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STAYING PUT
Governor issues 'stay at home' order for 30-day period

RALEIGH — N.C. residents are mandated to stay at home unless going out for essentials, according to an executive order signed by N.C. Gov. Roy Cooper on March 27.

“To continue our aggressive battle to slow the spread of COVID-19, today I have signed a stay at home order for the entire state of N.C.,” Cooper said. “Enforcement begins at 5 p.m. Monday, but we encourage you to start as soon as possible.” The governor said the order is in effect for 30 days, and that violations are punishable by a Class II misdemeanor.

View the N.C. Executive Order to Stay at Home

“Stay at home unless you need to leave for job, food, medicine, outdoor exercise or to help someone,” Cooper said. “It’s what we have to do to save lives. It has the force of law.”

Cooper asked citizens to think of others in their efforts to limit the spread of the virus, and that he was told by the Centers for Disease Control that North Carolina now has widespread transmission of COVID-19.

The order bans gatherings of more than 10 people, Cooper said, and directs people to stay at least six feet away from each other, which he called “physical distancing.”

Cooper stressed physical distancing of six feet or more for essential business.

When asked about enforcement, Cooper said he’s asking law enforcement to encourage people to abide by the order, saying that people who flagrantly violate the order can be charged by local district attorneys.

N.C. Department of Health and Human Services Secretary Mandy Cohen said that the numbers so far paint a sobering picture of the effects of the virus.

“We don’t have the luxury of time; we must do what we need to (do to) stop the spread of the virus,” Cohen said.

Cohen said many people getting sick at once could overwhelm the medical system.

“Our best weapon is social distancing,” Cohen said. “Our actions, your actions can save lives... There are many things that are not within our control right now. It’s up to us to act where we can. We can do this. We are strong. And we are in this together.”

N.C. Emergency Management Coordinator Mike Sprayberry said that a “frequently asked questions” document would be sent out to help citizens and businesses understand the order.

Sprayberry said that businesses allowed to remain open under the executive order do not need any additional permits or credentials.

“We are also working to prepare for the surge of patients expected at our hospitals,” Sprayberry said. “We are identifying facilities that can serve as overflow for our hospitals, and the U.S. Army Corps of Engineers is helping prepare facilities.”


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U.S. leads globe in COVID-19 cases, state shifts response as hospitals prepare

RALEIGH — As the United States on March 26 surpassed China and Italy to become the nation with the most confirmed COVID-19 cases in the world, North Carolina this week announced a shift in its response, and Appalachian Regional Healthcare System is preparing for a potential influx of patients at local hospitals.

The number of confirmed U.S. cases was at 164,719 as of Tuesday, March 31, according to figures reported by Johns Hopkins University & Medicine, with 3,170 deaths related to the virus and 5,945 people reported to have recovered.

North Carolina’s confirmed cases have grown from 134 on March 19 to 1,512 on March 31, according to the Raleigh News & Observer. Gov. Roy Cooper announced on March 25 that two COVID-19-related deaths have occurred in the state, including a Virginia resident who had traveled to N.C. A third death was announced by Harnett County on March 26. In all, a total of eight victims have succumbed statewide to the illness, according to the newspaper.

“These will not be our last (deaths),” Cooper said.

Cooper announced a statewide Stay at Home Executive Order on Friday afternoon, March 27, mandating N.C. residents must stay at home unless going out for essentials effective at 5 p.m. on Monday, March 30, for a period of at least 30 days.

New testing guidance

In the past week, the CDC, N.C. DHHS and AppHealthCare announced new guidelines for testing, prioritizing those with urgent medical needs as well as health care workers.

“Based on recommendations issued by the N.C. DHHS, most people do not need testing for COVID-19,” AppHealthCare stated. “When you leave your home to get tested, you could expose yourself to COVID-19 if you do not already have it. If you do have COVID-19, you can give it to someone else, including people who are high risk. If you are sick and unsure if you should get tested, please call your health care provider.”

The announcement came amid a nationwide shortage on personal protective equipment for health care workers, N.C. DHHS noted, as well as media reports of continued test kit shortages and test results taking up to seven days or more.

Appalachian Regional Healthcare System Vice President for Advancement Rob Hudspeth said that ARHS is following the new testing recommendations. On March 18, the health care group that includes Cannon Memorial Hospital in Linville and Watauga Medical Center in Boone announced a new partnership with telehealth provider RelyMD to “ease the burden on the health departments’ testing and to help people get a medical screening from the comfort and safety of their homes,” Hudspeth said.

