Wondering if the Novel Coronavirus (COVID-19) has spread in Craven County, I reached out to County Manager, Jack Veit.
I asked if tests were available in Craven County. He stated, “Yes, COVID testing is available at local physician offices as well as the local health department.”
When asked about the testing requirements, he referred me to an Internal Memo from the NC Department of Health and Human Services, Division of Public Health dated March 29, 2020 that was sent to all North Carolina Clinicians and Laboratories.
Takeaways from the Memo that I believe the public should know:
Background:
The respiratory disease named “coronavirus disease 2019” (abbreviated “COVID-19”), caused by a novel coronavirus named “SARS-CoV-2”, was declared a pandemic by the World Health Organization on March 11, 2020.
North Carolina now has widespread community transmission of COVID-19. Therefore, we are moving to a different phase of our response efforts and will be further increasing our population-based community mitigation strategies. The goal of mitigation is to decrease spread of the virus among our population – especially for those who are at highest risk of clinical severity – so fewer people need medical care at the same time.
Clinical Assessment and Management:
Recommendations included:
– Encouraging patients to call if they have medical concerns before seeking care in-person.
– Use telehealth/televideo and telephone triage to assess clinical status of patients with respiratory illnesses to allow patients with mild symptoms to have safe access to appropriate assessment, clinical guidance and follow up, and self-care information, while preventing further spread of COVID-19 or exposing patients to COVID-19 in a medical setting. Note: Telehealth is broadly being covered at parity for most patients with private insurance, Medicare and Medicaid and therefore should be used whenever clinically appropriate in lieu of face-to-face encounters.
– Use their judgment to determine if a patient has mild signs and symptoms compatible with COVID-19 (e.g., fever and cough) or more severe symptoms requiring in-person medical care (e.g. shortness of breath, difficulty breathing, chest discomfort, altered thinking, cyanosis).
– In general, patients in non-congregate settings who have mild symptoms compatible with COVID-19 that do not progress do not need testing for COVID-19 and should be instructed to stay and recover at home.
– Patients should be counseled to call if they have worsening signs or symptoms of respiratory illness (e.g. increasing fever, shortness of breathing, difficulty breathing, chest discomfort, altered thinking, cyanosis).
– Patients in high risk categories for clinical severity (e.g., 65 year and older, chronic lung disease or moderate to severe asthma, heart disease, severe obesity BMI > 40, other underlying poorly controlled chronic health conditions such as diabetes, renal failure, liver disease, and immunocompromised) should have more frequent follow up to assess clinical status.
– Pregnant women should be monitored closely as they are known to be at risk with severe viral illness, however, to date data on COVID-19 has not shown increased risk.
– While children are generally at lower risk for severe illness, some studies indicate a higher risk among infants.
Testing Recommendations:
– Testing is not recommended for asymptomatic persons.
– In general, patients in non-congregate settings with mild illness that does not progress do not need testing.
– Use clinical judgement and prioritize testing of patients with more severe respiratory symptoms; hospitalized patients; patients for whom clinical management would be different if they were infected with COVID-19; patients in high-risk settings (e.g., congregate living settings, long term care); and health care workers and first responders.
– For patients who have more significant symptoms and do need medical attention, clinicians are strongly encouraged to also consider and test for other causes of respiratory illness, including infections such as influenza.
Patients undergoing testing will be considered a person under investigation (PUI). Providers should give the Person Under Investigation Guidance (Spanish) to all patients undergoing testing and ensure patients are aware that they are expected to stay in isolation until results are back and longer if they are positive.
Requests for general information about Coronavirus for members of the public, please call the NC COVID-19 Call Center at 866-462-3821.
As of April 2, Ten individuals have been confirmed as positive. When asked about testing, Mr. Veit responded, “We are only aware of the ones we have placed in quarantine; private offices are not required to report how many are being asked to quarantine while they wait on test results. Four of the seven confirmed cases in Craven County have recovered”.
I asked him if they have enough personal protective equipment (PPE) and he responded. “The health department has an adequate supply of PPE at this time, other County Departments have needs but mostly related to gloves and hand sanitizer. We are actively working with the State to receive PPE, albiet a slow process at the moment. We cannot speak for others from CarolinaEast or CCHC.”
I also asked about the need for volunteers and he replied, “We have a great group of volunteers at this time, we are not actively promoting any volunteer opportunities as we feel our current group meets our needs at this time. This could change.”
We also received an updatefrom CarolinaEast Health System stating, “CarolinaEast Medical Center received its first confirmed positive COVID-19 test result on March 31, 2020. The COVID-19 patient is on isolation protocol and in stable condition at the hospital. CarolinaEast officials have been and will continue to work closely with the North Carolina State Division of Public Health (NC DHHS) and local health departments to coordinate preparation and response efforts to COVID-19 in accordance with guidelines from The Centers for Disease Control (CDC). The public is strongly encouraged to comply with the recent Stay At Home Executive Order of North Carolina Governor Roy Cooper. Additional preventive measures provided by the CDC can be found at www.cdc.gov/coronavirus/2019-nCoV/
Please let me know if you have any comments or questions by sending us an email.
Wendy Card