RICHMOND TIMES-DISPATCH, MICHAEL MARTZ

Richmond and Henrico County health officials are seeing fewer people seek free testing for COVID-19, even though positive cases of the virus have risen in both localities in the past month.

Instead of seeing an average of 200 people per day at community testing events, Richmond and Henrico health officials are seeing fewer than 100 people show up for free public health tests.

“The past 10 days, the number of turnouts has gone down, which is concerning,” said Dr. Stephen Richard, medical director of the Richmond and Henrico health districts, at a community testing event on Tuesday at Hotchkiss Field Community Center in North Side. “I don’t have an explanation for it.”

State health officials say they have seen “some drop” in demand for testing around the state, which they say could reflect a decline in COVID-19 cases compared with a month ago.

“Less cases means less contact or less people with symptoms,” Virginia Department of Health spokeswoman Tammie Smith said Wednesday.

But that’s not the case in Richmond and Henrico.

“It’s not because we’re all of a sudden seeing any less disease,” Dr. Danny Avula, director of the combined health district, said Wednesday.

Richmond recorded 73 positive cases on Wednesday, its second-highest daily total since the pandemic began, and 293 new cases in the seven days ending Friday. After a midsummer lull, COVID-19 cases spiked in Henrico at the end of July, when the county confirmed 81 cases in one day, the highest daily number of the crisis. The county recorded 251 positive cases in the past seven days.

The city has recorded 3,795 cases during the pandemic and 47 deaths, including four this week. Henrico has recorded 4,428 cases of COVID-19, the fourth-highest in the state after Fairfax, Prince William and Loudoun counties in Northern Virginia. But Henrico has the second-highest number of deaths from the virus in Virginia, 193, including three this week.

“This is not going anywhere,” said Tracey Avery-Geter, a women’s health care nurse practitioner who leads the testing team for the Richmond and Henrico health districts.

“At the beginning, it was a crisis, it was go, go, go,” Avery-Geter told U.S. Rep. Abigail Spanberger, D-7th, on Tuesday in a meeting at the Henrico health department. “Then there was a little bit of a break. But it’s going back up now.”

Spanberger, a Henrico resident, was one of 90 people to be tested for COVID-19 at the community testing event conducted by the health department at Hotchkiss in the Green Park neighborhood of Richmond.

She had just heard from Avula and 15 public health employees about the increasing difficulty of getting many people, especially in low-income and minority communities, to be tested for COVID-19.

“I think it’s a prudent thing to do,” she said.

That’s not to say it’s pleasant.

“They go all the way up and spin it around,” said Spanberger, describing the nasal swab test, tipping her head one way and then the other, “and all the way up and spin it around.”

She learned on Thursday, less than 48 hours later, that the test was negative — her second negative test since the pandemic began.

The high number of COVID-19 deaths in Henrico reflects the county’s high concentration of long-term care facilities, which bore the brunt of the disease in the early months of the pandemic, with 51 deaths in one facility, Canterbury Rehabilitation & Health Care in western Henrico.

Although the number of daily deaths has subsided, the threat hasn’t disappeared in nursing homes and assisted living facilities, said Hannah Quigley, co-leader of the health district’s long-term care team, who told Spanberger that it is currently dealing with COVID-19 outbreaks in 30 facilities in Henrico and Richmond.

The district includes more than 140 long-term care facilities, so identifying and controlling the virus’s spread in all of those facilities is “a lot of testing,” Quigley said. “It’s not even something the National Guard could do.”

The Virginia National Guard helped state and local health officials conduct mass testing in long-term care and other congregate facilities from April through July, and now it is preparing another major push over the next four months, beginning on Sept. 8, the day after Labor Day. The Guard is deploying with 85 soldiers and airmen who will mobilize and begin preparations on Sept. 1.

The Guard plans to deploy four teams to collect COVID-19 test samples from long-term care facilities and other congregate settings, and two other teams to train employees on proper fit of N95 masks and other protective gear. Six regional planners from the Guard also will support the state Health and Emergency Management departments with priorities for COVID-19 response.

Mass testing is critical to enable nursing homes, assisted living facilities and other retirement communities to reopen to public visitation under federal Medicaid and Medicare guidelines.

But testing also is crucial within broader communities, especially those with high concentrations of racial minorities who have been particularly susceptible to the virus because of income, housing and essential jobs that don’t allow working remotely.

“Our Black and brown communities are really taking the hit,” said Margo Webb, supervisor of the health district’s navigation services, which guides people looking for help.

Many people who should be tested are reluctant because they can’t afford the consequences of testing positive for the virus, said Keandra Holloway, community health worker in Fairfield Court, a public housing complex in Richmond’s East End.

“What I’m hearing from families is, ‘If I’m positive, how am I going to quarantine for 14 days? Where will I go? Who will pick up my children?’ ” Holloway said. “It’s the fear of being positive.”

Spanberger asked her, “What do you say to them?”

Holloway said she talks to people about their fears, rumors they’ve heard about the dangers and difficulties of testing.

“It’s being honest with them,” she said. “Until I come into the situation, they may not get tested.”

Richmond and Henrico have conducted almost 50 community testing events, including four at Hotchkiss. Two more are planned early next month — Sept. 2, at Broad Rock Community Center in South Richmond, and Sept. 3, at Tuckahoe Middle School in western Henrico. Both are scheduled from 9 to 11 a.m. Testing is free to the public.

Community testing relies not only on local health district staff but also on an army of experienced volunteers in Virginia’s Medical Reserve Corps.

Statewide, the corps includes more than 5,000 volunteers who have provided more than 75,000 hours of service. In Richmond, the number of Medical Reserve Corps volunteers has doubled, from 499 to 1,019, since the crisis began at the end of February. The number of corps volunteers has risen from 292 to 737 in Henrico during the same span.

“They are the backbone of our community testing effort,” said Richard, medical director at the health district.