While echoing N.C. DHHS and AppHealthCare in stating that most people do not need testing for COVID-19, ARHS now advises that if you are sick and unsure if you should get tested, you can call your health care provider or connect with a RelyMD provider online at relymd.com/covidarhs on your computer or mobile device. The screening costs $49 with the coupon code BEWELLARHS.

People who experience shortness of breath and difficulty breathing, chest pain or pressure, bluish lips or face or confusion or disorientation should call 911 or contact their primary health care provider, according to ARHS.

Preparing for a potential surge

Asked when North Carolina can expect COVID-19 cases to peak, N.C. DHHS Secretary Mandy Cohen said last week that officials are still working to determine what trajectory N.C. is on, but that they feel like the state is trending lower compared with other states.

Regardless, Hudspeth laid out the steps that ARHS is taking in preparation for a potential surge in patients due to COVID-19.

“Two weeks ago we formally established an incident command center to integrate facilities, equipment, personnel, procedures and communications within our organizational structure specifically aimed at responding to catastrophic levels of COVID-19,” Hudspeth said. “We communicate daily with N.C. DHHS, AppHealthCare, Toe River Health District, Emergency Management, Watauga and Avery County Schools, Appalachian State University, the N.C. Hospital Association, state and federal legislators and many law enforcement agencies to ensure synchronous response to COVID-19.”

“We’ve converted two large inpatient bed units into isolation areas — and have developed contingency plans if demand exceeds our bed capacity,” Hudspeth said.

Recently, ARHS barred all visitors from its hospitals (with a few exceptions) and mandated that all employees enter through a single entrance where they are required to get a temperature screening.

“Employees with a temperature of 100 (degrees Fahrenheit) or greater are not allowed to work. The temperature screening mandate was extended across all ARHS (clinical and non-clinical) facilities,” Hudspeth said on March 26.

Another action was the postponement of all elective surgeries and procedures, Hudspeth said, following guidance from the U.S. Surgeon General, the American College of Surgeons and the CDC. Hudspeth said the measure will help “ration much-needed personal protective equipment, keep hospital beds open and ... shield patients from the virus.”

COVID-19 testing sites in Avery and Watauga counties are located off site from hospitals to protect employees, Hudspeth said, and ARHS has created new supply chain and logistics channels to ensure continuity of supplies.

The Broyhill Wellness Center, closed to the public, is temporarily being used for child care for ARHS employees’ children.

One measure being implemented elsewhere, but that ARHS has yet to take, is utilizing retired doctors and nurses, Hudspeth said.

“Some external volunteer roles are being utilized, but in very limited roles,” Hudspeth noted.

Cohen said on March 25 that “hundreds” of health care professionals have answered the state’s call for volunteers.


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County moves for immediate suspension of all-short-term rentals in response to COVID-19

AVERY COUNTY — The COVID-19 pandemic continues to pose a looming threat to the health and safety of the people of Avery County. Avery County Government continues to be proactive in taking the necessary steps to slow the spread of the disease through all appropriate means, according to a March 25 press release from Avery County government.

Effective at 5 p.m. on Wednesday, March 25, 2020, Avery County government, the Health Department, Emergency Management, and Sheriff’s Office required that lodging facilities, such as air bed and breakfasts, campgrounds, timeshare units, condos, motels, hotels, and other rental programs or places where leases or rentals are for less than one month in duration, be suspended in Avery County until April 18, 2020, according to the release. This action is consistent with actions taken by other communities across the state and nation to slow the spread of the COVID-19 virus due to human travel.

According to the release, “Human travel promotes the spread of this disease and the presence of visitors in Avery County has the potential to exacerbate the spread of the virus and the anticipated strain on our limited health care facilities caused by it.” In addition, “This suspension is to assist in preventing the spread of the COVID-19 virus in a manner and at a pace that overwhelms the County’s ability to respond effectively in the coming days.”

The release did note exemptions related to work-related stays, emergency facilities and homeless shelters. “We understand that rentals for work-related stays for construction workers or other essential services already in place will need to continue. We also recognize the need to allow the use of hotels and other facilities for emergency service workers, essential service workers, displaced residents needing shelter, and other response and mitigation efforts related to COVID-19 in the coming days and weeks,” the release stated.

Additionally the release noted, “We realize this places a burden on the hotel accommodations and short-term rental sector of our economy and this requirement is not made lightly,” and that “the County will be constantly monitoring the need for this and may lift the requirement earlier if it is not needed to protect the public health.”

Business owners or individuals with questions regarding the supplemental declaration may call Avery County Manager Phillip Barrier at (828) 733-8201.