However, Macon County Public Health reported on Monday that a New York resident who tested positive for the virus was currently being isolated in Macon County.
“The patient is doing well and is in isolation. The patient is a resident of New York State and traveled to Buncombe County, where they became ill and were tested, and then traveled to Macon County,” according to a press release. “Since cases are reported under the state of residency, this case will be identified as a New York State case, not a North Carolina case. Therefore, this case will not show up on the North Carolina maps as a Macon County case.”
While awaiting confirmation of results from the Centers for Disease Control and Prevention, the N.C. Department of Health and Human Services and Macon County Public Health will treat presumptive cases as positive and follow CDC guidelines to protect public health and limit the spread of infection.
In the meantime, Macon and Buncombe County health departments are working to identify who might have come into close contact with the patient. Based on information provided by the individual, county health officials will assess risks of exposure, determine which if any additional measures are needed such as temperature and symptom checks, quarantine and/or testing.
On Monday, the CDC awarded North Carolina $13.8 million to support state and local health officials in their response to COVID-19. Sen. Richard Burr, R-NC, who supported the Coronavirus Preparedness and Response Supplemental Appropriations Act, applauded the CDC’s award.
“The next few weeks are critical for our efforts to flatten the curve and stop the spread of coronavirus,” he said in a press release. “We can do this by ensuring our state and local public health officials, who have been working on the frontlines of this outbreak day and night, have the resources they need to protect our communities. This funding will help coordinate and deploy needed supplies throughout the state and increase our ability to test, identify and track coronavirus cases.”
Local health departments are at the top of the chain of command in each community when it comes to taking precautions and dealing with the pandemic.
“Now is a critical moment in the growing outbreak of COVID-19 in North Carolina when certain measures can potentially impact the spread of the disease and protect the public’s health. My message is that we should expect the next two months to be difficult in terms of what we all need to do to manage this situation,” said Patrick Johnson, director of Haywood County Public Health.
While the canceling of events and social distancing is occurring quickly, Johnson said these measures shouldn’t be mocked as a sign of panic but as reasonable decisions to decrease the spread of the virus.
“Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested,” he said. “Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness.”
Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness — cough or difficulty breathing. Clinicians are strongly encouraged to also consider and test for other causes of respiratory illness, including infections such as influenza.
Johnson said commercial laboratory testing to detect COVID-19 is now available, but testing should not be done for asymptomatic persons.
“Prior authorization by public health for testing is not required for commercial lab testing but patients being tested will be considered PUIs (Persons under Investigation) and must be isolated either at home or in a hospital based on their need for care,” Johnson said.
Macon County Health Department is limiting non-essential services until further notice to allow staff to focus more on the COVID-19 response. The health department will still be providing maternal health, including pregnancy testing and prenatal services; symptomatic STD, communicable disease and TB testing; family planning (problem visits only); primary care (sick visits only) non-travel vaccinations; normal adult dental services and emergency child dental services.
For those in the WIC program, the state has allowed the health department to waive the physical presence requirement to ensure no interruptions in benefits.
Visitation limited at hospitals
Hospitals, including Harris Regional in Sylva, Swain Community in Bryson City and Haywood Regional in Clyde, have limited visitation and are implementing new screening guidelines.
“We have limited access to two points of entry for patients and visitors: the Main Entrance and Emergency Department,” said HRMC Spokesperson Lindsey Solomon. “Our hospitals and clinics have begun screening all individuals who enter our facilities, per CDC guidelines — including patients, visitors and staff — based on potential respiratory symptoms and travel history. Out of an abundance of caution until further notice, we are allowing only one well visitor per patient.”
All visitors should be 18 and older and visiting hours are from 7 a.m. to 7 p.m. Exceptions will only be made for pediatric, OB and end-of-life patients.
HRMC closed other public facilities, including the cafeteria and the health and fitness center. Cardiac Rehab and Physical Therapy located in the health and fitness center will remain open unless otherwise notified.
Visitation for the inpatient unit at Swain hospital has been suspended until further notice. Harris is asking the community to voluntarily restrict visitation with family members or friends currently in the hospital.
“While COVID-19 is new, effectively responding to other infectious diseases is not. We have tested processes and plans in place to respond to situations involving infectious disease year-round,” according to a press release from Harris and Swain hospitals. “We have a robust emergency operations plan in place and are reviewing and proactively completing a number of preparation checklists out of an abundance of caution. We are screening patients in our emergency department, inpatient units and outpatient clinics based on CDC guidance.”
Group homes and assisted living facilities are also restricting visitation to protect some of the more vulnerable populations. Phone calls, video conference calls and sending care packages to loved ones during this time is strongly encouraged.
Resources, grants available to communities
The Community Foundation of Western North Carolina, in partnership with the Dogwood Health Trust, announced the activation of its Emergency and Disaster Response Fund to accept and strategically disburse funds to address COVID-19 pandemic response and relief efforts in 18 counties of WNC including the Qualla Boundary.
“The Fund will provide flexible resources to organizations with deep roots in communities and experience addressing basic needs and filling public health gaps. The goal is to help regional front-line nonprofit organizations quickly meet increasing demands for help,” according to a press release.
Some proactive grants will be awarded. Other nonprofits will use a simple, expedited process to access funds with grants awarded on a rolling basis, as fundraising continues throughout the outbreak and recovery phases of the pandemic.
“COVID-19 may have long-term impacts on the health and wellness of our region that extend far beyond physical illness,” said Brian Myers, Chief Strategy Officer and Interim VP of Impact at Dogwood Health Trust. “Because no one yet understands what those impacts may be, we want to be ready to respond quickly and flexibly according to the needs of communities and nonprofit partners in the region.”
Vaya Health, which funnels state funding for behavioral health to local providers in WNC, has a 24/7 Access to Care Line available to residents experiencing a mental health or substance use crisis while the agency responds to coronavirus. Anyone in crisis can call 800.849.6127 for help from trained behavioral health professionals. For strategies to cope with anxiety and overwhelming emotions in yourself or your child, visit www.cdc.gov/coronavirus/2019-ncov/about/coping.html.
Protect yourself from COVID-19
• Avoiding close contact with people who are sick
• Avoiding touching your eyes, nose and mouth
• Staying home when you are sick
• Covering your cough or sneeze with a tissue, then throwing the tissue in the trash
• Cleaning and disinfecting frequently touched objects and surfaces, including your phone, computer, remote controls and doorknobs
• Washing your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating and after blowing your nose, coughing or sneezing
• Using an alcohol-based sanitizer with at least 60% alcohol if soap and water are not readily available.
• Practicing social distancing behaviors, including working from home, avoiding public gatherings and unnecessary travel, and maintaining a distance of approximately six feet from others when possible.
If you experience COVID-19 symptoms
• If you are having a medical emergency, you should call 911 or go directly to the Emergency Room. If possible, notify the dispatch agent that your emergency involves symptoms possibly related to COVID-19.
• For non-emergency needs, if you need medical attention due to respiratory illness symptoms (fever, cough, shortness of breath) and plan to visit our hospital, your primary care provider or an urgent clinic, call ahead before you go and let them know that you are experiencing symptoms that may possibly be related to COVID-19. This will allow providers to properly prepare for your visit and take the necessary precautions to keep others from being infected or exposed.