Health and Medicine
Apple and Google are expected to jointly release a new system soon that provides an electronic form of “contact tracing”. It offers the promise of quickly learning if you have been around someone with COVID-19, but there are ethical questions, as WFIR’s Evan Jones reports:
NEWS RELEASE: Effective Thursday, April 23, Valley Metro will be extending suspension of fare collections on all Valley Metro transit services until Friday, May 8. During this period of fare free transit service due to the COVID-19 Pandemic, passengers are asked to adhere to the following:
If you are sick, avoid public transportation.
Transit passengers are encouraged to limit interaction with the bus operator and travel for essential trips only.
Passenger capacity is limited to nine passengers per bus.
Use the front door for entry/use the rear doors for exit.
Signage has been placed on all buses to encourage social distancing and behaviors as prescribed by the CDC.
Extended rides on one transit route will not be permitted.
Valley Metro staff will be closely monitoring each transit bus in order to maintain a safe environment.
All Valley Metro vehicles are ADA accessible.
If you have questions, please contact Valley Metro offices at 540-982-2222.
PREVIOUS: The association that represents Virginia hospitals is calling upon Governor Northam to permit a resumption of non-emergency procedures. The executive order that put a temporary halt to such procedures is set to expire tomorrow. The Virginia Hospital and Healthcare Association says there are plenty of beds and respirators available for COVID-19 patients, and the many Virginians awaiting needed medical procedures should not have to wait any longer.
VHHC NEWS RELEASE: The order has accomplished its purpose of preserving personal protective equipment and freeing up additional bed space in preparation for the COVID-19 response so there is no need to extend it beyond tomorrow. Any extension would prevent patients with chronic conditions, and those with immediate medical needs, from receiving timely surgical care, which could have negative implications for their health. At this point, it is estimated that 15,000 inpatient and outpatient medical procedures are being deferred each week in Virginia as a result of the existing order. In addition to impacting patients, any potential continuation of the order also impacts health care providers and employees who have been furloughed during the pandemic.
Allowing the order to expire would put Virginia on similar footing with at least 17 other states which as of today (Thursday, April 23) have lifted restrictions on non-emergency procedures: Alaska, Arizona, Arkansas, California, Colorado, Georgia, Indiana, Kentucky, Nebraska, New York, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Utah, and West Virginia.
Also as of today (Thursday, April 23), Virginia hospitals are treating 1,379 COVID-19 patients, have 5,327 beds available, and have 2,264 ventilators available to provide respiratory support to patients, per the VHHA COVID-19 Data Dashboard.
Virginia hospitals and health systems have the capacity to meet the medical treatment needs of patients who need procedures that have been postponed due to the pandemic while also maintaining a high level of care for COVID-19 patients.
Virginia’s hospitals have also established a framework (see attached guidance document) for re-opening the health care delivery system in a responsible manner consistent with the Open Up America Again Guidance document recently issued by the Administration of U.S. President Donald Trump, as well as similar guidance issued by other national health care organizations such as the American College of Surgeons.
RICHMOND, Va. (AP) — Plans to convert three convention centers across Virginia into field hospitals as part of the state’s coronavirus response have been put on hold, according to Gov. Ralph Northam’s office.
Current trends suggest Virginia has sufficient hospital bed capacity to deal with the pandemic in the short term, Northam’s spokeswoman, Alena Yarmosky, said in an email.
Work has not begun to build the alternative care sites, which Northam announced in early April would be put in place within about six weeks at convention centers in Richmond, Hampton and Fairfax County. The sites were intended to free up capacity in the existing health care system, and Yarmosky said they remain a possibility if things change.
The Norfolk District of the U.S. Army Corps of Engineers has worked with state officials and health care providers on the design of the sites, said spokesman Patrick Bloodgood
“From the Corps’ perspective, we are ready to go as soon as the state says execute,” he said.
Dr. Danny Avula, who as director of the Richmond and Henrico County health districts was involved in planning conversations about the Richmond alternative care site, said the health systems he’d heard from didn’t think it was necessary to pursue such a huge overhaul. Instead, a projected surge in patients can likely be handled by overflow the systems can create on their own, he said.
In New York City, the epicenter of the pandemic in the U.S., an alternative care site set up at the Javits Center has had fewer patients than expected.
The number of confirmed cases of COVID-19 in Virginia surpassed 9,600 on Tuesday, with 324 deaths, according to the latest information available from the Department of Health.
Nearly 5,500 hospital beds were available, according to a report published online by the Virginia Hospital and Healthcare Association, which reported 1,331 hospitalized patients who have either tested positive for COVID-19 or who have test results pending.
