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COVID-19 Update: Governor extends stay at home order; cases reported at NFS; Ballad announces changes

By Richard Rourk

Governor Bill Lee has officially extended the stay at home order until the end of the month.

“In cooperation with the guidance from the White House, Tennessee’s stay at home order is extended through April 30,” Lee said during a press conference that was held on Monday, April 13. “The Unified Command Group will continue to consult with experts, analyze all available data, and monitor CDC recommendations for the remainder of this month.”

According to Lee, next month a newly formed group, the Economic Recovery Group, will start looking at ways to salvage the economy.

“Beginning in May, a phased reboot of the economy is planned,” Lee said. “The group will be led by Tourism Commissioner Mark Ezell and will work in coordination with legislative leadership, local mayors, health care professionals, and representatives of impacted industries. The Economic Recovery Group will issue industry-specific guidance so that businesses can be prepared to operate safely and protect their employees and customers.”

Lee’s already formed United Command Group will continue to monitor COVID-19.

“By formalizing an economic recovery specific group, this will ensure the Unified Command Group will continue their focused efforts of disease management, improving hospital and testing capacity, and increasing our PPE supply chain,” Lee said. “The Unified Command Group will also be making recommendations about when and how to begin the phased-in reopening of the economy.”

CASES REPORTED AT NFS

In Unicoi County, Nuclear Fuel Services has confirmed cases of COVID-19 among its employees.

“Due to personal privacy, we do not share individual specifics; however we have been acutely focused on protecting the health and safety of our employees and the community,” NFS Communications Specialist Laura Bailey said. “We are in regular communication with them and their families as we assist them through this difficult time.”

According to Bailey, NFS is following protocols to keep their employees safe during this crisis. “Our coronavirus response protocols call for enhanced cleaning across the site, social distancing, hand washing, hand sanitizing and use of face masks,” Bailey said. “In addition, NFS follows the CDC’s guidance governing self-quarantine for those who may have been exposed to coronavirus or who become ill. Employees who experience COVID-19-like symptoms, have potentially been exposed, or are ill have been instructed to stay home.”

NFS employees are still reporting to work as usual as they are considered essential.

“Because of its role in national security, NFS has been designated an essential business by the federal government and is open and operating at this time,” Bailey said “The coronavirus is obviously having a significant impact throughout our nation and our region. Like every other company, we are working hard to adapt to the current environment, even as it evolves on practically a daily basis.”

BALLAD PREPARES FOR SURGE

Ballad Health continues to prepare for a potential surge in COVID-19 cases regionally.

“We now have 300 beds ready for patients with COVID-19,” Ballad Health Corporate Director of Infection Prevention Jamie Swift announced during an April 10 press conference.

As Ballad prepares for a surge in COVID-19 cases, they continue to call for measures to flatten the curve. Ballad Health joined the CDC in requesting that people wear masks when they are in public during a press conference held on April 14.

“The CDC recommends that masks be worn out in public and this is a valuable tool,” Ballad Health Chief Physician Executive Dr. Clay Runnels said. “Wearing masks not only helps protect you, it protects others.”

Although masks are a useful tool to combat COVID-19, according to Runnels, the public still needs to be vigilant.

“It can create a false sense of security,” Runnels said. “The best way to combat this is to continue social distancing and to stay at home.”

During Ballad’s April 14 press conference, it was announced that Ballad Health has received a $200 million cash advance from Medicare from the $2.2 trillion CARES Act. According to Ballad Health Executive Chairman, President and CEO Alan Levine, this move is to help prepare for predicted losses.

“We are forecasting to have grim financial goals,” Levine said. “We are projecting that the finances in the fourth quarter will not be good.”

Levine went on to say he supports Governor Bill Lee’s May 1 call to ramp up the economy.

“I think the governor is taking a surgical approach to this,” Levine said. “There are several areas in the state that COVID-19 cases are under control. This is not a black and white answer, but I think the governor has been very pragmatic about this.”

COVID-19 numbers continue to grow on the national level as well as the state level.

