As life changed rapidly outside Reilly Starr’s 800-square-foot New York City apartment last week, she knew she couldn’t stay.
The Richmond native, who is 41 and has Stage 4 metastatic breast cancer, didn’t feel safe to have her nanny come over, because riding the subway posed too much of a risk in a city where more than 3,600 people have now tested positive for the coronavirus.
Starr wanted to go home to Richmond, where she, her husband and her 2-year-old son could have more space — something they craved because the global coronavirus pandemic forced both adults to work from home.
She had started transferring her cancer treatment to Massey Cancer Center, with an initial intake call on Monday and a follow-up conversation with an intake coordinator Tuesday morning. But on Tuesday afternoon, she said, a patient coordinator called and told her the hospital was rejecting her as a patient because she was coming from an area with a coronavirus outbreak.
“I am appalled,” Starr wrote Tuesday on Facebook. “Imagine if our country’s hospitals all respond this way to cancer (or any other kind of severe health condition) patients looking to relocate to safer areas?”
A communications professional in New York, she hoped sharing her story online would bring attention to the situation.
“When you’re a terminally ill patient, you often have to advocate for yourself because doctors are busy people and they don’t know your case as well as you do,” Starr said in an interview. “You really have to learn to speak up for what you need.”
Soon, Starr was getting calls from VCU apologizing and promising to treat her when she moves to Richmond, under the condition she self-quarantines for 14 days after leaving New York.
In a statement, VCU Health said that its policy prohibits turning away a patient and that it continues to accept new ones, even as the hospital is adapting to confront the COVID-19 outbreak. VCU Health, which is prohibited from discussing individual patients, did not address Starr’s case in the statement.
As part of its precautions, VCU Health is screening all transfer patients, regardless of where they are transferring from, for COVID-19 risk factors, but will continue to accept any patient regardless of their COVID-19 test result, VCU Health spokeswoman Laura Rossacher said in a statement.
VCU Health announced Wednesday that it is also canceling most elective surgeries to increase capacity for urgent and emergency medical needs and is trying to limit face-to-face patient visits in an effort to prevent the virus from spreading.
“The way we deliver care is changing to best serve all of our patients during COVID-19 while offering a safe environment for providing and receiving care,” Rossacher wrote. “The safety of everyone is our No. 1 priority.”
Starr said she believes her experience forced leaders at VCU Health to have important conversations about how to treat patients during a global pandemic.
“People have not been through something like this crisis before,” Starr said. “A lot of new decisions are having to take place.”
Starr, who received her diagnosis 15 months ago, said that people like her — who are more vulnerable to viruses because of a weakened immune system — always live in a world where they have to wash their hands and stay away from sick people. But a pandemic ratchets up the anxiety.
“I’m looking forward to being home and that comfort level that you get from being home,” Starr said.
She got her final cancer treatment Thursday in New York and was planning to make the drive with her husband and son down to Richmond on Friday.
Her first appointment at Massey Cancer Center is set for April.
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The number of confirmed coronavirus cases in Virginia has climbed to nearly 100, a statistic that was nearly a day old by the time state officials reported it Thursday.
The 94 cases is up from the 77 the Virginia Department of Health reported on Wednesday, with a total of 1,923 people having been tested for the virus and 19 people hospitalized. The cases include at least six in Chesterfield County, three in Richmond, three in Henrico County, one in Goochland County, one in Hanover County and one in Charles City County, according to VDH.
Those figures, however, are roughly 19 hours old by the time they’re posted to the agency’s website. State epidemiologist Lilian Peake said the lag is caused by a 5 p.m. cutoff the day before the Health Department’s noon update so officials can validate the information.
“We’re not trying to restrict that information,” Peake said. “We’re making sure that the local health departments and others are following up on any cases and if they need to put out a press release to let people know, they will do that. There will always be a lag.”
Richmond Mayor Levar Stoney said Wednesday that the city had four cases.
The Charlottesville-area health district reported Thursday morning that three more people had tested positive, bringing the city’s unofficial count to four. When the state Health Department updated its count at noon, it reported one case.
Peake, in a Thursday afternoon news conference with other state leaders, including Gov. Ralph Northam, said the state’s testing capacity has now grown to 1,000 tests. It remains unclear how many tests private labs are conducting.
Another assisted living case
In Northern Virginia, the city of Alexandria and the counties of Arlington, Fairfax, Loudoun and Prince William combine for more than 50 cases. Also, James City County in Hampton Roads has 14 cases.
