West Virginia voted for Bill Clinton by a huge margin only twelve years earlier, and it was still dominated by Democrats at the state level. It didn't become the Republican stronghold it is now until the 2010s, and even then it still has a Democratic senator (Joe Manchin) and Governor Jim Justice won as a Democrat before switching to the GOP.
Yes. When GWB won West Virginia in 2000 many of us thought of this as a fluke, myself included, just like Indiana voting Obama in 2008. I'm pretty sure Hillary would've won WV in 2008, but the overall trend would continue, maybe at a slower rate.