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From the First Patient Through the First Vaccine: The High Country’s COVID-19 Timeline from March Through December

By Nathan Ham and Harley Nefe

March seems like forever ago at this point as we all say goodbye to 2020 at midnight tonight. Unfortunately, after the first positive case of COVID-19 in Watauga County was discovered on March 15, the public is still dealing with this virus in full-force as the year comes to a close.

The High Country Press has put together a timeline of events related to the COVID-19 pandemic as a way to remind everyone how the pandemic started and how quickly the coronavirus spread throughout the High Country and North Carolina.


Governor Roy Cooper announced the first positive COVID-19 test in the state on March 3, a resident from Wake County.

On Sunday, March 15, Watauga County received the news that a resident who was working at Samaritan’s Purse and had recently traveled outside the country had become the first person in the High Country to test positive for the coronavirus.

On March 18, the ARHS announced a new process for sick individuals to get tested for COVID-19. The process included an online health screening with a doctor that would determine whether a person should take the next step in the testing phase. The sick person would then be tested for the flu and if that test were to come back negative, a COVID-19 test would be conducted. Since testing was extremely limited early on, especially in rural areas like the High Country, this program was designed to test only the sickest individuals. Later that day, AppHealthCare announced the second positive test in Watauga County. This person was exposed to the previous positive test and had been in quarantine the entire time. By March 23, AppHealthCare had conducted 62 tests in Watauga County. Across the state, a total of 8,438 tests had been conducted with 297 positive COVID-19 patients in North Carolina.

March 24 was a Tuesday on the calendar, and it marked the third positive COVID-19 case in Watauga County. The person also had a travel history and was in isolation. At the same time, there were still no positive tests in Ashe, Alleghany, Avery, Mitchell or Yancey counties.

On March 25, test numbers revealed the North Carolina was 18th in the nation with 398 positive COVID-19 tests, well behind New York’s staggering total of 25,665 and New Jersey at 3,675.

The first COVID-19 death in North Carolina was announced on March 25. A resident of Cabarrus County in their late seventies had succumbed to the illness.

Another Watauga County positive case put the total up to four on March 26. On the same day, Mitchell County had its first confirmed case from the Toe River Health District

March 31 was the first time that multiple cases had been confirmed on the same day. A Watauga County resident and a resident from outside the county who was in isolation inside the county had both tested positive.


April started with the seventh positive test announcement for Watauga County and the second confirmed case in Mitchell County on April 1.

Neighboring Ashe County received news of its first positive COVID-19 test on April 3. The person was a close contact to someone with known travel history. April 3 also marked the day that Watauga County reached the mark of 200 tests conducted by the health department. As a state, NC had completed 31,598 tests with 2,093 positive tests, and unfortunately 19 deaths. At the time, 86 of the 100 counties in North Carolina had recorded at least one positive test.

Ashe County was notified of its second COVID-19 test on April 7 and its third positive test on April 9, who was also an Appalachian State student that had not been on campus in over a month.

An ARHS employee tested positive for the virus on April 9. Although the employee did not provide direct patient care, they had come into contact with several other employees that were also quarantined.

On April 10, a fourth Ashe County resident tested positive for the virus and had been in contact with people at Boone Family Funeral Home in West Jefferson. AppHealthCare said that anyone who had attended a funeral service from March 19 through April 2 should contact the AppHealthCare office to provide guidance on self-quarantining.

Mitchell County had its fourth documented case announced on Saturday, April 11. Yancey and Avery counties were two of just nine counties in the state without a positive test at the time.

An eighth Watauga County resident tested positive on April 13 and was in isolation outside the state.

On April 15, AppHealthCare revealed that currently, Watauga County had access to only 105 test kits for residents. Ashe County had 77 test kits and Alleghany had 71 test kits available.

April 29 marked one of the scarier moments of the virus outbreak so far. A positive test case in Ashe County, the county’s fifth one total, had been linked to a nearby “hot spot” at the Tyson Foods Processing Plant in nearby North Wilkesboro. When it was all said and done, all 2,244 employees at Tyson were tested for COVID-19 by May 9 and 570 of those employees tested positive. The outbreak made national news at The New York Times and CNN, among others.

Watauga County learned of its ninth positive case on April 30, just as more info started to be released on when North Carolina would slowly begin reopening its state economy.


On May 4, Alleghany County had its seventh confirmed COVID-19 case, linked to a manufacturing facility in Sparta, the county’s biggest town. On the same day, AppHealthCare revealed that the number of test kits available in the High Country had started increasing. As of that date, over 400 test kits were available in Ashe, Watauga, and Alleghany.

