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COVID-19 Update

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Health Provider Information

COVID-19 Guidance for Providers - Provided by the NC Division of Public Health (DPH)

  • Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).
  • Persons in whom COVID-19 infection is suspected should also be evaluated for common causes of community-acquired respiratory illness, including influenza, if not already done.
    • In persons who are close contacts of known cases, state and local public health should be consulted even if the patient tests positive for another respiratory pathogen.

Patient Management

Local Guidance for Patient Management

  • If a person suspected of having COVID-19 is critically ill, call 911 and let the dispatcher know that the person has symptoms and a history concerning for COVID-19 so EMS is able to respond accordingly. Also notify the receiving hospital and local health department.
  • Do NOT send individuals to the ED for evaluation/testing unless critically ill (in which case, they should be going by EMS).

If your patient is not critically ill and you feel testing is warranted, you can now perform testing in your office through commercial labs.

  • Follow the most up-to-date infection control guidance from the CDC.
    • To protect other patients, your staff and yourself, consider seeing the patient at the end of the day or outside of your clinic (e.g., in a parking area that affords some privacy), keeping your distance as much as possible.
  • Do NOT send individuals to BCHHS for evaluation/testing.
  • BCHHS can send a Communicable Disease nurse out to test individuals in the community who meet criteria for testing through the SLPH and lack a primary care provider to perform the testing.

Testing for COVID-19

  • Testing through the NC State Laboratory of Public Health (NCSLPH) remains available with prior approval by the epidemiologist on call due to limited availability of testing. Patients meeting the following criteria for a Person Under Investigation (PUI) will be considered for testing at NCSLPH:
    • Fever OR signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) in any person, including healthcare workers, who has had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset.
    • Fever AND signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) AND negative PCR influenza test in any person with history of travel from affected geographic areas within 14 days of symptom onset.
    • Fever with unexplained acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization where no source of exposure has been identified with, at a minimum, negative PCR influenza test.
  • Testing through commercial laboratories is now available to clinics in Buncombe County. Do not send these patients to outpatient lab facilities.
    • Testing is not recommended for asymptomatic persons.
    • Follow specimen collection and shipping requirements of the commercial lab.
    • Prior authorization from NC DPH is not required for commercial lab testing, BUT patients being tested will be considered a PUI and must be isolated either at home or in a hospital based on their need for care.
      • For all patients being tested through a commercial lab who do not require hospitalization, providers should, at the time of testing:
        1. sign 2 copies of the attached document titled “NCDPH COVID-19 Guidance for PUI Home Isolation”, giving one to the patient and submitting one to the patient’s local health department (for Buncombe County residents, fax document to 828-250-6169),
        2. give the patient the attached “NCDPH Infection Prevention Recs for Home Isolation” and “Visitor Log” documents, and
        3. complete and submit the attached “CDC COVID-19 PUI and Case Report Form” to the patient’s local health department at the time the test is ordered. This document can also be found here. (For Buncombe County residents, fax form to 828-250-6169.)
    • Isolation can be discontinued if 1) the initial test is negative, or 2) by public health officials on the basis of 2 negative test results conducted on specimens collected at least 24 hours apart.

Notice: As this remains an ever-evolving situation, we will continue to send out updates as quickly as possible. For the most up-to-date guidance for healthcare settings, please visit CDC’s COVID-19 website for healthcare professionals and NC DPH’s website for healthcare professionals. If you continue to have questions after reviewing the available guidance, contact the BCHHS Communicable Disease staff at 828-250-5109 (available 24/7). Please know that we are experiencing a high volume of calls and will respond as quickly as possible.

Covid-19 Questions & Concerns

Notice: BCHHS Public Health Preparedness is here as a resource. If you have additional non-medical questions about COVID-19 preparedness planning, please email us with the form below.

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Public Health
P:(828) 250-5000
40 Coxe Avenue
Asheville, NC 28801

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