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The Western Tidewater Health District has reported 515 new COVID-19 cases in the 48 days since Virginia entered Phase II of Gov. Ralph Northam’s reopening plan. More than two-thirds of them have been diagnosed since the start of July.

With Virginia now in Phase III, the district crossed a grim milestone last weekend — its 1,000th confirmed case of the virus. As of Thursday, Western Tidewater’s rolling seven-day average for new cases stood at 55, the highest it’s been since the pandemic began.

Of the 358 cases reported since July 1 for all four localities that comprise the Western Tidewater Health District, 227 have come from Suffolk, 64 from Isle of Wight County, 36 from Southampton County and 31 from Franklin. Since the pandemic began, Suffolk has had 647 confirmed cases, Isle of Wight 245, Southampton 193, and Franklin 83. District-wide, 68 people have died, with Suffolk’s 44 accounting for 64 percent of that figure.

Southampton’s COVID-19 death toll since the pandemic began stands at 11, nine of which were reported since June 29. Prior to that date, the county had held at just two COVID-19-related deaths since May 13. But this doesn’t necessarily mean all eight died within a two-and-a-half-week timeframe.

According to Health District Director Dr. Todd Wagner, the VDH is notified of a new COVID-19-related death when informed by a physician or when a person’s death certificate is reviewed and adjusted to reflect COVID-19 as the cause. With death certificates, this does not necessarily occur on the same date that person died. In fact, weeks can elapse between the date of a death and the date the VDH is notified that the death was COVID-19-related.

Wagner confirmed there were indeed some COVID-19-related deaths in the district over the past two weeks. Isle of Wight’s death toll currently stands at nine, up one from its total at the start of July. Franklin’s death toll stands at four, up two from July 1.

Statewide, Virginia saw its record number of COVID-19 deaths reported in a single day — 57 — on May 27, followed by a steep decline in fatalities through mid-June. Since late June, Virginia has seen a spike in deaths and new cases are also on the rise.

This past Wednesday, Virginia reported 1,084 new confirmed cases statewide, its highest single-day increase since June 7. The state record for daily new cases is 1,615, which was set on May 26. Virginia reported another 904 cases Thursday, more than half of which originated in the Hampton Roads region according to WAVY TV.

As of July 10, the Hampton Roads region as a whole had seen its average of daily cases more than triple during the past two weeks, particularly in Norfolk where just over 16 percent of all COVID-19 tests are coming back positive. At a July 10 community COVID-19 testing event in Chesapeake, Gov. Ralph Northam warned that changes to his reopening plan may need to be made soon if these numbers continue to go up and if people continue to disregard state health guidelines.

“I hear people say we want to get our children back into school; I want to get our children back in school as well,” Northam said. “I want to get all the businesses opened up again. But we need to get this health crisis under control and behind us if we’re going to recover our economy.”

Where are Western Tidewater’s cases occurring?

Nine of the 13 outbreaks the VDH is currently tracking in its Western Tidewater Health District are tied to long-term care facilities. The most recent outbreak is at Harmony at Harbour View, an assisted living facility in Suffolk, which has 22 cases according to VDH data.

There are also two outbreaks tied to correctional facilities. One of these — Deerfield in Southampton County — has 81 confirmed cases, 78 among inmates and three among staff. It remains unknown where the second correctional outbreak is or how many cases are tied to it, as all three lockup facilities in the health district say it isn’t them. The remaining two outbreaks are reported to be at congregate settings, which can refer to apartment complexes, places of employment, churches, event venues and other group settings — including houses and neighborhoods.

Of the 1,168 district-wide cases reported July 13, less than half are tied to one of these outbreaks According to data from the VDH and the U.S. Centers for Medicare and Medicaid, just over 300 of the 440 outbreak-associated cases are among residents or staff members at nursing homes and assisted living facilities.

This indicates 728 cases — more than 50 percent of the district’s total — are resulting from person-to-person spread among individuals who don’t live or work at the site of one of these outbreaks.

“We certainly see clustering of cases involving families and other close family contacts,” Wagner said. “We can assume there is closer contact in those family settings but we have no way of knowing exactly what they are doing in other settings or what precautions, if any, they are taking.”

He added that VDH investigations have also shown cases tied to people who have traveled recently to North Carolina’s Outer Banks and Florida, the latter of which set a single-day nationwide record on July 12 with more than 15,000 new cases.

Of Western Tidewater’s Thursday caseload, 480 are Black, 254 are white, 46 are other or mixed race and 388 have no race reported. But so far, the VDH has no evidence linking Western Tidewater’s uptick to the Black Lives Matter protests that have taken place throughout the district since late May.

“Keep in mind that a large number of our residents that are tested are African American, so we would expect to see a higher percentage of positives from the overall number tested,” Wagner said. “In our testing venues, the difference in the percentage of positive cases between whites, African Americans and Latinos has not been statistically different.”

There likewise isn’t any direct evidence at present linking the spike in new infections to a particular gathering, such as at a beach or party.

“But certainly, larger gatherings do increase the risk of transmission, especially if social distancing isn’t performed,” Wagner warned.