Northam directed Virginia’s hospitals in late March to postpone elective surgeries, a move aimed at freeing up bed space and preserving personal protective equipment that’s in short supply.
Deaths and infections are still rising around the world. The virus has killed more than 175,000 people globally, including more than 43,000 in the United States, according to a count from Johns Hopkins University.
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VT Covid Lab- Dr Michael Friedlander (R)-VT photo
The turnaround time for results will be faster, the materials sent out to collect samples somewhat simpler. Virginia Tech scientists have developed a test for COVID-19 they also call unique, as WFIR’s Gene Marrano reports:
NEWS RELEASE: April 22, 2020 — Virginia Tech scientists have developed a new COVID-19 test and secured federal and state approvals to begin processing samples at on-campus labs in Blacksburg and Roanoke.
The university will support local health departments throughout the region to provide timely analysis to identify patients suspected of having COVID-19 – a critical step in the process of slowing the pandemic in Virginia. No patient samples will be collected at either of the labs – that step is done by health departments or health systems working with health departments, including the Schiffert Student Health Center at Virginia Tech.
“Virginia Tech has received emergency permission to begin testing COVID-19 samples and we have notified local health departments that we are ready to begin receiving samples soon,” said Michael Friedlander, executive director of the Fralin Biomedical Research Institute at VTC and Virginia Tech’s vice president of health sciences and technology. “With expanded testing becoming crucial to controlling the pandemic, in Virginia and the nation, Virginia Tech faculty, staff and graduate students went to work to answer the challenge.”
The U.S. Food and Drug Administration (FDA) issued Emergency Use Authorization on Monday for the university to proceed with testing. FDA review of the validation is pending. After review, the university will receive official notice as to whether full FDA approval is granted.
With hospitals challenged by shortages of critical resources and diagnostic labs glutted with potential COVID-19 samples, scientists with both the Fralin Biomedical Research Institute in Roanoke and the Fralin Life Sciences Institute in Blacksburg confronted the problem.
“We were alarmed that the backlogs at testing labs seemed to be growing without much relief, which makes it difficult to treat patients appropriately and to contain the pandemic guided by timely, accurate data,” Friedlander said. “With so many scientists at the forefront of biomedical technology, facilities, and expertise – we were confident our teams could develop assays and make a meaningful contribution.”
Faculty research leaders and their teams, led primarily by Carla Finkielstein at the Fralin Life Sciences Institute in Blacksburg and also by Harald Sontheimer at the Fralin Biomedical Research Institute in Roanoke, noticed the hardship and jumped into action.
“Everyone is helping in any way that they can from their positions at the university,” said Finkielstein, an associate professor of biological sciences in the College of Science and affiliated faculty member of the Fralin Life Sciences Institute. “It amazes me; it is a true team effort.”
All the analysis will be done in a standardized, safe manner under the certifications and guidelines of university, state, and federal oversight. The final approvals to conduct the tests came this week after weeks of stressful, round-the-clock work to overcome multiple hurdles.
The challenge of completing work quickly was magnified because access to critical reagents were in short supply and aligning instrumentation and protocols with state and federally mandated guidelines was a complex process.
“Despite the obstacles, Dr. Finkielstein rolled up her sleeves, went into her lab, and started cranking,” Friedlander said. “Carla is a non-stop force of nature with the compassion for service to others to match her grit and scientific acumen. She and her fantastic team of postdoctoral fellows have been working tirelessly ever since.”
Sontheimer, the director of the Center for Glial Biology in Health, Disease, and Cancer at the Fralin Biomedical Research Institute, and executive director of Virginia Tech’s School of Neuroscience in the College of Science, and his group of postdoctoral associates, technicians, and graduate research assistants used their experience in molecular biology and molecular virology to work closely and in parallel with Finkielstein’s team developing the assay and preparing the protocols for implementation at the Fralin Biomedical Research Institute in Roanoke.
All eight members of Sontheimer’s lab are devoting their attention to the effort, while postdoctoral fellows and research associates are working back and forth between Roanoke and Blacksburg, sharing information.
“In Roanoke, we couldn’t have done it without Robyn Umans of the Sontheimer lab and Carmen Munoz Ballaster of Dr. Stefanie Robel’s lab,” Friedlander said. “They and their colleagues are true heroes, completely dedicated – Carmen has been working around the clock and trains others in the techniques she has helped perfect – and she is expecting a baby in a couple of weeks on top of that.”
“This effort is the result of very purposeful support by Virginia Tech Provost and Executive Vice President Cyril Clarke to muster the university’s biomedical expertise against the pandemic,” Friedlander said. “His support has been key to our timely forward movement and tackling the scientific and regulatory challenges head on.”
