City infection rate is by far the state’s highest, for reasons that are unclear

At 467 cases per 100,000 residents, Harrisonburg has by far the highest COVID-19 infection rate in the state. Shown above are the statewide rate, the other localities with the ten highest rates, plus several other Shenandoah Valley localities. All totals calculated using VDH daily case counts and 2019 estimated populations for each locality.

By Andrew Jenner, publisher with additional reporting by contributor Calvin Pynn

After a sharp increase in local COVID-19 cases over the past week – including an outbreak at the long-term care facility Accordius Health that has infected 81 residents and left 10 dead – Harrisonburg has by far the highest per-capita rate of cases in the state.

As of Monday morning, the Virginia Department of Health reported a total of 252 cases in the city, or about 467 per 100,000 residents. That’s well over four times the statewide rate of 105 cases per 100,000 residents and far above Alexandria, in second place with 265 cases per 100,000.

A total of 93 cases were associated with the outbreak at Accordius Health, with 12 staff members and 81 residents testing positive, according to an April 18 press release. Even without those cases, the city would still have the state’s highest infection rate — an unwanted distinction with no clear explanation.

Central Shenandoah Health District Director Dr. Laura Kornegay pointed to factors such as the community’s density and interconnectedness — or “congregate settings” as she put it — as well as the number of still-open “critical businesses, and living conditions that make social distancing difficult” as potential culprits for Harrisonburg’s high number of confirmed cases.

“In some settings, it is more difficult to adhere to social distancing, and it can also be challenging for individuals to adhere to isolation and quarantine recommendations depending on their home environment and social supports,” Kornegay said in an email. “All of those factors seem to be playing some role in the case counts in this area.”

Far lower rates of infection are reported for other small cities in the region. Charlottesville and Winchester’s per-100,000 case rates are 83 and 89 people, respectively, while Waynesboro and Staunton have rates of less than 40 per 100,000.

Harrisonburg’s 252 cases outnumber the 236 confirmed cases in Richmond, which is more than four times larger. And Harrisonburg’s figure is close to the 281 cases confirmed in Virginia Beach, which has a population more than eight times larger than Harrisonburg’s.

Unprecedented blanket testing follows outbreak at long-term care facility

In the city and across the state, limited testing of people potentially exposed to the coronavirus or exhibiting symptoms of COVID-19 suggests that the true case counts have been higher than official totals. After the discovery of the first cases at Accordius Health, however, all residents and staff were tested, which is a first for the region, said city spokesman Mike Parks, in an email.

“That’s a huge group of people who otherwise wouldn’t have been tested and we would have taken an educated guess at the true number,” Parks wrote. “Dr. Kornegay pushed to make sure all those people got tested so this situation could be handled as seriously as possible, and her doing so is giving VDH a real look at the true scope of the outbreak there.”

Kornegay told the The Citizen that the increased testing as a result of the Accordius outbreak could mean that the city’s notably high official infection rate is simply closer in line with its actual infection rate. Or maybe not.

“As with a number of questions related to a novel pathogen, there are many questions that we simply don’t have the answer to yet,” she wrote.

Combined city-county rate also far above state average

Monday’s official case count in Rockingham County stood at 106 cases, equivalent to 129 per 100,000 residents. The combined 358 cases in the city and county represent an infection rate of 263 per 100,000 residents. That’s just below the 265 per 100,000 rate in Arlington, which the state’s second-highest concentration of cases after Harrisonburg.

Meanwhile, the combined case rate for Staunton, Waynesboro and Augusta County, which have a total population close to the same as Harrisonburg and Rockingham County, stands at just 33 per 100,000.

“We have too many positive cases in our area. Our local population is not doing enough to follow social distancing regulations and to keep themselves, their families and their neighbors safe,” wrote city spokesman Mike Parks in an email. “Why that is the case, I’m not sure, but we discuss how to address it every day. Perhaps we aren’t getting this message out in the right ways and some are missing it. Maybe we have some individuals locally who aren’t taking this seriously enough for some reason. Maybe it’s just bad luck.”

Parks said that after more than a month of working hard to promote social distancing, the city will “continue to try and come up with different ways to reach people.”

That will soon include 5,000 door hangers and 8,000 mailers with social distancing messaging in five languages.

“Ultimately, people have to make good decisions about how they distance not only while they are at their essential jobs … but also in how they congregate while home,” he wrote.


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