Loudoun Health Director Reflects on Pandemic Lessons, Future? – Loudoun Now

Loudoun Health Director Reflects on Pandemic Lessons, Future? – Loudoun Now

Loudoun’s state of local emergency, prompted by the COVID-19 pandemic and first declared on March 17, 2020, ended last Tuesday, just a couple of weeks short of its two-year anniversary.

News of a new virus spotted in China had been circulating since late 2019, but life in the U.S. largely proceeded as normal. The first case of “coronavirus disease 2019” was announced in Loudoun on March 10, 2020. On March 16, 2020, Loudoun County Administrator Tim Hemstreet issued a declaration of local emergency. Supervisors followed that up with a confirming vote the next day, launching the county government into one of its largest-ever undertakings.

By the end of the month, there were 87 known cases of COVID-19 in Loudoun. As of March 8, the Virginia Department of Health reported more than 66,000 cases in Loudoun, and 368 deaths attributable to the disease.

In the two years that followed, Loudoun County used its emergency powers to launch a whole-of-government fight against the pandemic—ranging from bringing government meetings into the 21st century with electronic public participation, operating to massive testing and vaccination sites, to dispersing millions of dollars in grants to help businesses and nonprofits coping with the pandemic.

The pandemic also thrust into the spotlight one person who previously seldom made headlines: Loudoun Health Department Director Dr. David Goodfriend. He gave elected leaders and the public constant updates and fielded questions from media. And when COVID-19 vaccines came to Loudoun, he was the first person to get a shot, inviting news cameras into the county’s first mass vaccination site to watch.

When COVID-19 arrived, Goodfriend said, in some ways public health officials were ready—particularly in Loudoun, home to Dulles Airport where any disease in the world could conceivably come off a plane onto U.S. soil. Loudoun has long had plans for health emergencies—and has faced health scares before.

“It’s something that we have trained on, and practiced, prepared for and planned for for at least 15, 20 years,” Goodfriend said. “So when anthrax came, we had a plan in place to respond to that. When we invaded Iraq and there was concern that smallpox might be unleashed, we had a plan for smallpox vaccinations if needed—Ebola, H1N1, SARS, but none wound up to be as long lasting and as impactful as COVID has. But it’s the same plans that we had in public health, emergency management, and our healthcare system for each of those that allowed us to be so successful with COVID.”

Health Department Director Dr. David Goodfriend gets the first dose of the Moderna COVID-19 vaccine. [Renss Greene/Loudoun Now]

Like those other health scares, in the beginning nobody knew how serious COVID-19 would be.

“In this case, definitely we were overcautious, and it turned out to make sense to be cautious with COVID. There were times when we were overcautious and it turned out, like SARS, that it doesn’t become a big pandemic, and then people may think we overreact,” Goodfriend said. He said the key for public health officials in those early days and throughout the pandemic is always open and honest communication with what they do and do not know.

The pandemic also came with its own lessons for health officials. Goodfriend said he and his peers had known lower-income and immigrant populations were more at risk—and during the pandemic, he took steps to address that—but were surprised that rural residents were also at higher risk. He said that will be something they learn from, such as learning how to reach out to those communities better.

But overall Loudoun handled the pandemic well, Goodfriend said.

“If we look at the data, Loudoun did amongst the best of any jurisdiction during COVID in terms of vaccination rates, infection rates, hospitalization rates, death rates, and it’s great testament to our residents to get us this far,” he said. In addition, Loudoun had an active and trained Medical Reserve Corps, a group of volunteers who the county would lean on heavily as it began providing mass testing and mass vaccinations.

COVID could also lead to some lasting changes in behavior—it remains to be seen whether some people will simply make wearing a mask a regular part of their life each winter, for example. It’s happened before.

“It’s hard to tell. I know when we came out of H1N1, it really changed how people sneezed. It changed from a lot of people sneezing into their hands to sneezing into their elbows,” Goodfriend said.

The Health Department remains watchful. COVID-19 is still around, and new variants could still evolve. Last summer was a lesson—with warm weather and a lull in new infections, people were ready for a break, when the highly infectious Delta variant arrived and started driving up cases in July. Then Omicron partially dodged the vaccines—although vaccines still prevented most people from getting seriously ill, that variant was better able to infect vaccinated people.

But new variants have also followed the trend of previous pandemics, becoming more infectious but less deadly.

“We don’t know if there will be another change to COVID in the upcoming months where we’re back again to either this past winter or a year ago. We just know right now we have a respite, and so what I take pains to tell people is, fortunately, this isn’t at the front of what you need to worry about right now,” Goodfriend said. “This is a good time to think about what we’ve gone through in the last two years, how do we move forward, how do we take care of our community.”

It’s a time to address the other health effects of a two-year-long pandemic. Goodfriend pointed to a report by the Virginia Office of the Chief Medical Examiner which compared the pandemic years to the average number of deaths that would otherwise have been expected. Only about 80% of those additional deaths were COVID-19 cases.

“The rest were just because we were going through this traumatic period of COVID—suicide, substance abuse, other people not getting preventative healthcare leading to an increase in deaths,” Goodfriend said. That was particularly true in Loudoun, with its rapidly growing and changing community.

“We have a lot of people coming into our community that may not have a lot of social support. For two years to be isolated is a really challenging time for those individuals,” Goodfriend said. “It’s also an incredibly challenging time for our kids. Two years in the development of a teenager is a real impact on them. So, I think from a mental health standpoint, from a standpoint of people being integrated back into their communities, getting through that isolation, catching up on preventative services, getting access to mental health care, is all going to be a challenge,” he said. The county government is already looking into revising its Human Services Strategic Plan.

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