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Unicoi County prepares for COVID-19

By Richard Rourk

COVID-19 has made its way into Northeast Tennessee following a recent positive test result in Sullivan County. As of The Erwin Record’s deadline, the reported positive test in Sullivan County is the only positive test in the region to date.

Unicoi County officials, like the rest of the United States, are preparing for COVID-19. According to Director of Schools John English, Unicoi County Schools will be closing from March 17 through April 13.

“Letters were sent home with students,” English said. “This is a preventative measure. We did not want to put anyone at risk.”

According to English, Unicoi County Schools Food Service Department will provide meals during the COVID-19 school closure.

“We will have buses running Monday through Thursday providing three meals at a time for those students in need. This means our students will receive 12 meals a week while we are out,” English said. “We will also have drive thru locations set up at each elementary school in the county from 11:30 a.m. until 12:30 p.m. Monday through Thursday,” English said.

English acknowledged that the decision to close was a tough one.

“We understand that it’s hard for families to figure out childcare – that’s not to be taken lightly,” English said. “We understand that it has been really stressful for everyone. We just want people to know from a school standpoint we have been in close contact with (Governor Bill Lee), the health department and the commissioners, but we felt like this morning, it was time to go ahead and close.”

For more information and updates from Unicoi County Schools, follow Unicoi County Schools News and Announcements on Facebook.

This announcement came on March 16, following an announcement by Tennessee Governor Bill Lee.

“As the response to COVID-19 evolves, I urge every school district in Tennessee to close as soon as practically possible, with all schools expected to close by Friday, March 20, at the latest,” Lee said. “Schools should remain closed through March 31, to further mitigate the spread of this infectious disease and we will issue further guidance prior to March 31. Superintendents and local leadership have the full support of my administration to determine effective dates for closure this week as they evaluate what is best for families within their respective districts. We understand the tremendous burden school closure places on families and we will continue to work with both the federal government and school districts to ensure we continue essential supports like meals for students in need. Every Tennessean has a role to play in preventing the spread of COVID-19 and I urge Tennesseans to be quick to help neighbors as new needs surface with the closure of schools.”

Lee’s office has been following the COVID-19 outbreak very carefully and issuing statements frequently. On March 12, Lee issued Executive Order No. 14 declaring a state of emergency in Tennessee to facilitate the treatment and containment of COVID-19.

“Today’s action will move us into position to utilize additional emergency funds as needed and relax provisions of certain laws to provide the flexibility needed to respond to this disease,” Lee said. “While the risk to the general public remains low, we encourage all Tennesseans to exercise caution and maintain good hygiene practices as there are serious risks to our vulnerable populations. We will continue to evaluate and adapt our position accordingly to fit what we believe is best for Tennesseans.”

Executive Order 14 declares a state of emergency to facilitate the treatment and containment of COVID-19. To achieve these goals, the order:

• Implements the Tennessee Emergency Management Plan;

• Permits health care professionals licensed in other states to provide health care services in Tennessee related to COVID-19;

• Allows pharmacists to dispense an extra 30-day supply of maintenance prescriptions as needed in response to COVID-19;

• Allows health care professionals to provide localized treatment to patients in temporary residences;

• Expands testing sites for COVID-19;

• Allows the construction of temporary health care structures in response to COVID-19;

• Implements price gouging protections on medical and emergency supplies;

• Suspends restrictions on vehicles transporting emergency supplies to areas affected by COVID-19;

• Permits the waiver of certain regulations on child care centers as needed to respond to the effect of COVID-19;

• Authorizes TennCare policy changes to ensure that covered individuals receive medically necessary services without disruption; and

• Directs coordination with health insurance plans to improve access to screening, testing, and treatment for COVID-19.

According to Lee, vulnerable populations should stay home where possible and avoid large gatherings or locations where they are more likely to contact the virus. Vulnerable populations include older adults and adults with underlying conditions like diabetes, heart disease and respiratory illness. Non-essential visits to nursing homes and hospitals are strongly discouraged.

