Charleston – While the number of known COVID-19 cases nationwide has spiked dramatically over the last several days, state officials still don't know how many people could be carrying the virus and potentially transmitting it to vulnerable people in West Virginia.
As of Monday afternoon, a state lab had tested 84 samples, with four results pending and 80 negative for the respiratory illness.
Nonetheless, Gov. Jim Justice declared a state of emergency for all 55 counties during a Monday news conference at the West Virginia Capitol.
Justice said he wasn't calling for the closure of bars and restaurants at this time. "We've got to keep on some way living and doing what we're doing," he said.
He advised people not to panic and not create a "mad rush on trying to buy all the toilet paper in the store."
"As far as our restaurants and our bars, that may be a situation that we address soon," he said. "As far as shutting down the Capitol or shutting down our cities or whatever it may be, it may be a situation we have to address soon. You've got to understand, this virus is without question in West Virginia, probably somewhere right now."
Brian Abraham, a lawyer for the governor, said the emergency declaration would mean requirements for state agencies are relaxed if they need to alter work schedules or make purchases, as examples. Dr. Cathy Slemp, commissioner of the West Virginia Department of Health and Human Resources's Bureau for Public Health, added, "We need every sector of society to think about how do we do social distancing."
"We have to pull together as a community and we have to together think about creative ways to function," she said. "It's not about closing everything. It is about doing things that sustain those operations, that sustain that connectedness among people in smart and different ways."
COVID-19 cases are typically mild. Symptoms may include fever, cough and shortness of breath. But in some cases, particularly in older people and those with some underlying health conditions, it can lead to pneumonia and become fatal. People may spread the disease before they show symptoms.
The federal Centers for Disease Control and Prevention (CDC) reports that in coming months, most of the nation will be exposed to the virus.
Testing for COVID-19, a new disease for which humans have built no immunity, is limited nationwide. ProPublica has reported that rather than using World Health Organization test guidelines used in other countries, the CDC set out to develop a test of its own, losing valuable weeks in the process. The test was flawed, and it took the agency weeks to find a fix.
Slemp said West Virginia currently has the capacity to test 500 people.
"The reason we have those 500 right now is because I've pulled all my supplies from flu," she said.
She said the state lab is using extraction kits that were in supply for flu season. Other components of testing, such as cotton swabs, are also in short supply, she said.
She said extraction tests are used at the state lab after nasal swabs are received from providers. They've ordered more and expect them to arrive within a couple weeks, doubling testing ability, she said.
LabCorp, a private company, has conducted a "handful" of tests, she said.
Slemp said they are currently testing seriously ill people at high risk for complications, as well as people with symptoms who've traveled to areas experiencing outbreaks, including domestically, or were likely exposed to a known case.
Friday, President Donald Trump declared a national emergency and said there are plans for drive-through testing at retailers.
Slemp said even though federal officials are only implementing that effort in 12 states, West Virginia officials requested over the weekend that federal officials send supplies. West Virginia workers will perform community-based testing themselves.
The number of cases is climbing at a dramatic rate nationwide – from about 1,000 five days ago to 3,487 on Monday.
If testing were more widespread, officials would be able to focus on limiting social contact by people who've tested positive for the disease.
Instead, across the United States, many states are implementing broader measures. Several state leaders have called for the closures of bars and restaurants, following widespread rejection of public health experts' pleas to practice social distancing, including remaining six feet from others and avoiding large groups. Schools and colleges have also closed.
Social distancing refers to separating people. During this global pandemic, health officials have also advised people to wash their hands more frequently, stop shaking hands, cover coughs with the crook of their elbow, and stay at home as much as possible.
"Take it seriously and do your homework because we all really can play a role in it, and I think we take that nervous energy that we have around this, and channel it into effective action," Slemp said.
Justice said that testing is free. A spokeswoman for Highmark Blue Cross Blue Shield WV said Monday that co-pays and deductibles are waived for the test, but costs still apply for other fees, such as treatment for symptoms, office visits and inpatient care.
Justice urged people to avoid groups of more than 50, and to work from home if possible.
Federal officials previously recommended people avoid groups of more than 50, then changed that recommendation to groups of 10 during President Trump's Monday news conference.
"We need to dismiss, don't we?" Justice said.
Dozens of reporters and state officials had gathered for the event, although organizers placed several feet in between chairs.
Minutes earlier, the governor had said, "If you want to go to Bob Evans and eat, go to Bob Evans and eat."
Also in its announcement Monday, the White House said that it was recommending people avoid visiting nursing homes, avoid discretionary travel, shopping trips and social visits, and avoid eating or drinking at bars and restaurants.
Dr. Slemp said that when public health officials say avoid even smaller groups, they mean avoid intermingling with people you don't already frequently see.
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