Joe Shuhy, a retired scientist whose studies ranged from the depths of the ocean to the heights of space, posed an interesting question about coronavirus cases.

As the Spotsylvania County man has tracked COVID-19, he’s been intrigued by comments from local, state and national officials about “making it over the peak so we can start to return to normal,” he said. Virginia is expected to hit its peak in cases later this month or in early May.

There were 5,274 confirmed cases in the state and 154 in in the Rappahannock Area Health District as of Sunday, but that count probably is underestimated, according to the Virginia Department of Health. It’s going through changes in its reporting structure and should have normal reports again on Monday, according to the website.

Shuhy wonders if the only reason cases will peak—causing the flattening of the curve espoused by local and national health experts—is because of preventive measures in place, including schools and businesses closed, social distancing and everyone asked to wear face masks and wash their hands rigorously.

If the country starts to open up again, after the peak, won’t that mean people will still be carrying the virus, and, as soon as precautions are relaxed, “we will start the epidemic all over again?” Shuhy asked, wondering if the only safe measure will be global vaccinations.

“Am I missing something?” he wondered.

As with so many aspects of communicable diseases, the answer is complicated. Dr. Donald Stern, acting director of the local health district, said a proven vaccine certainly would speed the recovery along, but there are other factors at work, which he explained.

There will be a natural rise and fall of COVID-19 cases in coming months because that’s how highly infectious viral diseases work, he said. The virus will peak as more people get infected and then become immune.

Public health officials typically put classic measures in place to suppress the peak of any communicable virus, including identifying and isolating the sickened as well as encouraging people to cough and sneeze into their sleeves, rigorously wash their hands and surfaces they touch and to stay away from each other. More dramatic measures include, seen with the COVID-19 pandemic, have included shuttering places where people gather and ordering people to stay home.

“Since everyone is susceptible, there would be not only a lot of disease transmission, but a lot of very sick people who could then overwhelm our hospital level of care, resulting in even more deaths,” Stern said. “The peak in the curve we are really trying to lower is the number of people with disease who are hospitalized . . . so that our hospitals are not overwhelmed.”

As of Sunday, about one in five residents in Fredericksburg and the counties of Caroline, King George, Spotsylvania and Stafford counties with confirmed cases of the illness remained hospitalized, according to the local health district. Thirty of the 154 people with COVID-19 were still being treated in the hospital.

Statewide rates of hospitalization were slightly lower. While Virginia still hasn’t hit its peak in hospitalizations, according to projections, current figures from the Virginia Hospital & Healthcare Association show the state is faring considerably better than some of its neighbors to the north and south.

Only 22 percent, or 627, of the state’s 2,815 ventilators are currently in use, according to the VHHA. Less than half are being used with patients who have tested positive for the virus or are awaiting test results.

In addition, while state hospitals are concerned about the ongoing shortage of personal protective equipment, there have been no reports of the federal government seizing shipments of items in Virginia as it’s done in other states, Gov. Ralph Northam said on Friday.

When the state starts to see a flattening, or drop, in the number of hospitalizations, admissions to intensive care and use of ventilators, “it’s at that time we can begin slowly backing off some of the more dramatic disease mitigation efforts,” Stern said. He stressed the process would have to take place slowly.

As Shuhy suggested, if a vaccine is not available, those infected will continue to spread the virus and more people will acquire natural immunity from having the disease, Stern said.

That will contribute to “herd immunity, which will then help curb the disease spread, but not stop it,” Stern said. “Transmission of COVID-19 will continue for months and likely drop slowly for months, by which time it is hoped a vaccine will be available.”

Even if people are allowed to go back to work in coming weeks, Stern cautions that it will take months for things to return to normal.

Shuhy, for one, hopes that people won’t abandon actions they’re learned during this pandemic.

“Even when we go back to some semblance of normal,” Shuhy said, “it is going to be crucial that people continue to take preventive measures.”

As for the daily case count, there were 72 cases in Stafford on Sunday; 50 in Spotsylvania; 14 in King George; 12 in Fredericksburg and six in Caroline. Elsewhere in the region, there were 25 cases in Fauquier County; 19 in Culpeper County; 13 in Orange County; and eight in Westmoreland County, according to the state health department.

Cathy Dyson: 540/374-5425

cdyson@freelancestar.com

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