• • •

Ballad Health, which owns Unicoi County Hospital, has also been making preparations in regards to COVID-19. First, Ballad Health has activated its Corporate Emergency Operations Center (CEOC) to coordinate response efforts across the system and around the region. The CEOC is composed of key leaders overseeing essential functions of the health system.

The Board of Directors of Ballad Health has acted to delegate its full authority to the chairman and CEO to ensure rapid response to the rapidly changing situation. Ballad Health Chairman and CEO Alan Levine has appointed Chief Operating Officer Eric Deaton to serve as incident commander for the Ballad Health Corporate Emergency Operations Center. The delegation of authority permits the incident commander to deploy resources rapidly and to implement policies as necessary to ensure the Appalachian Highlands is best-served.

“COVID-19 has arrived in our region, and we are taking steps to ensure we are responsive to the needs of the people who may rely on our care,” Levine said. “The establishment of our Emergency Operations Center enables the most rapid response possible as the situation may evolve.”

On Tuesday, March 10, the Sullivan County Regional Health Department announced the first positive case in the Appalachian Highlands of the novel coronavirus, COVID-19. That patient was never admitted into any Ballad Health facility, and is currently isolated at home with contact tracing being handled by the health department.

Second, Ballad Health has established a call center for individuals to contact if they are experiencing mild symptoms and wish to speak with a healthcare professional. If you believe you are experiencing mild symptoms, please stay at home and self-isolate, and call Ballad Health’s Nurse Connect at 1-833-822-5523. A Ballad Health team member will provide a screening over the telephone. The phone line is active 24 hours per day, and the service is free. 

Importantly, if you are not symptomatic, but have general questions, the best source of information is to go to balladhealth.org/COVID19, the Tennessee Department of Health at tn.gov/health/cedep/ncov.html or the Virginia Department of Health at vdh.virginia.gov/surveillance-and-investigation/novel-coronavirus/. Telephone hotline information for the Tennessee and Virginia Departments of Health can be found on these websites.

“Our Nurse Connect will be an instrumental first point of contact for people where we can assess the risk factors for people who are concerned about symptoms,” Chief Clinical Officer of Ballad Health Dr. Amit Vashist said. “The call center is supported by nurses and physicians who can provide an appropriate initial assessment, and then provide guidance to individuals based on their specific symptoms, risk factors and possible need for testing. If we utilize this system, we can reduce the possibility of a surge that can impact our emergency access points for other patients, and we can provide a more orderly mechanism for getting patients to care who may need more immediate access. It also minimizes unnecessary exposure to health care professionals and protects patients in the workforce. Isolation of high risk cases is the most important thing we can do to prevent the possible spread.”

If you choose not to utilize this service, and instead prefer to go to your doctor or to an urgent care, Ballad Health is urging consumers to call ahead to ensure the physician or urgent care office is prepared. If you have fever, respiratory issues, a cough or other symptoms which may be related to the coronavirus, you can expect to be immediately asked to wear a mask upon entry, and to be tested for other respiratory issues, such as the flu or other more common viruses, before being tested for the coronavirus. As of now, it is likely the condition relates to something other than the coronavirus, according to Ballad Health.

Third, anticipating the need for more COVID-19 testing in the region, Ballad Health is in the process of establishing multiple access points for testing if indicated. More details will be announced in the future.

Fourth, Ballad Health will be implementing restricted entrances to its hospitals, with screenings for those who enter the facilities. These measures are intended to ensure the protection and sustainability of the healthcare workforce. The restrictions will go into effect in the coming days.

“We ask that our neighbors remain calm and understand the steps we are taking today, and will take in the coming days and weeks, are intended to protect the health care workforce, and also to reduce the potential for the spread of this virus,” said Deaton. “We can’t pretend to know what is to come, but we can take responsible steps to mitigate the situation. Our goal is to serve our region, provide care to those who need it, and to be a reliable source of information. Our Emergency Operations Center is staffed with people who are experienced and determined to get this right.”

