COVID-19 Situation Update for Watauga County August 20, 2020 This document is intended to provide a regular update on the local response to COVID-19 in our communities and timely, trended data related to COVID-19. This report will be published on Thursdays each week for the Sunday through Saturday of the prior week. Situation Update for August 9 through August 15, 2020 As cases continue to increase for Watauga County, we are urging everyone in the community to help us slow the spread of this virus. Of the newly identified cases for this week, we are continuing to see the same trend with cases exposed due to close contact with others through living or working closely with others or attending social gatherings. “This pandemic has made it more apparent than ever that each person’s health is affected by the community as a whole and in order to slow the spread of this virus, it will take all of us. We recognize the benefit college students have within our local community and know they are an important part of our COVID-19 response effort. This virus is highly contagious and sometimes people can spread the virus without realizing it because they have mild or no symptoms at all. Now is not the time to be attending large gatherings and parties with large groups. We are depending on the community to support contact tracing efforts. These actions help protect everyone in our community and helps make sure we have the healthcare system capacity that we all depend on,” stated Jennifer Greene, Health Director, AppHealthCare. Key points from this week: ● ● ● Our case trends have continued to increase with the largest percentage of cases in the 18-24 old age group. We are continuing to work closely with our University partners and provide public health guidance and recommendations to ensure our response efforts are coordinated. This week App State announced a cluster of cases associated with the football team. Every Monday through Friday, we meet with App State to review confirmed cases and outline a plan of action to care for those students who need to be in isolation or quarantine. There are protocols in place to continue surveillance of cases to identify response testing needed. Collaboration continues on the weekends between App State and the AppHealthCare case investigation team. ​App State has a dedicated website​ that highlights guidance, regular updates and data for the Appalachian community. We are continuing to work with ​Watauga County Schools​ as they started a new school year this week. We are continuing to provide public health information to inform their decisions about school operations. ● ● ● ● ● We are continuing to work to increase testing opportunities for the community. Planning for proactive testing for staff in locations that have opted-in to that service continues. Also, we are conducting response based testing when data gathered in the case investigation of a positive case informs the need to conduct broader testing. These response based testing events are intended to focus on areas where there is potential for further spread, a cluster of cases, or an outbreak. PPE (personal protective equipment) levels remain stable in most areas. Turn-around times for testing have improved with most tests resulting around 2-4 days. We have posted additional positions to assist with COVID-19 response efforts to respond to the increased demand due to increased cases. More information about those positions can be found here​. Outreach continues to be an important part of our collective community strategy to address COVID-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 those outbreaks and clusters that are active and ongoing. 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. Additional information on the ​definitions of outbreaks and clusters​ is provided by the North Carolina Department of Health & Human Services. The numbers of cases provided reflect the number of cases at the time of this report. Setting Type Setting Name Cumulative Cases Total Cases Nursing Home Glenbridge Health & Rehab 1 staff, 2 residents 3 Child Care Appalachian State University Child Development Center 4 staff, 6 children 10 This week App State announced a cluster of cases associated with the football team. By proactively testing these athletes, App State Athletics has been able to identify opportunities for isolating positive cases and quarantining others who have been exposed. Routine testing continues through App State Athletics to continue identifying early any positive cases. In addition, App State Student Health Services provides testing for students each weekday. ​App State has a dedicated website​ that has guidance, regular updates and data for the Appalachian community. 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 the support 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 and enforcement Demographic Data from NC DHHS as of August 20th 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 on the A ​ ppHealthCare dashboard​, as the data below is past data trended. 