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With a decline in new COVID-19 cases in state nursing home residents since mid-January, and with cases overall at their lowest levels since early summer 2020, the Virginia Department of Health recently announced that healthcare facilities can expand visitation for residents and their families.

The state health department announced the changes March 10, when the Centers for Disease Control and Prevention released updated healthcare infection prevention and control recommendations in response to COVID-19 vaccination for all healthcare settings, including nursing homes and assisted living facilities.

As of March 11, 279,969 vaccine doses have been administered to residents and staff at the state’s long-term care facilities.

In the Western Tidewater Health District, there have been 26 outbreaks, with 1,591 positive COVID-19 cases associated with them and 333 cases in healthcare workers.

Of the 26 outbreaks, 14 have been in long-term care facilities, six in congregate settings, four at correctional facilities and one each in a healthcare setting and a child care facility.

For the most recent dates reported, the Eastern Region — inclusive of Western Tidewater but also covering Hampton Roads and the Peninsula — there have been two outbreaks at long-term care facilities and four in congregate settings between Feb. 28 and March 6. There was one each at a K-12 school, a child care facility and a college or university.

Statewide, the seven-day positivity rate is 5.2%. In the health district, it ranges from 6.2% in Southampton County to 9.1% in Franklin. In Suffolk, it is 8%.

The state health department noted that relaxing current restrictions on indoor visitation could increase the risk for COVID-19 in post-acute care facilities. However, it said that vaccination progress in long-term care facilities “can mitigate some of these risks, and public health officials understand that expanding visitation has substantial benefits to residents.”

Using the CDC’s guidance, the state health department recommends that indoor visitation can be allowed for residents except in the following circumstances:

• Indoor visitation for unvaccinated residents should be limited solely to compassionate care situations if the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated.
• Indoor visitation should be limited solely to compassionate care situations for vaccinated and unvaccinated residents with SARS-CoV-2 infection until they have met criteria to discontinue transmission-based precautions and vaccinated and unvaccinated residents in quarantine until they have met criteria for release from quarantine.

Facilities experiencing outbreaks should continue to follow guidance from their local health department, the CDC said. In addition, visitors should be counseled about their potential to be exposed to SARS-CoV-2 in the facility if they are permitted to visit.

The state health department said long-term care facilities should continue to vaccinate staff and those who get admitted on a regular basis, and there should be routine testing for staff and people who have COVID-19 symptoms. It also recommends outbreak testing.

Despite recommending for a relaxing of restrictions, the state health department and the Virginia COVID-19 Long-Term Care Task Force call on long-term care facility residents and staff to wear a mask, stay at least six feet apart and regularly wash their hands.