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Coronavirus (COVID-19) Conversation with Toe River Health District Director Diane Creek

By Tim Gardner

Diane Creek, Director of the Toe River Health District

High Country Press reporter Tim Gardner recently conducted an interview with Diane Creek, Director of the Toe River Health District (TRHD), which governs the North Carolina High Country counties of Avery Mitchell and Yancey and their health departments.

The interview is solely about the Coronavirus, an ongoing global pandemic of coronavirus disease 2019 (COVID‑19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2).

Avery County includes the townships and communities of Newland, Banner Elk, Elk Park, Beech Mountain, Linville, Invershield, Pineola, Crossnore, Ingalls, Pyatte, Hughes, Minneapolis and Cranberry.

Mitchell County includes the townships and communities of Spruce Pine, Bakersville, Penland, Minpro, Estatoe, Ledger, Red Hill, Poplar, Pigeon Roost, Loafers Glory and Buladean.

Townships and communities in Yancey County include: Burnsville, South Toe, Micaville, Newdale, Bald Creek, Cane River, Egypt, Ramseytown, Green Mountain and Pensacola.

The COVID-19 outbreak was first identified in December 2019 in Wuhan, China. The World Health Organization declared the outbreak a Public Health Emergency of International Concern on January 30, 2020 and a pandemic on March 11, 2020. As of December 15, 2020, more than 72.8 million cases have been confirmed in 191 countries, with more than 1.62 million deaths attributed to COVID-19. There have been 16,725,319 cases in America and 303,948 deaths. The Toe River Health District has had more than 1,000 cases and dozens of deaths. (Sources: Wikipedia, CNN and TRHD).

The pandemic continues to rage across America and Avery, Mitchell and Yancey are among the counties state-wide with the highest number of COVID-19 cases by percentage of population in the State of North Carolina. In fact, Avery has led the state in that unwanted statistical category.

Gardner’s interview questions and Creek’s answers about what specific measures the Toe River Health District has underway to help combat the disease and stop its spread as well as related topics follows.


High Country Press (HCP): For those who still may not know, what are the symptoms of Coronavirus (COVID-19) and when should a person be tested to determine if he or she has the disease?

Diane Creek (DC):   Symptoms of COVID-19 are: cough, fever/chills, runny nose, sore throat, nausea, diarrhea, muscle/body aches, headache, “pink eye” or red eyes, fatigue, shortness of breath/difficulty breathing, loss of taste, loss of smell, congestion and ear ache.

If someone knows they have been exposed to another person who is positive for COVID-19, then they should be tested 4-6 days after exposure even if they don’t have any symptoms. That period of time allows the virus to build up enough in the body to show up on a test. If a person has symptoms they should be tested immediately. They may have been exposed and not know it.

HCP: What does a coronavirus test entail?

DC: First, there is no charge for the COVID test from the any of our health departments at this time. If a person has insurance, his or her insurance company will be billed, but there will be no co-pay for the person. For those who are uninsured there is no charge, at least not currently. This could change depending on what the Federal Government does with its funding for COVID testing.

There are three kinds of test methods. One is the nasopharyngeal test. This is a long swab that goes way back in your sinuses. This is the most accurate testing method. The second type is a nasal swab. This swab just goes in the outer part of your nose. This type of test is highly accurate. The third type is an oral swab of the back of your throat. It is not done by any agency that I know about because it isn’t very reliable.

There are three different kinds of tests: the rapid (antigen), the lab (PCR) and the rapid PCR.

The rapid (antigen) test uses a swab, either nasopharyngeal or nasal swab, and takes about 15 minutes. This method is great for picking up positive test results. But if someone is experiencing symptoms and he or she have a rapid test that comes back negative, he or she needs to have a lab PCR test as a follow-up.  That’s because there is a high likelihood that the test could be a false negative. The rapid PCR test is also accurate for picking up positives but a symptomatic negative also needs to be followed up with a lab PCR test. The lab PCR test is the most reliable.

HCP: What are the different results a person can receive from a Coronavirus test such as positive, negative, inconclusive, etc.?

DC: A positive result means that you are positive for COVID, even if you don’t have symptoms. Some people are “asymptomatic” which means they don’t show symptoms. Other people have very mild symptoms that they don’t attribute to COVID. And then there are others who get very sick.

A negative test means that the test isn’t picking up any COVID virus at this time. If it’s a negative rapid test and the person is having symptoms then the negative test needs to be followed by a lab test since there is a high probability that the rapid negative could be a false negative.

An inconclusive test means that something happened to the sample that made it unable to be tested. Usually, it’s because the swab didn’t collect enough mucus to test.

HCP: How long does it take to get results from a coronavirus test?

DC: This varies depending on holidays, and the number of people being tested. The lab the Toe River Health District uses works with a large area of the southeast. Its employees work 7 days a week, but sometimes when there is a large demand for testing the lab gets swamped with samples. Most of the time the test results are back within 2-4 days. On some occasions, it may take up to 7 days.

HCP: A two-part question… Are certain people more likely to get Coronavirus than others and who are they?

DC: Research has shown that African Americans and Hispanics tend to be more susceptible and get sicker. What we’ve seen is certain families who seem to be more susceptible to COVID. We have families where COVID has infected everyone in the family and they have been very sick.

HCP: What are the step-by-step follow-up quarantines and treatment measures the Toe River Health District takes once a person tests positive for coronavirus in the counties it serves or at one of its medical facilities?