Friedlander and Matt Hulver, the executive director of the Fralin Life Sciences Institute, pressed forward to make arrangements to reconfigure lab space for Virginia Tech scientists to process COVID-19 samples in Roanoke and Blacksburg,
“Many faculty members stepped outside of their normal roles and routines, but ultimately these people are scientists who are at the top of their game,” Hulver said. “We realized this testing uses technologies that many of us have available in our labs, and we could be part of the solution. We have robotic equipment. Our scientists understand biomedical research. We have software. We have safety training. It’s what we do.”
Meanwhile, Friedlander moved forward connecting faculty members who could meet the COVID-19 testing problem head-on, working with Virginia Tech Legal Counsel Kay Heidbreder and Assistant Vice President for Emergency Management Michael Mulhare in identifying and clearing regulatory hurdles, and working to reach agreements with the Virginia State Health Department, the U.S. Food and Drug Administration, and regional health departments.
Critically important, Virginia Tech had federal CLIA certification – short for Clinical Laboratory Improvement Amendments – to do complex testing through its Schiffert Student Health Center, which permits the university to perform non-research tests such as the COVID-19 assay using human samples.
Kanitta Charoensiri, director of Schiffert Health Center, and other center leaders worked to help Friedlander and the teams in Blacksburg and Roanoke apply for testing approval under Schiffert’s license.
Sample testing will enable Virginia Tech to support health providers throughout the region.
“We anticipate a wave of COVID cases, and we need to be ahead of it,” said Sontheimer, a professor of neuroscience in the College of Science. “If you can immediately identify someone as positive for the virus it is a great help, because otherwise that person will infect at least five or 10 more people unnecessarily. We are approaching the point where we should be able to return a conclusive test result of a number of patient samples in a day. Once we get going, our faculty and postdoctoral associates hope to process several hundred samples a day.”
Researchers, such as Finkielstein and Rich Helm, an associate professor of biochemistry in the College of Agriculture and Life Sciences who leads Core Services and the Genomics Sequencing Center, Sontheimer, and others collaborated on the novel assays to identify the virus, using a quantitative real-time polymerase chain reaction (qRT-PCR) protocol to test for RNA of the coronavirus in patient samples.
Meanwhile, neuroscientists Anthony LaMantia and Tom Maynard are working with Friedlander and Sarah Glenn, the associate director of facility development and technical operations, in Roanoke at the Fralin Biomedical Research Institute.
Lamantia and Maynard relocated their research laboratories to the Fralin Biomedical Research Institute from George Washington University in Washington, D.C., two months ago and readied their new sophisticated platforms for qRT-PCR testing that were recently purchased for developmental brain research to begin using in the newly re-configured COVID testing suites at the research institute.
The New River Valley Health Department has provided samples for validation through the Fralin Life Sciences Institute’s platform in Blacksburg, which are being shared for dual analysis at the Fralin Biomedical Research Institute in Roanoke. Both sites are ready to begin processing samples from the health departments.
“We are appreciative that our colleagues in the College of Science and throughout the university were able to quickly commit themselves to working to address the pandemic that has affected scores of nations and is now in our community,” said Sally C. Morton, dean of the College of Science and former interim director of the Fralin Life Sciences Institute. “Scientists solve problems, and COVID-19 represents one of the most extensive challenges to our national health care system in many decades. The work of Drs. Finkielstein and Sontheimer and others will make a definitive impact in Southwest Virginia and beyond.”
Virginia Tech President Tim Sands said the collaboration to establish two sample testing labs exemplifies Virginia Tech’s commitment to community service as a land-grant research university.
“We have the scientific expertise to address the COVID-19 pandemic throughout the state and the world,” Sands said. “Diagnostic health testing may not be part of our normal academic and research routine, but when lives are at stake, it is Virginia Tech’s role to take action and make a difference wherever we can.”
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Fast facts
- Virginia Tech researchers have developed a new COVID-19 test and facilities to support local health departments in their efforts to identify patients suspected of having the novel coronavirus – a critical step to slow the pandemic and monitor the spread of the virus in Virginia.
- Virginia Tech secured federal and state approvals to begin processing samples at on-campus labs in Blacksburg and Roanoke. The testing effort is led by Michael Friedlander, Virginia Tech vice president of health sciences and technology and executive director of the Fralin Biomedical Research Institute.
- No patient samples will be collected at either of the Virginia Tech labs at the Fralin Biomedical Research Institute in Roanoke or the Fralin Life Sciences Institute in Blacksburg – that step is done by health departments or health systems working with health departments.
- Health departments worked together to develop testing priorities.