A new case in Fairfax County is a man at an assisted living facility, the second in the state as concern mounts over the elderly, who are most susceptible to the virus.
The uptick in confirmed cases comes as officials continue their efforts to control the spread of the virus and deal with its implications.
Law enforcement, along with fire and ambulance agencies in the Richmond area, are meeting to coordinate with the Virginia Department of Health. The Northam administration announced more action, including an extension on the due date of tax payments. The state’s delegation in the U.S. Senate is debating a proposal to send checks directly to Americans.
Virginia officials recommend against arrests
Virginia officials are asking law enforcement agencies to avoid arrests when possible, amid calls from civil rights groups about jail conditions amid the COVID-19 outbreak.
Secretary of Public Safety Brian Moran said his agency is encouraging law enforcement officers to use summonses instead of arrests when possible.
Northam’s administration is also asking magistrates and judges to consider alternatives to incarceration. In addition, it is asking judges and prosecutors to consider modifying sentences for low-level offenders in favor of avenues like electronic monitoring.
“This is an encouragement. Obviously, public safety weighs on all of these decisions,” Moran said, adding that he hopes the effect will be to further protect the state’s incarcerated population and correctional staff from COVID-19.
“We really would like to emphasize and encourage our entire criminal justice system to take this virus as seriously as all of us are doing.”
The state will also suspend enforcement of motor vehicle inspections by 60 days.
The announcement comes after the Virginia ACLU and others called on the state to release some inmates out of concern for their well-being amid the pandemic.
Moran said Wednesday that the state had suspended visitation and transfers for incarcerated individuals, and had made it easier for lawyers to have no-contact consultations.
Also announced Thursday, Virginia is eliminating copays for all services covered under Medicaid, extending prescription refills to 90 days and expanding the services that can be conducted over video.
The state’s Medicaid program is taking advantage of flexibility from the federal government due to the pandemic.
Fairfax calls for ‘bolder and swifter actions’
In a letter to Northam, dated Wednesday, Lt. Gov. Justin Fairfax urged “bolder and swifter actions” to address the COVID-19 pandemic.
Fairfax echoed at least three lawmakers in calling for a special session to tackle legislation related to COVID-19. Among his proposals, Fairfax is asking for the state to delay all tax payments for 120 days, and to increase unemployment benefits.
Fairfax is also asking Northam to use his authority to mandate the closure of all bars, restaurants, gyms and theaters at least through April 15, with exceptions for carry-out and delivery.
“I have personally heard from many Virginians, including small business owners, employees, health care workers, families and community leaders across the commonwealth pleading that we implement much bolder and swifter measures to … combat this unprecedented health and, consequently, economic threat,” Fairfax’s letter reads.
Northam spokeswoman Alena Yarmosky said in a statement: “The governor found out about this letter through the press. This is a fluid and quickly changing situation, and he is in constant communication with public health experts. He will continue to make decisions in the best interest of Virginians.”
In December, Fairfax announced he would run for governor in 2021. He is among a handful of Democrats who have at least hinted at a run. Virginia’s governors are barred from serving consecutive terms, which means Northam is ineligible for re-election.
In February 2019, two women publicly accused Fairfax of sexual assault. He has rejected calls for his resignation, arguing that the accusations are false and are meant to damage his political career.
In his letter, he also asked Northam to mandate that all schools close through the end of the academic year, while making sure “no student is penalized.”
Lawmakers are scheduled to reconvene for one day on April 22 to take up Northam’s proposed amendments to and vetoes of legislation passed during the 2020 regular session.
Fairfax is asking for a special session in the weeks before lawmakers are scheduled to reconvene.
Drive-thru testing reopens
Sentara Healthcare, Virginia’s largest hospital system, on Thursday reopened two of its drive-thru COVID-19 screening and testing sites.
The hospital system originally opened three screening sites in York County, Virginia Beach and Chesapeake on Monday and screened a total of 1,760 people and tested 786 before closing on Wednesday due to a shortage of testing supplies.
The hospital system has received additional testing kits and said it would reopen the testing sites at Sentara Princess Anne Hospital in Virginia Beach and Sentara Williamsburg Regional Medical Center in York County. The Chesapeake site will not reopen.
