On July 1, Virginia entered Phase 3 of reopening. To avoid the resurgence of disease experienced in many other states and contributing to record numbers of new infections, two actions are critical: 1) Individuals must maintain protective behaviors; and 2) Persons who have fever and/or symptoms consistent with COVID-19 must be tested. A positive test triggers Health Department case investigation and contact tracing with isolation and quarantine. Healthcare providers should also be aware of new recommendations to test all close contacts of confirmed and probable cases and of an updated list of people at risk for severe COVID-19 infection.
- Use your position as a trusted health resource and leader in your community to remind people to maintain protective health behaviors and to be tested if COVID-19 symptoms occur. For patients you see in the office or via telemedicine, through information you share in print and online, and in the communities where you work, key messages to disseminate include:
- Rigorously maintain behaviors such as physical (social) distancing of 6 feet from others; wear a cloth face covering; and practice good hand hygiene. These effective measures are even more important as people spend more time outside of their home.
- Just because more activities are allowed does not mean that they are safe or prudent. “Safer at home” remains an important message, particularly for those at higher risk of severe infection.
- Anyone with fever or symptoms of COVID-19 needs to contact a healthcare provider to be evaluated and, in the absence of an alternative diagnosis, be tested for COVID-19. Persons who don’t see a healthcare provider, can still be tested at multiple sites around the county.
- Review and incorporate updated CDC recommendations in your practice:
- As capacity has increased, PCR testing for SARS-CoV-2 is now recommended for all close contacts (symptomatic and asymptomatic) of confirmed and probable COVID-19 patients. Testing is most effective 5-7 days after exposure to the case. If exposure occurred over several days, test 5-7 days after the most significant exposure following onset of symptoms in the case. Contacts who test negative should still be directed to complete their 14-day quarantine.
- Based on a detailed review of available evidence, CDC has updated and expanded the list of who is at increased risk for severe COVID-19. CDC warns that among adults, risk increases steadily with age and it is not only persons over 65 years old who are at increased risk. CDC also updated the list of underlying medical conditions that increase risk of severe illness.
- COVID-19 case data for the Fairfax Health District can be found on our Case Data Dashboard. The Health Department urges healthcare providers to use this resource to track the progress of the pandemic in the community and share this information to raise overall awareness in the community.
- No increase has been observed yet since the start of reopening in Northern Virginia on May 29, though the data lag and are incomplete for recent weeks.
- To date, disease burden has disproportionately affected Fairfax’s Hispanic community.
- Availability of COVID-19 testing continues to increase in the Fairfax Health District and across Northern Virginia. As reopening occurs, the Fairfax County Health Department (FCHD) urges providers promote COVID-19 testing for all symptomatic patients. Specimens can be collected safely in the office and tested commercially, increasing convenience for your patients and increasing the proportion who are appropriately tested. PCR specimen collection now includes nasopharyngeal, nasal, and oral with no preference stated by CDC. Self-collection also is an option. CDC provides guidance on PPE needs for each collection strategy. CDC also has provided further guidance for infection prevention and control that you can make in your office to minimize exposures.
- All patients who are tested for COVID-19 should be told to stay at home and away from others until they receive test results. Further guidance will be provided by public health if the test result is positive.
- Household contacts of a tested patient whose results are pending should be advised to be alert for subjective fever or other COVID-19 symptoms. If they feel feverish or develop cough or other symptoms during this self-observation period, they should take their temperature, self-isolate, limit contact with others, and seek advice by telephone from their healthcare provider to determine whether medical evaluation and testing are needed.
- Healthcare providers who are unable to safely collect specimens for testing can refer patients to the following resource for testing information/locations.
- FCHD is expanding its case and contact investigation work to enable isolation or quarantine of all identified cases and contacts. Patients with positive test results should expect to receive a call from the local health department providing guidance on isolation and strategies to use at home to keep their families safe, work restrictions, and other infection prevention measures. Contacts of persons who test positive will be instructed quarantine themselves for 14 days and be tested. Health care providers are encouraged to reinforce adherence to community mitigation measures and cooperation with isolation and quarantine.