According to the Centers for Disease Control and Prevention, there have been 554,849 positive cases of COVID-19 in the United States and 21,942 deaths reported as of The Erwin Record’s  press deadline on Tuesday, April 14.

Also on Tuesday morning, there have been 5,610 positive cases of COVID-19 and 109 deaths as a result of the virus in the State of Tennessee, according to the Tennessee Department of Health. The deaths from COVID-19 in the State of Tennessee amount to two percent of the total positive cases in the state.

Of the positive cases, roughly 1,671, or 30 percent of the positive cases have recovered. According to tn.gov/health, “recovered” is defined as people who have been confirmed to be asymptomatic by their local or regional health department and have completed their required isolation period or are at least 21 days beyond the first test confirming their illness.

Roughly 10 percent of COVID-19 positive patients in Tennessee ended up in a hospital.

Unicoi County is currently reporting one positive case and one recovered case of COVID-19. Washington County has 42 cases with 23 cases being classified as recovered. Sullivan County has 42 total cases with 21 being considered recovered and one death. Greene County has 27 total cases with 18 recoveries and one death. Hawkins County has had 24 total cases with six recoveries and two deaths. Carter County has had three total cases with two recoveries and Johnson County is reporting two total cases and no recoveries so far.

For more information including up to date statistics, please visit cdc.gov and tn.gov/health. To find out the latest information regarding COVID-19 and Unicoi County, please visit unicoicountystrong.com.

BALLAD FURLOUGHS EMPLOYEES

Elsewhere in the region, Ballad Health made some drastic changes to its operations following the fallout from COVID-19, including the furlough of 1,300 employees on Friday, April 10.

According to a press release from Ballad Health, the furlough is a measure to reduce fixed administrative costs during this period of severe volume disruption, team members in certain support departments, administrative functions and non-critical locations of service will be placed on furlough as well. These team members will have access to the same unemployment benefits as furloughed team members in volume-dependent positions. Any team member furloughed may be recalled based on the needs of the organization, and these furloughs will be constantly evaluated to ensure Ballad Health can meet the needs of its patients and the region.

“Many of the staff members have already been notified and we hope to have them back as volume increases,” Ballad Health Executive Chairman, President and CEO Alan Levine said. “We ask those team members to be ready, we may need you as we expect a surge from COVID-19.”

Ballad Health is also reportedly taking several other steps to reduce overall costs and ensure critical services are available for a potential COVID-19 surge, including: the compensation for all individuals who serve as senior vice presidents or above shall be reduced by 20 percent for 60 days, with such action being reviewed in 60 days; the compensation for all individuals who serve as assistant vice president or vice president shall be reduced by 10 percent for 60 days, with such action being reviewed in 60 days; the chairman/chief executive officer shall forego 100 percent of his compensation for 60 days; all capital spending is suspended unless specifically authorized by the chairman/chief executive officer; and due to the reduced volumes, all supply inventory par levels shall be evaluated and reduced under the oversight of supply chain leadership

“The goal is to welcome everyone back once it is viable to do so,” Levine said.

Ballad Health has also temporarily closed down six urgent cares in the region and expanded telehealth. Levine acknowledged that some of the employees of the six urgent care facilities are a part of the 1,300 Ballad employees that have been furloughed. “Our patient volume is down and with that we had to furlough some of the employees and move other ones to one of our 11 other locations,” Levine said.

The six Ballad Urgent Care locations that are being consolidated include the Jonesborough, Gray, Elizabethton, Marion and two Bristol locations.

BALLAD EXPANDS TELEHEALTH

According to a press release by Ballad Health sent out on April 10, expanding on what was already the region’s most expansive network of telehealth technology, Ballad launched a region-wide, technology-driven virtual urgent care center for on-demand care to patients from the comfort of their homes.

Already, Ballad Health has been providing telehealth technology in 108 schools throughout the region, in addition to telehealth technology access to Niswonger Children’s Hospital in every emergency department throughout the Ballad Health system. This technology investment is unparalleled in the Appalachian Highlands, making it one of the more aggressive efforts to create virtual access in the nation, according to the health system.

