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These people are protecting us from coronavirus

Health care providers, first responders, public information officers and others met Thursday to coordinate the county's response to the coronavirus threat.

Steve Smith, the director of the Henderson County Public Health Department, was in a coffeeshop on Tuesday when he met a fellow coffee drinker with a science background, retired from the pharmaceutical industry.

“As soon as he heard that I was in public health, naturally we talked about the coronavirus,” Smith said. His new acquaintance said, “You know there’s a lot to think about with the coronavirus and how you react,” with schools, hospitals, first responders, public information officers and numerous agencies. “He looked at me and said, ‘It would be really smart to get all those people in a room.’
Steve SmithSteve Smith“You can imagine the smile on my face when I said, 'I’m in that room with about 80 people in two days.”
That room was a training room at the Henderson County emergency management headquarters and the people facing Smith were doctors, nurses and other clinicians, first responders, hospital administrators, public information officers, law officers, emergency medical services leaders and newspaper and television reporters.
The county’s Epidemiology Team has met regularly for a long time but only since last year has its work become so critical and so worthy of attention. The Epi Team is on the front lines of the county’s battle to protect the public from the corona virus.
In a 40-minute presentation on Thursday morning, County Manager Steve Wyatt, Smith, Emergency Services Director Jimmy Brissie, Crystal O’Dell, the public health department’s nursing director; and Anita Glance, its preparedness coordinator, outlined the steps the county has taken to fight the virus.
“One of the things that makes Henderson County unique is the teamwork but it’s also the talent we have,” Wyatt said in opening remarks. “I’ve been in other places and I’m telling you the talent we have in this community, the medical resources of two fine hospitals, the fact that we have one of the finest emergency services delivery systems, we have a public health department that is equal to any in the state of North Carolina. I can tell you, because I have been in other places, but we also have people come in from other places to look at what we’re doing here in Henderson County and when they leave they say something like, ‘Wow. You’ve got people that can work anywhere.’ And it’s true, we do.”
Wyatt urged the team to stay healthy themselves.
“Another thing I know about Henderson County is we are at our best when things are worst,” he said. “I’ve got one message for you and that is, take care of yourself, because there may be a time when you need to be at 100 percent or 110 percent or 120 percent. Take care of yourself and this too shall pass.”

Crystal O'Dell, Henderson County director of nursing, describes the coronavirus plan.The Epi Team, which has carried out its work in obscurity until now, is suddenly on the ramparts.
Crystal O'Dell describes the coronavirus plan.Crystal O'Dell describes the coronavirus plan.“We have had plans in place for a really long time,” said Anita Glance, preparedness coordinator for the health department.
As with any emergency, the county applies an incident management system, with a clearly defined objections and a breakdown of who is responsible for what parts of the response.
“So it’s no different than looking for little Johnny that went missing from a camp,” Brissie said. “This is the same process.” The unified command structure is led by Wyatt, Brissie, Smith and Sheriff Lowell Griffin. Under the command team are public information officers, a liaison coordinator, and chiefs of operations, planning, logistics and finance. “These are things we’ve been planning for for years,” Brissie said. “So what we do is we blow the dust off of them. Let’s pull out our existing plans, see what’s applicable, what may not be applicable and what needs to be enhanced.”
Rumor and misinformation are the enemies of an effective response.
“One of the big pieces of this is the public concern,” he added. “That’s something this team is very cognizant of and we’re working very closely with the partners in this room to make sure the right messaging is going out. What should be done, what shouldn’t be done. What may be overinflated in some reports, what folks can do to stay prepared themselves. The Epidemiology Team is going to work very closely with the providers in the community to make sure they have the accurate information … because it is a dynamic situation changing very much.”
“Having a unified message starting from Mr. Wyatt all the way down to our boots on the ground with our deputies and our paramedics that may be in the field is critical,” he said.
Here are other highlights of the corona virus as it stands today and what the county team has in place.

  • Prevention. Masks worn by healthy people don’t reduce transmission. Masks worn by ill persons may reduce transmission by decreasing the spread of droplets that carry the virus. Patients who show up at a doctor’s office or hospital with symptoms should be given a mask.
  • Incubation period. Believed to be two to 14 days. “That’s why you’re seeing quarantine periods of up to two weeks,” said O’Dell, a nurse practitioner.
  • Severity. Varies widely but most cases are not severe. “What we are seeing very consistently is that 80 percent of persons infected with this have very mild illness and may not even recognize how sick they are,” O’Dell said. “They may think that they just have a common cold.”
  • Number of cases. The case count is updated at noon daily by the CDC. Totals as of Thursday morning were 93,090 cases worldwide, 80,422 of them in China with 2,984 deaths. Outside of China there are 12,668 cases in 76 countries and 214 deaths.
  • Monitoring possible infections. There are two levels. People returning from China are self-quarantined at home. They monitor their health and “and then we call them daily,” O’Dell said. “Once they become symptomatic then they become a person under investigation. This is anyone that we feel is symptomatic of COVID-19 that requires testing to either confirm or rule out the diagnosis.”
  • Reporting and testing. O’Dell urged the providers to do everything they can to “educate your patients, your friends that if someone has symptoms to call their providers first (instead of going in person). That’s a great kind of basic thing to do during flu season, not just for this illness.” If a symptomatic person arrives without calling first, clinics should immediately isolate the patient, take droplet and respiratory precautions, contact the health department’s communicable disease nurses and review whether the patients meets the criteria for testing (828-694-6019). Tests are processed at the North Carolina state lab in Raleigh, with a turnaround time of 24 to 48 hours.
  • What providers and employers can do. Access information from trusted sources, be a credible source of information, review clinical response plans, separate sick individuals and emphasize importance of staying home when sick. “If you are a provider, if you are an employee who is sick, please don’t come to work,” Glance said. “Have great policies in place and educate your employees ahead of time about staying home when you’re sick.”
  • Supplies. “One of the things you may have seen at the grocery store — stuff is getting gone,” Brissie said. “Supply chain is a concern. The nationwide supply of masks has been obliterated on the commercial market. Those are really important to protect our health care workers.” The state has implemented a centralized process to get resources under which a provider would make a request through the county’s emergency management office.

"And please always wash your hands and cover your cough and sneeze,” Glance said. “That’s something we can all do.”

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