Twin Tragedies: COVID-19 and the Northam Administration

by James C. Sherlock

Communication in this time of crisis has not been a notable strength of either Governor Ralph Northam or his cabinet. I discovered the reason why in the Governor’s press conference today: They are clueless.

The Northam administration’s online communications

The state’s official website as of today has no information about the real time activities of emergency management, about testing availability, about personal protective equipment, or about anything else that matters.

  • As for the Virginia Department of Health (VDH), the last entry on the Health Commissioner’s Blog is dated October 15, 2018.
  • Not a single entry in the media room discusses what the state is actually doing, only what they see happening.
  • Not a word about the functioning of Virginia’s six Health Care Coalitions (HCCs).

No word either about the actions of Virginia’s Emergency Operations Center (VEOC), just that the center is conducting response operations. The situation report tells us nothing about what state officials are doing, how they are doing it or what success they may or may not be having.

The Governor’s April 1 Press Conference

Now for today’s Governor’s press conference. I must report that I am literally stunned.

The Commonwealth has had in place for eight years a plan[1]  in which is written the following planning assumptions among others (italics are mine):

  • Pre-event planning is critical to ensure a prompt and effective response to a pandemic influenza, as its spread will be rapid, recurring in multiple waves, and difficult to stop once it begins.
  • A pandemic disease outbreak may precipitate infection rates exceeding 25% in an affected population, with projected mortality rates as high as 2 percent among those infected.
  • Due to the universal susceptibility of the public to an influenza virus and the anticipated pervasive impact on all segments of society, the majority of the medical and non-medical consequences of the event will be addressed by the public and private sectors in the context of the existing emergency management framework, supporting infrastructure, available resources, and associated supply chains with marginal support from new or external parties.
  • Although technical assistance and support will be available through the federal government prior to, during, and following the event period, it will be limited in contrast to other natural and human-caused events that impact a specific geographic area in a more defined, shorter, and nonrecurring timeframe.

There was no one on that stage today, including the Governor, the Secretary of Health and Human Resources, the Health Commissioner, and a woman who I assume to be the Director of the Division of Consolidated Laboratory Services, who demonstrated any knowledge either of those planning assumptions or current events.

Some examples:

Modeling. There was a discussion by the Health Commissioner about modeling. He is still waiting for more data to project infection rates and resulting healthcare requirements in Virginia. He seemed totally unaware of the 2012 planning assumption that infection rates will exceed 25%. He did not mention that the state’s modeling and simulation center in Suffolk has been operational since 1996.

Protective gear. There were unhelpful discussions about Personal Protection Equipment (PPE). When asked how much PPE might be required, Secretary Carey replied, “As much as we can get.” Pretty definitive. Did the state do any modeling between 2012 and now on how much PPE would be required if its published assumption of a 25% infection rate were met? Did it take measures before now to acquire the PPE that would be required? Same question about hospital and ICU capacity. The answer clearly is no.

Testing. Then there was the testing discussion. The Director of the Division of Consolidated Laboratory Services (assuming that was the person on the stage) was proud to announce that the state laboratory system had achieved sufficient automation of testing to assess 200 samples a day. She described a backlog of 2,000 samples.  No one mentioned or seemed to have any knowledge of commercial lab capacity. On February 29, the FDA cleared the regulatory barriers preventing commercial labs from performing COVID-19 testing. Since then, American Clinical Laboratory Association (ACLA) member laboratories have steadily increased COVID-19 testing capacity each week. As of March 29, ACLA members had performed approximately 650,000 COVID-19 tests nationally, including 84,000 tests completed on March 28 alone. In a press conference 33 days after the federal clearance, no one on the stage at the Governor’s press conference seemed aware that commercial labs were testing, much less how many have been conducted and can be conducted in Virginia, or whether the data from those tests are informing the Virginia model from which the Health Commissioner is awaiting results.

Hospital capacity. The Secretary of Veterans and Defense Affairs answered questions about military hospital capacity in Virginia. He specifically mentioned a phone call with the Commander of Naval Hospital Portsmouth and said they were preparing to serve their military clients. The Secretary did not mention that USNS Comfort is in New York Harbor with 1,200 medical personnel from that Naval Hospital.