Sentara officials said only people who are over the age of 60 or have health conditions that make them vulnerable are eligible for testing. In addition, they must be experiencing two of three main symptoms for COVID-19 (fever of 100.4 degrees or higher, cough, shortness of breath) — and have either traveled internationally or been in contact with a confirmed COVID-19 case.
The drive-thru sites will open on a day-to-day basis as testing supplies allow, Sentara said.
Groups offer free books as schools stay closed
Read to Them, a Richmond-based nonprofit, and the Children’s Museum of Richmond are giving more than 1,000 books to city elementary school students as schools remain shuttered.
The groups announced Thursday that the books will be available for pickup at the city school system’s 20 food distribution sites starting next week.
“These are anxious times. With schools closing and communities taking action to address health concerns, we want to assist in encouraging families to continue making reading at home a priority,” said Read to Them Executive Director Christa Donohue.
Richmond schools are closed, as are those in Chesterfield, Hanover and Henrico counties, through mid-April. Northam has ordered schools across the state shut down until at least March 27, and state education leaders are asking the federal government for a waiver from Standards of Learning testing.
The state Board of Education is scheduled to hold a meeting via phone at 1 p.m. Friday as the body weighs revising graduation requirements for seniors, among other things.
ABC location closes
An ABC store near Virginia Commonwealth University’s main campus is closed after the roommate of an employee tested positive for COVID-19.
The Virginia Alcoholic Beverage Control Authority announced Thursday that its store at 1217 W. Broad St. will be closed for at least two weeks.
No ABC employees have tested positive for the coronavirus, according to the state agency, but all the Broad Street store employees have been asked to self-quarantine for two weeks. The store has 11 workers.
A group of nursing home medical directors says Virginia Department of Health rules are delaying COVID-19 testing for the state’s most vulnerable residents, putting the people most likely to die from the virus at risk.
Six doctors who manage more than a dozen long-term care centers sent a letter to state officials Wednesday calling for change and voicing their frustrations about a requirement that the flu and other respiratory infections be ruled out before a COVID-19 test is provided. That process takes up to a week.
“The Department of Health has been misaligning resources to more healthy people rather than the people at most risk from bad outcomes,” said Dr. James Wright, medical director of Canterbury Rehab and Our Lady of Hope in Henrico County and the Memory Center in Chesterfield County.
Wright, who signed the letter, said mortality rates for those 80 and older who become infected can approach 15%, making the need for testing even greater. Elderly people are particularly vulnerable to COVID-19, the illness caused by the coronavirus. Nearly 30 of Washington state’s 40 deaths have come from the Life Care Center of Kirkland, which reported an outbreak last week.
The physicians’ concerns come as Virginia recorded positive infections this week for people living in nursing homes or assisted living facilities:
Wright said one of the facilities he works for, Canterbury Rehab, has four patients with COVID-19-like symptoms awaiting official tests from the Department of Health. Two of those patients completed all of the preliminary screenings to rule out other possibilities over a week ago, he said.
The residents have been isolated in a wing of the facility, but Wright said the state needs to make changes. He called the department’s decision to prioritize resources elsewhere a “slap in the face” to long-term care providers.
A spokeswoman for the Virginia Department of Health did not return a request for comment Thursday.
Virginia health officials have asked anyone 65 or older or with chronic health conditions to self-quarantine.
Local retirement community representatives say they are taking pre-emptive measures to curb the spread.
Sunrise Senior Living in the Tuckahoe area of Henrico is limiting staffing to essential positions, such as nurses and caretakers, and screening workers for COVID-19 symptoms before each shift, spokeswoman Nicole Vasile said in a statement.
“Sunrise is taking extra precautions — beyond our existing infection control and emergency preparedness programs — to help prevent the spread of the virus,” Vasile said.
Lucy Corr, a 75-dwelling facility in Chesterfield, announced Tuesday that it would prohibit outside visitors. On Wednesday, staff notified residents that the community’s Adult Day Center would close for a minimum of two weeks.
Social gatherings of more than 10 people have been banned by Gov. Ralph Northam.
Others, such as Henrico-based Pinnacle Living, which manages five communities across the state including Cedarfield in western Henrico and Hermitage Richmond, outlined additional steps Monday, before the Westminster case was confirmed, including canceling group activities, suspending housekeeping services and canceling non-emergency medical services.
Westminster instituted a complete lockdown and self-quarantine after the confirmed case of a resident there on Tuesday. Gayle Haglund, the facility’s vice president of resource development, said it has been challenging but residents understand the measure.