As of Monday, March 16, all Ballad Health hospitals will limit their public entry points and engage all visitors in screening protocols. Visitors will also be limited to one guest per patient, and no visitors under age 12 will be allowed.

Specific entrances vary per facility, and each one is clearly identified for the public. Ballad Health team members can still access restricted areas through their employee badges.

Additionally, before visitors can see patients, they will answer several questions to evaluate any potential COVID-19 risk. If needed, visitors might have their temperatures checked, be given masks or not be permitted to visit.

Exceptions to the one-visitor rule will be in place for the system’s birthing center and pediatric departments, which will allow two visitors per patient. Further exceptions to screening limitations and visiting hours are available for hospice, end-of-life care and other circumstances, and they will be evaluated on a case-by-case basis. Privately employed patient sitters will follow the same screening guidance and protocols as Ballad Health team members.

The Tennessee Department of Health has released the following recommended precautions.

• Wash your hands often with soap and water. Use alcohol-based hand sanitizer if soap and water are not available.

• Cover your mouth and nose with a tissue when coughing or sneezing.

• Don’t touch your eyes, nose or mouth with unwashed hands.

• Stay home if you are sick.

• Stay away from people who are sick.

• Flu shots are available for free at your local health department.

The Northeast Regional Health Office has created an information line for local residents and healthcare providers to call with questions or concerns related to the

COVID-19 novel coronavirus. Tennessee Department of Health employees and Medical Reserve Corps volunteers will take calls starting Wednesday, March 11.

The information line is 979-4689 and is designed to provide callers with trusted information related to COVID-19. Residents with medical questions will be referred to their health care provider. TDH has additional information available at www.tn.gov/health/cedep/ncov.html. The information line will be open Monday through Friday from 8 a.m. until 6 p.m.

• • •

Despite no positive cases of COVID-19 appearing in Unicoi County, local representatives have begun preparing for the worst. According to Unicoi County Mayor Garland “Bubba” Evely, representatives from all three municipalities and area first responders met with the Unicoi County Health Department and Dr. David Kirschke from the Northeast Regional Health Office to discuss and gameplan for the virus.

“We wanted to get ahead of the curve with this,” Evely said. “This is such a fluid situation; things are changing so quickly so we wanted to be sure that we are prepared.”

According to Evely, the county is following CDC guidelines and the CDC’s mitigation plan which includes background on the virus itself. The CDC is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in more than 100 locations internationally, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”).

On Jan. 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization (WHO) declared the outbreak a “public health emergency of international concern” (PHEIC). On Jan. 31, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. On March 11, WHO publicly characterized COVID-19 as a pandemic. On March 13, the President of the United States declared the COVID-19 outbreak a national emergency.

Citizens are asked to check with their churches before attending and to check with nursing homes and assisted living facilities prior to visiting loved ones. Some area facilities are not allowing visitors.

According to Unicoi County Emergency Management Director Ed Herndon, residents of Unicoi County need to be careful and be patient.

“It’s vital that we wash our hands, avoid handshaking, and avoid touching your face as best you can and participate in social distancing of at least three feet,” Herndon said.

If you are feeling any of the symptoms such as fever, cough or shortness of breath, you may want to stay home and call your physician. If you are experiencing difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face or any other symptoms that are severe or concerning please seek medical attention immediately.

For Unicoi County residents, if you are concerned you may be ill with COVID-19, call the Regional Health Department at 946-4689. You will then be directed to your primary care physician or another testing location depending on the immediate need.

Those that are eligible for screening are:

• Those that have been in direct contact with confirmed cases.

• Those that have traveled internationally or other high risk areas.

• Pregnant, elderly and immune compromised.

• High risk occupations such as health care workers.

• Severe pneumonia without known origin.

Plus you must have symptoms of fever, cough and/or shortness of breath.

For more information and to follow the latest on COVID-19 at cdc.gov/coronavirus/2019. For a full list of confirmed cases of COVID-19 in Tennessee please visit tn.gov/health/cedep/ncov.html.