The press release went on to claim that the Connected Care Virtual Urgent Care Clinic offers access to care for adults and children experiencing illnesses, such as the cold or flu; eye infections; sinus infections; stomach or gastrointestinal illness; heartburn or acid reflux; minor skin conditions; sore throat; headaches; and more. However, it does not fully replace the need for in-person physical examinations, and some consultations, such as those for strep or flu, might require a referral for a visit to a local clinic for testing or to confirm a diagnosis.

The Virtual Urgent Care Clinic is not a replacement for emergency services in the event a patient is experiencing life-threatening symptoms, in which case the patient should call 911 or immediately get to one of Ballad Health’s 17 emergency departments.

This technology expansion reportedly creates even more access to its already broad network by enabling telehealth connectivity with a flat cash fee of $30, which includes a visit with a healthcare provider, an appropriate diagnosis and a prescription, if necessary. This $30 cash fee applies regardless of insurance coverage, and will not count towards a deductible.

Patients who want to schedule an appointment with the Virtual Urgent Care Clinic can call 224-3950 to speak with a patient service representative. The Telehealth Urgent Care Clinic is open Monday through Friday, from 8 a.m. to 8 p.m., as well as Saturday and Sunday from 8 a.m. to 6 p.m.

Connected Care utilizes VisuWell, a cloud-based, virtual health platform that gives patients the ability to connect directly to their healthcare provider using a web-enabled device, such as a desktop computer, laptop, tablet or smartphone. The device must have a front-facing camera and microphone. Patients will also need an active email address and internet access to use the Connected Care services.

To learn more about the Virtual Urgent Care Clinic, please visit balladhealth.org/virtual-urgent-care.

Ballad Health also announced last week that more than 300 primary and specialty care providers are now available through the Ballad Health Connected Care Telehealth program, giving existing patients the ability to access their doctor and healthcare team without having to travel or be seen in person. 

Ballad Health Corporate Director of Virtual Health Debbie Voyles explained that the expansion of Connected Care’s Telehealth offerings with these providers will be especially important to patients living in rural areas and vulnerable patient populations, such as those who are immunocompromised or have pre-existing conditions.

“The expansion of Connected Care Telehealth now gives patients access to certain physician specialties, such as oncology and palliative care, that previously weren’t available through telehealth,” Voyles said.

Dr. Michelle Estes, a pediatrician for Ballad Health, has been using telehealth services for a little more than a week to connect with her patients. The service is available for school-aged (age four and up) and older children – not infants or toddlers.

“I like telehealth because I can ‘see’ my patients and counsel parents, while they can avoid coming into the office during this time of physical distancing,” Estes said.“While telehealth isn’t conducive for all pediatric visits, I have been pleasantly surprised at what I can accomplish via telehealth. Plus, as a pediatrician, it’s fun to see kids in their home environment, where I can meet their pets, and they can show me their favorite toy.”

Existing patients can call their Ballad Health provider to determine if Connected Care Telehealth might be an option for them.

The cost of a telehealth primary or specialty care visit is the same as a traditional office visit. Uninsured patients should contact their health insurance provider to determine what that cost might be. Uninsured patients will be billed the same discounted rate, based on their income, as an in-person visit, and Ballad Health’s charity and discount policies will apply.

To learn more about the Ballad Health Connected Care Telehealth, please visit balladhealth.org/connectedcare

Now, all Ballad Health emergency departments can connect virtually to Niswonger Children’s Hospital for access to pediatric providers. A tele-neonatology program is also available at Holston Valley Medical Center, Indian Path Community Hospital and Bristol Regional Medical Center.

“For inpatients at any Ballad Health facility, Connected Care will also be used to provide care and consultations by expanding our current resources, including specialties, to all facilities where the need exists,” Voyles said.

If anyone is experiencing moderate symptoms of COVID-19, including cough, fever or shortness of breath, please call the Ballad Health Nurse Connect line at 833-822-5523 (833-8-BALLAD) to be screened. The hotline is active 24 hours a day, seven days a week. As always, anyone experiencing an emergency should call 911.

To learn more about COVID-19 and how you can stop its spread, visit balladhealth.org/COVID19.