The homeless. The Governor was asked about provisions for the homeless. He looked stunned by the question. He looked around in panic and called Dr, Carey to the mike  His answer – working on that.

There was not a single mention of (or question about) the functioning of the State Emergency Operations Center or the six HCCs in this crisis.

I could not make that up. I have been the one on here regularly asking readers to cut the Governor slack on several fronts. I take it all back  It is too late to impeach him, and it wouldn’t be fair. Whoever replaced him would be stuck with his cabinet.


[1] Commonwealth of Virginia Emergency Operations Plan, Hazard-specific Annex #4, Pandemic Influenza Response (Non-Clinical)

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25 responses to “Twin Tragedies: COVID-19 and the Northam Administration

  1. Hey, thanks to sign-language lady, at least Northam is doing a good job of communicating with the deaf:

  2. On the topic of Virginia’s epidemiological modeling efforts… Virginia Health Commissioner Norm Oliver made reference to models developed by the Imperial College in London, the University of Washington, the University of Pennsylvania, the University of Virginia. “The Governor mentioned that we are working on modeling. … [UVa has] been working with us the last couple of weeks, and we will in just a few days be able to present a model that has Virginia-specific data, which will therefore be a much more accurate projection of what we can expect.”

    Yikes! Still no model! This is a confession that Governor Northam has been flying blind through this crisis.

    Olive also provided the following data:

    Hospitalized patients: 305
    Number in ICU beds: 135
    On ventilators: 108

    The data on ICU beds and ventilators is not published on the Virginia Health Department website. It’s good to know that that state does, in fact, have the data.

    • Tell us how you feel about climate models. How do you feel about their results and developing public policy based on model results?

  3. Thank you, JS — we needed this. Somewhere — anywhere? — is there a well-informed source of information in this administration about Virginia’s preparedness? If N. can’t rise to the occasion, who can do it for him?

    What’s the status of test availability in our health facilities and drive through for the public?

    What’s the status of supplemental beds by hospital referral district if not by county?

    What’s the status of additional protective equipment and ventilators (same breakdown)?

    What’s the State’s current estimate of the range of rates of infection, the likely date of the peak load our hospitals, and the likely mortality associated with that?

    Yes, what about those not covered by the federal dole– the homeless, the undocumented, the elderly ,(apparently SSA payments doesn’t get you a check from IRS)?

    What’s the financial health of our Virginia medical facilities?

    Where, oh where, is a sense of leadership here?

    • As I have answered others here, the waters of incompetence in this area in the Northam administration are too deep. We could replace everyone in his cabinet and the new people would still be served by incompetent staff.
      The Department of Health (VDH) has been a mess for a long time. The VDH has treated the lobbyist group Virginia Hospital and Healthcare Association (VHHA) like a government agency for a as long as I can remember. The Commissioner himself deferred to VHHA on a policy related matter in an email exchange with me. That is a bad idea in normal times and a tragedy now.
      I don’t have personal experience with the Virginia Department of Emergency Management (VDEM), but I am not impressed in this outing. Maybe they know everything there is to know about hurricanes, floods and terrorist attacks, but this is a different arena. I doubt they have exercised rigorously in this scenario.
      Finally, the failure of the General Assembly to regulate the business of healthcare in normal times under the pressure of that same VHHA leaves in its wake a lack of competence and information in a crisis. Jim

  4. Leadership. Hmm. I seem to recall saying something about that a day or so ago on this blog. But it was called “hogwash” .

    • More revisionist history from you. Who here didn’t expect that?
      “Hogwash” was in response to your “ Trump is aspirational, Northam (and by extension every Democrat breathing today) is playing the victim.

      Is Northam doing a stellar job? No. Do I want him to make stuff up to make me feel better? No. Is the hypocrisy of the small government crowd clamoring for absolute government oversight, after they broke government, too much? Are the outlandish cries of libertarians for government oversight of hospitals and clinics while also claiming that socialized medicine wouldn’t make this outbreak more manageable (indeed!) blindingly contradictory? Yes. It’s still hogwash.

  5. An indictment indeed, and unlike others this one with a relevant bill of particulars provided by someone with hands on experience.

