking, then put the dashboard people to work helping to schedule distribution of the vaccine instead of partly duplicating already available information. Either way, the priority needs to be on saving lives.