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Appalachian Regional Healthcare System Responding to New COVID-19 Surge

Appalachian Regional Healthcare System (ARHS) officials are extremely concerned about the latest surge of COVID-19 cases and encourage everyone to get vaccinated to protect themselves and those they love.

“COVID-19 rates are going up, again, in the High Country and hospitalization rates have followed,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System. “Our staff are working 24/7 to plan and manage this latest surge but we are experiencing a shortage of staff.”

What ARHS has done

Watauga Medical Center (WMC) has established three COVID-19 isolation units with the capacity to care for up to twenty-five critically ill COVID patients. WMC does have the ability to increase the number of beds to care for COVID and non-COVID related conditions.

Leaders meet daily to discuss how and where to expand capacity next if the surge moves beyond our current capacity.

ARHS contractors are working tirelessly to complete the renovation of the new ICU space early in order to provide an additional 10 ICU beds.

ARHS reinstated vendor restrictions on Monday, August 16th.

ARHS has established a pediatric work group that consists of hospitalists, pediatricians, and staff from the birthing center, respiratory therapy and critical care management to prepare for a potential surge in pediatric populations.

Per federal regulations, ARHS continues to require masks be worn by all staff and visitors regardless of vaccination status.

ARHS continues to enforce visitor restrictions at Watauga Medical Center and Cannon Memorial Hospital. Persons under the age of 18 are not allowed to visit or accompany a visitor. Visitors are required to wear a mask, at all times, while in an ARHS facility.

ARHS leaders have begun participating in daily WebEx meetings with regional partners and hospitals to discuss capacity and transfer options. Most large healthcare systems are at capacity and are currently “closed to transfers.”

ARHS has established a COVID Virtual Hospital to assist in helping less acute COVID patients recover while quarantined at home. These patients receive oxygen, a pulse oximeter, daily calls from nurse navigators to check vital signs – and are provided an emergency number if their symptoms worsen. We are currently working with the County to augment those services.

ARHS has developed a vaccination program for employees to ensure patient and co-worker safety. Until all staff are fully vaccinated, we have enhanced mask requirements to reduce the risk.
ARHS continues to allow isolated COVID patients to communicate with their family via FaceTime calls.

What We Have Seen

On July 13th, WMC did not have any patients hospitalized with COVID. As of today, there are twenty-one COVID patients at WMC. We have tripled our COVID patients in the last two weeks.
Non-vaccinated patients who are hospitalized during this COVID-19 surge exhibit greater symptom severity.

In this surge, approximately 80% of hospitalized COVID-19 patients are unvaccinated. These patients are requiring higher levels of respiratory support.

Patients who have received the vaccine have minimal symptoms, and none have required ventilators or intensive levels of care.

Patients range in age from infants to 90 years of age. Most patients are between 50-60 years of age.
WMC has reported 2 COVID deaths in the past three weeks.

The number of patients in the COVID Virtual Hospital have been increasing by four each day.
ARHS is competing with hospitals across the country in recruiting additional staffing resources, including nurses and support staff. On-boarding typically takes 3-4 weeks.

Hospital Capacity and Supplies

WMC has twenty-five isolation beds for COVID patients. Through a Centers for Medicare and Medicaid Services (CMS) 1135 waiver, WMC has the ability to increase the number of beds available to care for patients with COVID and non-COVID related conditions.

WMC has space that could be converted for additional COVID units, however more ICU-level trained staff would be needed to manage the units.

WMC has 20 ventilators.

Leaders meet daily to discuss how and where to expand capacity if the surge continues.
ARHS continues to monitor supplies to mitigate any shortages that may be encountered.

Our Challenges

As with many hospitals across the U.S., ARHS staffing is at a critical level. There are not enough ICU-level trained medical professionals to care for the current surge of COVID patients.

Staff are working longer hours and covering more shifts.


ARHS anticipates an extreme increase in Emergency Room volumes as students return to class the next few weeks. As of August 18, 2021, the CDC reported that only 45.8% of individuals aged 18-24 have been fully vaccinated.

For the most up-to-date information about COVID precautions, visitor restrictions, obtaining medical records and more, visit apprhs.org/covid19