For now, there are no signs the virus has spread, Haglund said.
The Richmond and Chesterfield County police departments are giving targeted businesses a grace period to comply with Gov. Ralph Northam’s order limiting gatherings larger than 10 people.
The limit was imposed specifically upon restaurants, fitness centers and theaters. Both Chesterfield and Richmond police said it does not apply to private gatherings.
By Tuesday, when the order was announced, nearly every local restaurant had already suspended dine-in service due to concerns about the spread of the coronavirus.
“Our primary goal is to educate business owners and managers about the order to gain voluntary compliance,” Chesterfield County police spokeswoman Liz Caroon said in an email. “When responding to the first complaint at a given location, officers will identify the owner or manager and educate them about the executive order (including providing a copy of the order). When they respond to multiple complaints at a given location, the officers may issue a summons.”
Col. Jeffrey S. Katz, the Chesterfield police chief, issued a similar statement on Facebook saying he anticipated “overwhelming cooperation” from area businesses.
“We value and appreciate our local business community and the good, upstanding folks who have undertaken great risk and tremendous sacrifice to add value to our Chesterfield County, Virginia community while making an honest and purposeful living,” his post said. “You — and those you gainfully employee — feed and entertain us ... and you make us stronger and more healthy; for this, we are grateful.”
Richmond police said they want to first get the word out and ask for cooperation before citing any business owner, adding that there had been little guidance from state officials.
Violation of the order would be treated as the equivalent of a traffic ticket, according to Richmond police spokesman Gene Lepley. A class 1 misdemeanor is subject to punishment of up to 12 months in jail and/or a fine of no more than $2,500, according to the state code.
Representatives from the Richmond police, fire and ambulance agencies, along with their colleagues in Henrico, Chesterfield and Hanover counties, are meeting under one roof to coordinate efforts and to support the Virginia Department of Health.
The Central Virginia All Hazards Incident Management Team has established a task force command center at the Greater Richmond Convention Center to advise agencies and to prepare for the “what-ifs” of the coronavirus.
“It is a wide group of individuals,” said Richmond police Lt. Robert Marland. “We do this separate from our regular jobs.”
When the VDH offered a drive-thru testing center in eastern Henrico on Wednesday, the Henrico police were there for traffic control, and the Henrico Sheriff’s Office maintained security.
Another pop-up testing site will be offered Friday, though the location was not announced Thursday morning, and the task force is preparing for the next round of testing. The command center helps its organizations determine the manpower they need, how to respond to calls, how officers need to protect themselves and how to deal with the public.
If you have symptoms related to COVID-19, you can call the VDH’s hotline at (804) 205-3501.
The command center also gives police and first responders the chance to talk about what’s next — how the coronavirus will affect the community in the future and what challenges it will present.
“Everybody’s planning,” Marland said. “All constituents are planning for events or possibilities. You’ve got to. You can’t just sit back and not do it.”
Despite the threat of the virus and recommendations to stay home, crime continues and police continue to respond.
Chesterfield police reported a slight uptick, 6.6%, in calls for service over the past week, compared with the same time last year. The number of offenses has gone down slightly, 4.6%.
Of the 3,302 calls for service received March 10 to 18 in Chesterfield, only 10 made mention of COVID-19 or related terms, according to Caroon, the police spokeswoman.
Chesterfield police said the increase in calls and decrease in offenses appear to be related to measures taken to respond to the virus and more people being at home rather than work or school. The types of calls they’ve seen increase, like “suspicious” persons or activities, are similar to those they usually see increase during summer when school is out, the department said.
Richmond and Henrico police did not respond to requests for crime statistics on Thursday. There have been four fatal shootings in the city since Sunday.
Public Safety Secretary Brian Moran said Thursday that state officials are going to try to keep jail populations from rising by asking law enforcement to issue summonses instead of making arrests when possible, and reconsidering some jail sentences for low-level offenses.
This directive comes after the ACLU of Virginia and others called on the state and city this week to release some inmates out of concern for their well-being amid the pandemic.
Also on Thursday, federal law enforcement officials announced “a coordinated takedown” in Richmond’s public housing communities. Eight people were arrested on federal drug-related charges.
“Lest there be any doubt, crime doesn’t self-quarantine,” said Zachary Terwilliger, U.S. attorney for the Eastern District of Virginia. “And our brave law enforcement partners will not allow the rule of law to disintegrate amidst this pandemic.”