    In the post before, Jim implied a similar lack of competence in the financial realm, responding to the impending revenue cliff. I don’t know a darn thing about the medical side, but I’ve been a nosy observer on the finances for decades. I managed a state agency budget myself. I know those players and have confidence. I would be stunned if the amendments produced on April 11 leave us appalled.

    But we won’t know until we see them. Wishful thinking is a powerful hallucinogen. And giving the boss good advice is no guarantee it gets taken.

    When it comes to crisis communications, the Northam team’s failings were on display to the entire world last year. That’s another field where I feel qualified to throw stones. If there were Razzie’s in the field, it would be on the mantle in the Patrick Henry Building. Perhaps they get a second one this year.

    • I fervently wish my bill of particulars weren’t true.

    • Other past criticisms of the Northam Administration on this blog used quantitative testing data from the 50 states to demonstrate that Virginia has fallen badly behind on per capita testing. Now the failed Northam Administration has admitted by omission that it is not focused on private lab testing. This is undoubtedly the reason other states have sailed ahead of Virginia in per capita testing.

      This criticism of Northam and his administration was discounted on this blog by the usual Richmond apologists who are part and parcel of the problem we have with a grossly incompetent, corrupt and culpably negligent state government.

      • I certainly resemble that remark, but my point has been that carping during the crisis is not very helpful. Trump and Northam are our guys, and if you want either to listen, rather than just to grandstand, another tone might be better.

  6. Thank you, JS — we needed this. Somewhere — anywhere? — is there a well-informed source of information in this administration about Virginia’s preparedness? If N. can’t rise to the occasion, who can do it for him?

    What’s the status of test availability in our health facilities and drive through testing for the public?

    What’s the status of supplemental beds by hospital referral district if not by county? What emergency facilities are being readied and where?

    What’s the status of additional personal protective equipment and ventilators (same breakdown)? Who’s doing what on this?

    What’s the State’s current estimate of the range of rates of infection, the likely date of the peak load our hospitals, and the likely mortality associated with that? New models be damned; what about existing projections such as https://covid19.healthdata.org/projections ?

    Yes, what about all those not covered by the federal dole– the homeless, the undocumented, the elderly (apparently SSA payments w/out a tax refund don’t get you into the IRS system for a federal check)?

    What’s the financial health of our Virginia medical facilities?

    Where, oh where, is a sense of public service or leadership here

    (apologies for double post)

    • Your questions are right. The administration has no clue about the answers. There is no mechanism to replace him and his entire cabinet now, and (1) it would not help and (2) it’s too late – – to much time would be required to spin up the new people, and the professional staffs of the cabinet clearly don’t help the current bosses.

  7. The Health Commissioner has access to proven models, just insufficient data to populate one with any level of faith in a model run. One could assume that since the Governor and his cabinet don’t know that commercial labs have been testing for more than a month, the state may not have data from commercial lab tests with which to populate the model. That itself assumes that any of the hundreds of thousands of tests done by those labs included subjects in Virginia, which the Governor and his cabinet also don’t know. And as for ventilators, she knows how many COVID-19 patients are using them. Does she know how many Virginia has total? And where they are? What is your guess?

  8. Roanoke TV stations are doing some things to educate the public with health department folks out here. I’ve seen several virtual joint events advertised.

  9. Sure, the TV and radio and print media are all hungry to spread the word, to the extent there is any offered to spread.

    My family just got off a “town hall” discussion with Congressman Don Beyer. He was well informed about Virginia, and this from someone in the federal legislature who has no responsibility for planning and execution of emergency and health policy at the State level.

  10. I have a near term fix in mind, at least for procuring competent advice for the Governor, that I will offer in a column tomorrow.

  11. It always amazes me that the people, who don’t want to spend money to do anything, are the first to complain when nothing was done.

  12. Interesting report. My perspective is that the role of state governors in the pandemic is even more important given the utter incompetence of Donald Trump

  13. There is always the possibility that yesterday’s press conference was an elaborate April Fool’s joke perpetrated by the governor…

  14. Here’s a model. Conflate these two maps…

    to get this map of counties at greatest COVID risk

  15. Ralph Northam joins Eileen Filler-Corn and Dick Saslaw as walking advertisements against voting Democrat in Virginia.

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