- The U.S. Food and Drug Administration (FDA) issued Emergency Use Authorization for the university to proceed with testing, while FDA review of the validation is pending.
- Faculty research leaders and their teams, led primarily by Carla Finkielstein at the Fralin Life Sciences Institute and by Harald Sontheimer at the Fralin Biomedical Research Institute, addressed the need for accurate testing by developing and perfecting the test.
- The scientists developed a novel procedure to test for coronavirus RNA in the patient samples based on a laboratory technique call reverse transcription polymerase chain reaction (rRT-PCR).
- Sample results will be returned in one day.
Carilion is offering patients the opportunity to postpone payments on their current Carilion medical bills for one month, interest-free and penalty-free. Officials say they see this an opportunity to improve not just the physical health, but the economic health of our region as well. WFIR’s Evan Jones has more:“This past month, our communities have faced unprecedented economic challenges in response to COVID-19,” said Chief Financial Officer, Don Halliwill. “As a local business, this is just another way that we’re looking to support our communities.”Other existing programs will continue to be available through this period, including Carilion’s Bill Pay program, which offers extended payment plans; discounts for those who do not have insurance; and financial assistance that helps with up to 100 percent of the cost of care for those who qualify.
“As our mission states, we exist to improve the health of the communities that we serve,” said Halliwill. “We see this as an opportunity to improve not just the physical health, but the economic health of our region as well.”
Photo: VTC School of Medicine
The Virginia Tech Carilion School of Medicine is growing; it has approval to increase its class size from 42 to 49, effective this fall. It is part of a longer -term plan to expand the medical school, which is currently among the smallest in the country.
NEWS RELEASE: April 21, 2020 –After a nine-month process, the Virginia Tech Carilion School of Medicine has received all approvals needed to grow its class size from 42 to 49. The expansion will start with the Class of 2024, which is set to begin study this fall.
When Lee Learman arrived as the new dean in July 2019, one of his first initiatives was to explore growing the class size at the Virginia Tech Carilion School of Medicine, which is currently among the smallest medical schools in the country.
In fall 2019, Learman formed a Class Size Incremental Increase Task Force to look at possible expansion. The task force featured faculty, staff, and students to get a variety of inputs and to weigh if there was room to expand. A high priority for the task force was maintaining the best parts of a small class size, including comradery amongst classmates, easy access to faculty, and some signature pieces of the curriculum, such as small-group, problem-based learning.
The task force recommended initial growth of seven students – the number chosen because it would require one additional small group for the problem-based learning method.
The medical school submitted a request to expand to its accrediting body, the Liaison Committee on Medical Education (LCME), which approved the request in February. The college then sought approval from the university, Virginia Tech, as well as Carilion Clinic to make sure the additional students could be accommodated. With each partner’s approval, the VTCSOM Medical Curriculum Committee and Academic Committee formally approved the expansion this week.
“We thank all of the faculty, students, and staff who served on the growth task force and whose thoughtful recommendations guided our request for growth,” said Learman. “Also thank you to the commitment of Virginia Tech President Tim Sands and Carilion Clinic CEO Nancy Howell Agee for their support of these growth discussions over the last nine months.”
Since its charter class, the Virginia Tech Carilion School of Medicine has received thousands of applications for the 42 available spots. Over the last four years, the medical school received 4,000 or more applications for 42 spots. A majority of applicants are academically qualified for admittance.
“Increasing our class size using an incremental approach equivalent to one small group allows us to preserve part of what makes us special – maintaining close, personal relationships among students and faculty – while also giving more people who are deserving and qualified the opportunity to experience it each year,” said Learman.
The admissions team is monitoring current acceptances to see if additional offers will need to be made. Admitted students must hold only one medical school acceptance by April 30, so the class make-up will be more apparent by that date.
“If there was ever a time when we needed a strong, health-systems minded physician workforce, it is now. We look forward to welcoming 49 incoming students in the Class of 2024 to increase our contribution to that workforce,” Learman said. “Looking at the talent and diversity of our current applicants, I’m confident that these future physician thought leaders will fit in well with our growing community of students and alumni at the Virginia Tech Carilion School of Medicine.”
Virginia recorded 640 new COVID-19 cases in the last 24 hours. That is the highest daily number so far, and it reverses three previous days of declining case counts.
The Virginia Department of Health’s latest COVID-19 numbers show more of a breakdown – such as hospitalizations and deaths per locality. The only WFIR-listening area locality with any recorded deaths on the newest numbers is Botetourt County with 3. Hospitalizations in our area, 9 in Botetourt, 5 in Roanoke City, 2 in Franklin County, 1 in Bedford. Statewide the death toll is at 324, with 321 of those deaths COVID-19 confirmed.
