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AppHealthCare COVID-19 Situation Update for Watauga County November 20, 2020

Situation Update

This week, NC DHHS released a County Alert System to give counties another tool to understand COVID-19 spread in their community. Watauga County is YELLOW which notes significant community spread. This system outlines actions we can take to lessen the impact and spread in our community. You can read more about the County Alert System on NC DHHS’s website .

For the week of November 8-14 (graphs below), we saw an increase in trends for active cases and those who are in quarantine. We have also seen another increase this week in the number of people hospitalized locally for COVID-19. Our case trends have continued to increase with the largest percentage of cases in the 18-24 old age group.

With the Thanksgiving Holiday next week, we encourage everyone to be mindful of the fact that this virus is still with us and there are actions we can all take to avoid and lessen our exposure and a potential spike that could overwhelm our healthcare system. If you will be hosting or attending an event, NC DHHS has compiled some tips for gathering safely and some guidance for private social gatherings .

Some of those tips include:

  • ●  Stay home if you are sick or have been exposed to COVID-19,
  • ●  Keep the gathering small,
  • ●  Stay outdoors if you can,
  • ●  Avoid self-serve food,
  • ●  Consider asking guests to self-quarantine for 14 days before the event, and if you cannot, atleast minimize your exposure to others prior to attending, and
  • ●  Maintain a safe distance of at least 6 feet from others, wash your hands and wear a face covering.For college students returning home for the holidays, we encourage you to be tested close to your departure time and self-quarantine for 14 days when returning home to prevent spreading the virus to your loved ones. App State has published a Holiday and Winter Break Departure and Return Plan for all of campus , which includes faculty, staff and students, that also encourages individuals to get tested and self-quarantine.

As we see the start of ski season, guidance has been developed by NC DHHS to decrease the spread of COVID-19. This guidance includes requirements and recommendations for Ski Lodges.

“We understand that everyone wants to return to normal, especially with Thanksgiving next week. However, we are at a critical point in our response efforts, and we don’t want to see a spike in cases that will strain our healthcare system. We encourage everyone to practice prevention measures like the 3Ws when you are around anyone who you do not live with, including any gatherings you may be attending or hosting for Thanksgiving,” stated Jennifer Greene, Health Director, AppHealthCare.

Key Points

  • ●  Free COVID-19 Testing at AppHealthCare: We offer free COVID-19 testing Monday throughFriday beginning at 9:30am. Please do not just show up for testing. We request that you schedule an appointment through our website or by calling our COVID-19 Call Center at (828) 795-1970.
  • ●  We continue case investigation and contact tracing efforts to reduce the spread of COVID-19. If you receive a call from a member of our case investigation or contact tracing team, we urge you to cooperate and provide information that will help us conduct response efforts. You may receive a call from (844) 628-7223 or (828) 264-4995. It may also show up as “NC Outreach” or “Contact Tracing.” Your cell phone carrier may flag the call as spam. It is so important to answer the call of a contact tracer. It is a key tool in slowing the spread of this virus.
  • ●  We continue to work closely with App State and Watauga County Schools to provide public health guidance and recommendations to inform their decisions about operations. App State has a dedicated website that highlights guidance, regular updates and data for the university community.
  • ●  PPE (personal protective equipment) levels remain stable in most areas.
  • ●  Turnaround times are around 2-4 days. NC DHHS provides data on testing turnaround times.This data is updated daily and can be found here .
  • ●  We continue to add positions and capacity to respond to the demand in this response effort.More information about those positions can be found here .
  • ●  Outreach continues to be an important part of our collective community strategy to addressCOVID-19. Regular meetings take place with community partners to discuss the current situation in the county, strategize areas for growth and improvement and provide a time for questions and answers.Outbreaks & Clusters

    Data is provided for outbreaks and clusters that are active and ongoing. The number of cases for outbreaks and clusters are current as of each Thursday at 9:00am. The case counts vary day by day as new cases are identified and as cases are moved in and out of isolation. This data may not match other reported data since this is a point in time. As we conduct outbreak and case investigations, the data included in this report are subject to change. For a current case count, visit the AppHealthCare data dashboard , which is updated daily by noon.

Based on additional clarification from NC DHHS of documenting and reporting clusters, we have identified and added clusters in off-campus apartments to the cluster report after clarifying cluster linkages among Appalachian State students with NC DHHS.

An outbreak is defined as two or more laboratory confirmed cases. A cluster is defined as a minimum of five cases with illness onsets or initial positive results within a 14-day period and plausible epidemiologic linkage between cases. An outbreak or cluster is considered over if 28 days have passed after the latest date of symptom onset in a symptomatic person or first date of specimen collection from the most recent asymptomatic person, whichever is later. Additional information on the definitions of outbreaks and clusters is provided by the North Carolina Department of Health & Human Services.

NC DHHS also provides regularly updated information on outbreaks and clusters . A newly added “COVID-19 Clusters in North Carolina” report includes aggregate data of settings where clusters are occurring. These settings include workplaces, shopping services, community events, etc. This report will be updated each Monday.

Routine surveillance and exit testing continues on the App State campus through Dec. 16. App State Student Health Service also continues providing testing for students each weekday. Surveillance testing- including mandatory entry testing for residence hall students, student athletes and other students as determined necessary- will resume prior to the beginning of the Spring 2021 semester. The university is providing five washable, re-usable face coverings for all students, faculty and staff prior to the start of the Spring 2021 semester. App State has a dedicated website that has guidance, testing schedule information, regular updates and data for the Appalachian community. The university’s holiday and winter break departure and return plan m ay be found here .

Mitigation and Response Efforts

  • ●  Ongoing testing continues to monitor the health of residents in skilled nursing facilities
  • ●  Educational outreach on COVID-19 prevention with these facilities
  • ●  Positive cases are separated from others to allow for safe isolation
  • ●  Ongoing daily health monitoring is occurring at the facilities
  • ●  Monitoring of positive cases continues with public health staff
  • ●  App State and AppHealthCare review cases daily to ensure that staff and students get thesupport they need to safely isolate or quarantine and to support contact tracing efforts by public health staff
  • ●  Ongoing messaging continues from App State to campus about prevention measures andenforcement
    • ●  App State is offering on-campus students the ability to voluntarily opt-out of their housingcontracts if they want to return to their hometowns, and is implementing mandatory, large-scale testing in residence halls with active clusters.

    Demographic Data from NC DHHS as of November 20

    NC DHHS updates this data daily and can be found on NC DHHS’s website .

    Data for Watauga County

    An important note about data context: The graphs below show the available data. Please carefully read the descriptions below the graph to understand the data limitations. The most current data is available ontheA ppHealthCaredashboard ,asthedatabelowispastdatatrended.

    Important Disclaimer About Data

    It is imperative that this report and the data contained within is understood in the appropriate context. Please, if you use this report, please be certain that the information included within is shared within the appropriate context. Doing otherwise may be damaging to the public health response efforts. There are multiple factors involved in addressing this virus, including compliance with public health control measures implemented by the local health director and referenced in NC GS 130A. These measures are imperative for limiting the spread of COVID-19. AppHealthCare strongly advises that when data is shared for the purposes of educating the public or informing policy decisions, it should come directly from NC DHHS or AppHealthCare as it is presented with appropriate context from those directly involved in public health response.