On May 7, AppHealthCare released info that another Watauga County resident tested positive, bringing the total to nine while three more people tested positive in Ashe County, bringing the total to eight.

Ashe County kept seeing its positive tests continue to creep upwards in the coming days. Five more positive cases were announced on May 10 and then on May 18, Ashe’s total case total had jumped to 27 cases after more residents were linked to the Tyson Foods outbreak in Wilkesboro and an outbreak among workers on a farm inside the county.

Watauga’s first big spike in positive cases happened on May 14 when AppHealthCare learned that 16 subcontracted workers working on App State’s campus had all tested positive for the virus.

On May 18, Avery County, who had outlasted every other county in North Carolina, finally had its first positive case. Mitchell County had six positive cases by this date.

Avery’s second confirmed case followed soon on May 21.

Monday, May 25 will be remembered as the date of the first COVID-19 related death in the High Country. An Ashe County resident in their 70s with underlying health conditions passed away that morning.

On May 27, three more subcontractors at Appalachian State tested positive for the coronavirus.

On Friday, May 29, AppHealthCare tested 137 different individuals, the highest single-day test total since testing started in March.


Eleven more positive tests among the subcontractors were announced on June 2.

Avery County received news of two additional positive tests on June 4, bringing the county’s total to four.

On June 6, AppHealthCare confirmed a total of 36 positive cases among subcontractors working on the new student housing project at Appalachian State.

June 14-20 had five cases reported in Watauga County.

June 21-27 had 19 cases reported in Watauga County.

June 28 – July 4 had 31 cases reported in Watauga County.


July 5-11 had 35 cases reported in Watauga County.

Watauga County surpassed 100 total cases on July 8.

July 12-18 had 49 cases reported in Watauga County.

On July 18, a total of 533 Watauga County residents took advantage of free COVID-19 testing at Watauga High School.

July 19-25 had 53 cases reported in Watauga County.

Avery County was up to 78 total cases reported on July 28.


COVID-19 clusters were reported at Glenbridge Health & Rehab on August 15.

Watauga County surpassed 400 total cases on August 21.

The AppHealthCare district surpassed 900 total cases on August 28


September 6-12 had 95 cases reported in Watauga County.

September 13-19 had 125 cases reported in Watauga County.

On September 18, 54 cases were reported at the Avery-Mitchell Correctional Institution.

September 20-26 had 175 cases reported in Watauga County.

September 27 – October 3 had 295 cases reported in Watauga County.


October 4-10 had 246 cases reported in Watauga County.

October 11-17 had 95 cases reported in Watauga County.


November 1-7 had 62 cases reported in Watauga County.

The third COVID-19 death in Avery County was reported on November 6.

November 8-14 had 145 cases reported in Watauga County.

November 15-21 had 154 cases reported in Watauga County.

November 22-28 had 124 cases reported in Watauga County.

On November 23, it was announced the five COVID-19 deaths had happened in Avery County over the previous three days. That put the total number of deaths at 11.


On December 2, 653 people hospitalized in western North Carolina with 22 of those at Watauga Medical Center.

On Monday, December 7, Watauga Medical Center had almost 80 percent of its COVID-19 beds occupied.

The Blowing Rock Chamber of Commerce and AppHealthCare partnered to provide a free COVID-19 Testing Event in Blowing Rock on December 9.

On December 22, Appalachian Regional Healthcare System’s first COVID-19 vaccines were administered. Occupational health nurse, Crystal Minton, RN, vaccinated Kevin Wolfe, MD, a pulmonologist who is treating COVID patients at the hospital, followed by Emergency Department nurse Madison Bakken, RN.

As of December 31, there have been 2,958 cases reported in Watauga County since testing started in March. Ashe County has had 1,421 total cases and Alleghany County has had 711 total cases. There are currently 95 people hospitalized in the three-county district.

As of December 31, 33 people in Ashe County have died of COVID-19 complications, 19 people in Watauga County have died and four people in Alleghany County have died.


Here are some additional numbers concerning COVID-19 cases as of Dec. 31:

Number of Confirmed COVID-19 Cases

In the World 83,716,174
United States 20,395,613
North Carolina 539,545


Positive Case Count in the AppHealthCare Region

(Cumulative Since Testing Began)

Alleghany County 711
Ashe County 1,421
Watauga County 2,958
Total 5,090


Number of COVID-19 Deaths in the AppHealthCare Region

(Cumulative Since Testing Began)

Alleghany County 4
Ashe County 33
Watauga County 19
Total 56


Appalachian State University’s Current Cumulative Case Count 

Students 1,193
Employees 90
Subcontractors 44
Total 1,327


Appalachian State University’s On-Campus Testing 

Number of Tests Given 31,293
Number of Positive Tests 884