Health Department leading the way in coronavirus battle
By Dave Russell
The Jackson County Department of Public Health is focusing intently on COVID-19, aka the coronavirus, though it has not been reported in the county as of Wednesday morning. The N.C. Department of Health and Human Services reports 63 cases – most of them in Eastern North Carolina – and no deaths.
Nationwide, on Wednesday the Centers for Disease Control and Prevention reports 4,226 cases with 75 deaths.
Testing is available locally, but only for people showing symptoms.
“If someone is showing symptoms and believes that they need to be tested, they should call their primary care provider or the Health Department to discuss their symptoms,” Deputy Director Melissa McKnight said.
That phone call ahead of a visit for testing at any treatment facility is very important, she stressed.
“By calling your primary care provider or the Health Department, we will be able to give you the best guidance on your situation and prevent potential exposure of others in the community,” McKnight said. “At that point, we can give guidance on next steps – if testing is needed, where to go to get tested, what other illnesses should be ruled out first, etc.”
The State Lab of Public Health has put together collection kits for local health departments, she said. The kits are being sent or have already arrived at local health departments.
The Health Department has requested three collection kits from the N.C. State Laboratory for Public Health with the option to request more when/if needed, McKnight said.
“We also have additional supplies (beyond these three collection kits) on hand to test patients for COVID-19 if they meet the criteria.
“These kits consist of the supplies one would need to collect the specimen, i.e. labels, shipping container, cold packs, transport media, tubes, swabs, etc.,” McKnight said. “Many health departments and healthcare providers already have these items on hand without being a part of this ‘collection kit,’ as these are items that are being used in other types of specimen collection.”
State officials at the Department of Health and Human Services recommend collecting and testing upper respiratory (nasal and oral swabs) and lower respiratory (sputum, if possible) for patients with productive coughs, she said.
“Turnaround time for results is dependent on testing volume at the N.C. State Lab for Public Health,” she said. “If a specimen is found to be positive (called at this point “presumptive positive”), it will be sent to the Centers for Disease Control and Prevention for confirmatory testing.”
Results from the CDC can be expected within 24-72 hours, depending on volume. All presumptive positive cases are public health actionable, meaning they would be treated as an active infection. Testing is also now available through commercial labs like LabCorp and Quest.
As of March 10, patients meeting the following criteria will be considered for testing at the N.C. SLPH:
• Fever or signs/symptoms of respiratory illness in any person, including healthcare workers, who have had close contact with a lab-confirmed COVID-19 patient within 14 days of symptom onset.
• Fever and/signs symptoms of lower respiratory illness and a negative influenza test and no other more likely diagnosis.
Testing should not be done on asymptomatic persons (those showing no symptoms).
A visit from citizens who flew from a foreign country where the virus has been reported, or attendance at an event with large crowds is not necessarily reason enough for a test, she said.
“Our communicable disease nurse would need to collect more information from you to give you an accurate answer,” she said. “She can review your circumstance, ask questions about your symptoms (if any) and advise further. Call the Health Department at 586-8994 and you will be transferred to her.
“We definitely don’t want people getting tested if they are asymptomatic, not necessarily because the test kits are rare but more because we want to rule out other respiratory illnesses first as we are not at this time experiencing community transmission of COVID-19.”
Testing can be completed through other means as well, such as testing from primary care providers who are able to work with the commercial labs, she said.
Health department staff are following enhanced safety precautions.
“It’s similar to what we do during flu season,” McKnight said. “Respiratory etiquette and hand hygiene is emphasized with staff and the public through signage around the building. We are following all routine environmental cleaning precautions.”
Staff have been trained in respiratory protection and appropriate staff have been fit tested. Patients showing respiratory symptoms are asked to wear a mask when they enter the facility, she said.
“We’ve been monitoring the situation, responding to calls from the public and our partners, convening our stakeholders, informing our partners with updated guidance, sharing information with the public and more,” she said. “While there is no community transmission in Jackson County at this time, we want to make sure that our community has accurate information from reliable resources to help prepare for and prevent COVID-19.”
Based on the increase in cases reported, the state is moving towards more of a mitigation stage and adding additional recommendations for those that are at a higher risk for severe illness, she said.
Individuals who are at higher risk for severe illness (65 years or older, those with underlying health conditions, or those with weakened immune systems) should follow additional precautions.