The number of confirmed cases of COVID-19 in Gloucester County took a sudden upswing on Saturday, with the Virginia Department of Health reporting six cases, double the number reported as recently as Friday. The number of confirmed cases in Mathews also doubled, from one to two.

By Wednesday, the figure stood at eight in Gloucester, while it remained two confirmed cases in Mathews.

But Dr. Richard Williams, director of Three Rivers Health District, of which Gloucester and Mathews are part, said that the number of cases detected is not what the focus should be on. What is important, he said, is that the virus is in the community and that the only way for people to protect themselves from it is by staying at home and away from other people as much as possible.

“Only by everybody trying to be in near self-quarantine can we slow the spread,” he said. “We need to do it voluntarily. We must take immediate steps to protect ourselves … We are just seeing the beginning of what may become widespread community infection.”

On Saturday, the Three Rivers Health District also saw its first confirmed cases of the coronavirus in Lancaster (one) and Northumberland (two) counties, bringing the total in the district at that time to 11 confirmed cases. Williams said that two of the 11 people infected were ill enough to be hospitalized. Those numbers are in line with the 15 to 20 percent of cases requiring hospitalization seen in other parts of the world, he said.

By Wednesday, the total in the Three Rivers Health District had risen to 16, with cases also reported in King and Queen and King William counties.

While there are only 16 confirmed cases regionally, said Williams, it’s not indicative of how many cases there could be overall. Rather, he said, the 16 cases are representative of what is coming “and coming quickly.” People need to stop focusing on the number of confirmed cases, he said, because that could give them a false sense of security. He expressed certainty that there is more widespread illness in the community, with some people who are only slightly ill possibly thinking they have the flu, while the coronavirus is in its incubation period in other people.

“What does it matter if there are 10 or 20 or 100 or 200 cases reported in Gloucester? What is important is that it’s in the community now. We don’t need to focus on who has tested positive, or how old they are, or how sick they are … The virus is here now, and we should be protecting ourselves. We should be acting as if there are 1,000 cases,” he said.

The surge in cases in New York is just the beginning, said Williams. He projected that other major cities with large, dense concentrations of people such as Washington, D.C., will see a surge within another week, while smaller cities such as Richmond will be a few days behind them. More rural areas such as Gloucester and Mathews may begin to see a surge, as well, said Williams.

The disease transmits primarily person to person, he said, with rates and extent of transmission depending on population density.

The significance of an increase in cases has to do with the ability of the medical system to handle the worst cases, said Williams.

“There’s nothing we can do to stop it, only slow it,” he said. “The number of people infected will be determined by the number of people exposed (and) the size of the population that develops pneumonia will determine whether we’re overwhelmed.”

Medical supplies

In order to combat the coronavirus outbreak, hospitals must be kept from becoming overwhelmed, said Williams, and that means getting them the supplies they need. Not only that, but the larger medical community needs to have adequate supplies, as well, he said, from nursing homes to physician offices to EMS personnel and first responders.

Regional hospitals currently have the supplies they need, he said, but they’ve already put conservation measures in place because “running out could happen any day.” He said he hopes production of personal protective equipment, PPE, can ramp up to meet the demand as it grows.

“If not, the virus will have its way even more than it is already,” he said. “If the workers aren’t protected, they’re guaranteed to become ill.”

Williams said that the virus tends to contaminate everything in the room of a very sick person who’s producing a high viral load. “It’s very dangerous, and PPEs are not perfect,” he said. “You ideally need an environment that’s hermetically sealed, like in a high-hazard situation. People on the front lines are at very high risk.”

Health department procedures

The health department is attempting to track down anyone who might be at significant risk for having contracted the disease from the people with known cases, said Williams, and identified people are being placed in self-quarantine to try to slow transmission.

In a follow-up email, he outlined the process used. In the event someone in a work environment tests positive for COVID-19, he said, “we immediately ensure that person is isolated. We do a quick and thorough investigation of possible contacts, and we identify, interview and quarantine any person who is at significant risk of exposure. We provide consultation to business owners on cleaning the workplace in accordance with CDC-approved procedures.”

Williams said the process is designed to prevent the spread of disease to the greatest extent possible, and that if someone has not been contacted by the health department, there is no indication they’re at significant risk from that exposure event.

If a business isn’t closed, he said it’s safe to assume that it’s okay to enter it and shop. If there is not a potential for broad exposure, a business isn’t required to close and no announcement is made that someone there has contracted or been exposed to the illness.

“We must all try to protect the privacy of anyone who gets infected to the greatest extent possible,” said Williams. “To do otherwise is not allowed under privacy laws.”

In ending the interview, Williams once again emphasized the importance of self-isolation and social distancing.

“It’s out there. It’s everywhere,” he said. “We will see cases increasing over the coming days. We have a hope of blunting it, especially in our rural communities, but only if we take very, very careful care of ourselves. Now.”