Western North Carolina has been spared the worst impacts of the coronavirus pandemic so far, but that’s about to change, according to the CEO of Dogwood Health Trust.
Antony Chiang, in a March 25 conference call with journalists, warned of tough times ahead, but added that Western North Carolina is in a better position than most areas of the country to slow the spread of the virus.
As of 11 a.m. Tuesday, March 31, there were 1,498 confirmed cases of coronavirus in North Carolina, with eight fatalities and 157 people hospitalized, according to the N.C. Department of Health and Human Services.
Two people have tested positive in Macon County, but both were travelers to the county.
Dogwood Health Trust, the nonprofit funded by proceeds from Mission Health’s sale to HCA, has committed $10 million to address the outbreak in its coverage area of 18 counties and the Qualla boundary. The funding is intended to increase access to testing, invest in the production of personal protective equipment, advocate social distancing measures and mitigate social impacts such as food insecurity.
There’s still time to slow the spread of the virus in Western North Carolina, Chiang said.
“Timing is absolutely critical, he said. “If we could control access to the region, have moderate social distancing and do widespread smart infectious disease protocol testing ... Western North Carolina could get there. Even while other cities are exploding, we could potentially be in a semi-normal situation.”
Social distancing
The first line of defense is social distancing, Chiang said.
“We’re hoping that more and more businesses, individuals, homes, government leadership will do whatever they can to flatten the curve,” he said. “Let’s slow down the transmission rate. Instead of doubling every three days, we double it over a much longer period.”
Slowing the spread is everyone’s individual responsibility, he said.
“Don’t stay home based off of your symptoms or lack of symptoms, do it first for our first responders, do it for our doctors and nurses, do it for our seniors, who are at highest risk of what’s coming.”
Flattening the curve
“The challenge for Western North Carolina [is to] slow down the spread so it stays under the number of beds and the number of ventilators in the region,” Chiang said. “We’ve been looking at the data, what’s been happening across the country and across the world. The number of positive cases doubles every three days. … How do we slow that down?”
Increased testing is one of the keys to flattening the curve, he said, and the lack of testing available in the region remains a major concern.
“The faster you identify a positive, the faster you can do a contract trace,” Chiang said.
Shortage of supplies
Another major challenge is posed by the lack of adequate resources.
“We have approximately 125 ventilators in the region. ... We have about 85 that are available,” Chiang said. “By our calculations, when we go past 1,000 reported cases, we’ll start to push our health system into stress mode.”
The number of ventilators currently available falls well short of the expected demand.
“For every 100 reported cases [diagnosed with COVID-19 globally], 70 percent end up needing ventilation,” Chiang said.
And it’s not just ventilators that are short supply.
“There is a severe shortage of personal protective equipment, from face masks to face shields to gowns,” he said. “Hand sanitizers, even, are in short supply. The main problem is global shortages of key supplies, lack of swabs, lack of reagents. It’s a critical situation right now, nationally and internationally.”
Dogwood has partnered with a McDowell County apparel maker, Kitsbow, to shift the company’s production from cycling apparel to making reusable masks and face shields for paramedics and health care workers.
Behind the curve
Positive test results are only the tip of the iceberg, Chiang said.
“For every positive case reported, there are about 10 people walking around right now who are in the midst of a 14-day life cycle for the virus,” he said. “If we have 30 cases today, we have 300 people in Western North Carolina who are out there transmitting right now.”
“In three days it’ll double to 600. Three days after that, 1,200.”
Chiang was citing data from March 25.
Mitigating social impact
Another of Dogwood’s priorities is getting help to residents most in need.
“We’re working with senior and food organizations, with over 150,000 meal kits that can be deployed to seniors, dropped on their doorstep without contact,” he said. “We’re working with k-12 schools, funding the purchase of more than 100 WiFi hotspots to go on buses.”
“We’re in discussions with a significant organization that helps housing-unstable folks. There might be an opportunity ahead of a crisis to bring online several hundred quarantine beds.”
“Most of our rural counties have very few tests available to them. Dogwood has been ... working to establish a local production of these tests and lab testing itself. As we’re able to access tests in addition to the supply state is giving to each county.”
Advantages in WNC
The impact of the pandemic will become more severe, but Western North Carolina is in a better position to deal with the crisis than other areas.
“The first is that even though we’re a popular tourist destination, we were in low season. That’s very bad for the tourism industry, hospitality and restaurants, but the likelihood of transmission from other parts of the country and state is going to be slower than other regions.”