DC: When a person receives a positive COVID test result the health department will call and talk to that individual about any symptoms he or she might be experiencing. They will determine how long a quarantine period needs to be. If you are experiencing symptoms then your quarantine will be at least 10 days from the start of symptoms. For your quarantine to be lifted you will need to have spent your 10 days plus not have any symptoms for 24 hours without the help of medication.

There are people who have to quarantine for a longer period of time because their symptoms persist. If you test positive, but don’t have symptoms then your quarantine is dependent on when you were tested and could be as long as 14 days. If you have been exposed to someone who had a positive COVID test then you still must quarantine. Those quarantine times are a little more complicated, but they will be directed by the health department.

As far as treatment in the home, there really isn’t anything that anyone can do other than treat the symptoms, for instance fever, coughing and congestion.

HCP: How long does coronavirus immunity last after a person afflicted with the disease has recovered from it?

DC: Approximately 90 days.

HCP: Coronavirus can create severe and long-lasting physical medical as well as mental problems on those it afflicts. In what ways are your health departments’ staff members providing help to Coronavirus patients with any mental anguish they may develop because of being diagnosed with the disease?

DC: When someone is diagnosed with COVID we have people who call that person daily to check in on them. If the person needs food or medicine then we make arrangements with local partners to provide those things. If the person is experiencing mental issues, we can refer them to a mental health specialist for assistance.

HCP: Coronavirus has often been compared to Influenza (Flu).  In what ways are they similar and different?

DC: Influenza and COVID are both coronaviruses, although different strains. Their symptoms are very similar, so it’s impossible to tell the difference unless a person is tested. 

HCP: Can a person develop both coronavirus and the flu during the same time span?

DC: Yes, and that can definitely create even more medical problems than just having COVID-19 does. Either disease is plenty dangerous, but having both can be fatal quickly.

HCP: In what ways is the Toe River Health District working to better educate people about Coronavirus?

DC: We are providing new positive case numbers daily and cumulative numbers weekly every Wednesday on our Facebook pages. Yancey, Mitchell and Avery Counties all have their individual Facebook pages. We also post guidance and other information on our Facebook pages. We do interviews, such as this one, when requested as time allows. If someone wants an interview it helps to be flexible with the time frame and the method of interviewing.

HCP: It has been said by some that coronavirus is just a hoax or it is politically motivated with its primary purpose to help defeat Donald Trump as President and that it will go away shortly after the election if he was re-elected as President this year. Doctors, medical scientists and other healthcare professionals have repeatedly warned that the virus is real, not a hoax, and that the election has absolutely no ties to coronavirus.  What response would you tell those who may think that coronavirus is still a hoax, not as serious as the medical professionals and the media may state and/or that it is or has been politically motivated?

DC: This virus is definitely not a hoax and it should not be political in any way. It’s been made political by some politicians and others, but not by those of us on the front lines so-to-speak. We’re just trying to deal with a very real, very deadly virus that nobody has immunity to. I would welcome anyone who has had COVID or lost a family member or friend to COVID to share their story. We will be happy to post those stories on our Facebook pages. It might be helpful for people who think it’s a hoax to read the stories from real people who have had the virus.

HCP: What extra precautions are the Toe River Health District’s employees and other medical profession workers in Avery, Mitchell and Yancey counties taking while working with coronavirus patients and ones who are being tested for the disease? 

DC: We have kept our clinics open since the pandemic started but we only allow people in once they have been screened for COVID. We scheduled our clinic appointments so nobody had to wait in the waiting room and we sanitized after each patient left the building. Our staff members are required to wear masks at all times unless they are in an office alone or if they are eating lunch. They must also social distance as much as possible. Our employees wash their hands often and wipe down desks, phones, door knobs, light switches and any other highly touched surfaces often throughout the day.

HCP: Avery County was the last county in the State of North Carolina to have a positive coronavirus case. But the county now ranks among the state’s highest in percentage of populations in a surge of such cases. What do you think that has happened?

DC: I think what has happened is the same thing that’s happening everywhere. People are tired of wearing masks and social distancing so they’re getting lax in following the guidance. But this is not the time to let down your guard. In fact, this is the time to wear your mask anytime you’re out of your own home. It’s the time to make sure you stay at least 6 feet from all others when outside of your home. I try to stay at least 8 feet away from everyone.

There are a lot of working family members who are taking the virus into their homes and infecting their families. It would be very wise to clean your home more often more carefully. It would also be very wise to take your shoes off on the porch or in the garage if you work outside the home. If you experience any symptoms please stay away from your family as much as possible until you find out if you have COVID.

 HCP: The lives of health care workers around the world has changed since the beginning of the coronavirus pandemic, including in the Toe River Health District and in medical facilities in Avery, Mitchell and Yancey Counties.   How has the workload for you, your staff and other medical workers in the three counties increased since the pandemic struck?DC: The workload has increased dramatically since early March. We have staff members who have worked 7 days a week for the past 9 months. Our nurses work very long hours, monitoring cases, calling people, and managing the paperwork.

 HCP: Another two-part question…There also has been a horrible surge in coronavirus cases nation-wide in the last few weeks. When do you think that will start to decline and when do you believe the virus may come to an end in America and our lives can return to how they were before the it struck?

DC: If people in our counties would follow the guidance, wear a mask, social distance, stay home as much as possible, then we could get this virus under control again. I don’t foresee this pandemic getting any better until the majority of people receive the vaccine. I think eventually this virus will be like the flu, there will be a yearly vaccine that will help either prevent the virus or make the case lighter, and some will still die from COVID, much like the flu now. But until the majority of the population receives the vaccine, we will be battling this virus as it continues to rage as it has the last several weeks.