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. Cumulative Case Count by Week in 1Watauga County cumumnvs ms: COUNT {JulyS-August 15, 2020} {Asofg?i15f2m 383 140 120 100 ??013 we?ll if 3 to l? *Watauga County Resident . . . . . Non-Residents The solid navy blue line in this graph number of positive cases among 1Watauga County residents by week. This graph also shows the number of non-re sidents that have tested positive for (SQUID-19 but reside outside Watuga County. Number of Active Positive Cases by Week in 1Watauga County {July 5 - August 15, 2020.15 .15 ?Fill? 1,319 112 .e 35 15.19% got-1' we? Ed'- This graph re presents the number of active positive cases by week in IMata uga County. A positive case is considered active for a total of ten days after the initial positive test result. Total Weekly Tests Re ported vs. Weekly Positive Case Count in Watauga County [July 5 - August 15, 2020} 2000 1300 1600 14m 10-18 1000 85:55 as? 5999 ?le-l" wi- we? - Total Testing *Positive?ases This graph represents the number of positivecases by week compared to thetotal number of reported tests that were completed by AppH ealthCareand outsideagencies each week. Number of People Being Actively Monitored by Week in Watauga County [July 5 - August 15, 2020#13? w?'g 933% we? 'i This graph represents thetotal numberof Watauga County resid ents that AppHealthCaresta? have monitored dueto being exposed to a confirmed tower; case. lndividualsare notified and asked to quarantine and monitor for ior fou rteen days. Additional data can be found on ​AppHealthCare’s data dashboard​. This data is updated each day by 8pm. You may notice a difference between our case count and the ​NC DHHS state database​. Sometimes we get notification of positive results before they show up on the state dashboard. Also, individuals can sometimes get “assigned” to our counties that actually do not reside in our counties. When that happens, we work with the state to get that data reassigned to the person’s place of residence. Additional Data and Information from NC Department of Health & Human Services ● Zip Code Data​ - NC DHHS publishes data for confirmed cases by zip code for the state. The map and data can be found ​here​. ● Outbreak Data & Information​ - This data is broken down by type of congregate setting like a nursing home, residential care facility, correctional facility, or a congregate working setting. The map by county and report can be found ​here​. ● Hospitalizations​ - More detailed data around hospitalizations, ventilators and bed capacity is now available by regions and can be found ​here​. Our district counties are in the Triad Healthcare Preparedness Coalition. Key Messages ● Show Your Love! ​This multi-county communication campaign focuses on showing your love to yourself, others around you and the community. Posters and social media graphics for the 3Ws are now available on our website in both English and Spanish. Download them ​here​. ● Practice the 3Ws if you have to leave your house - ​Wear ​a cloth face covering, ​Wash ​your hands frequently or use hand sanitizer and ​Wait ​6 feet from others. ● Regularly clean and disinfect high-touch surfaces like doorknobs, handles, light switches, countertops, etc. ● If you are sick, please stay home except to receive medical care. ● If you are at higher risk for severe illness due to COVID-19, we encourage you to stay at home to the greatest extent possible to decrease your chance of infection. Testing If you meet any of the criteria listed below, we encourage you to be tested for COVID-19. You can call your healthcare provider or AppHealthCare. You should be tested if: ● You believe you have symptoms of COVID-19, ● You have no symptoms and you are at higher risk for severe illness (you are 65 or older, you have an underlying health condition or chronic condition), or have been in close contact with someone who is known to have a positive result, ● You are someone working in a frontline role or essential business where social distancing is hard to maintain, ● You are a first responder, law enforcement officer, fire department staff member, or healthcare staff member, ● You live in or work in a facility where social distancing is hard to maintain, like congregate living, healthcare facilities or home care. ● ● You are part of a historically marginalized population who may be at higher risk for exposure. You have attended protests, rallies, or other mass gatherings where you could have been exposed to someone with COVID-19 or could have exposed others because it may have been difficult to practice social distancing. What should you do while waiting for test results? What if the test is negative or positive? Answers for those questions, including prevention measures and home care if someone is sick are included in NC DHHS guidance ​here​. NC DHHS has tools for the public including a website to ​Check Symptoms​ and ​Find My Testing Place​. AppHealthCare does not require someone to have symptoms to be tested. Alleghany (336) 372-5641 Ashe (336) 246-9449 Watauga (828) 264-4995 AppHealthCare COVID-19 Hotline (828) 795-1970 General COVID-19 Questions:​ ​preparedness@apphealth.com Media inquiries: ​media@apphealth.com www.AppHealthCare.com​ and follow us on Facebook & Twitter