ASHEVILLE - Buncombe health officials are reviewing five emergency response plans to prepare for the possibility of a COVID-19 outbreak in the area.
The plans — which have been provided to the Citizen Times — include an EMS novel infectious disease response plan, the public health all hazards response plan, a continuity of operations plan, a high consequence pathogen plan and an isolation and quarantine plan.
There have been no confirmed cases of the disease in the county, but local entities say they have been preparing for weeks. As of March 6, two people in North Carolina have tested positive for COVID-19, according to state officials.
More on WNC's coronavirus response:
- How prepared is Buncombe for COVID-19? Here's what we know.
- With COVID-19 in NC, health officials react
- Area schools take steps to keep coronavirus off campuses
Some details of the county's plans are subject to change during review. Here are the highlights as of March 5.
Buncombe EMS novel infectious disease response plan
What it is: The EMS novel infectious disease response plan includes instructions for emergency dispatchers and responders and medical workers. It provides guidance on dealing with patients who may be infected and includes details about preparing ambulances and donning personal protective equipment.
The highlights:
- Emergency dispatch is instructed to screen 911 callers for possible exposure to infection.
- On the scene, EMS staff will contact the on duty emergency supervisor if a patient presents symptoms and either traveled to affected countries in the last 14 days or came into contact with a known infected person.
- EMS are to remove themselves from homes of potentially infected patients, immediately clean their hands and isolate themselves for evaluation.
- The EMS supervisor will notify other health and safety officers and Mission Hospital's Emergency Department if the are aware of a possibly infected patient — or a "patient under investigation."
- On the scene with a PUI, the EMS supervisor is to contact the patient by phone to explain the situation and response.
- EMS is to let the patient know it will take extra time to transport them to the hospital and advise them not to leave their home until the hospital is ready to receive them.
- If the patient wants to leave, EMS is to contact law enforcement and the county Health Department director. The health director can issue a verbal quarantine, which can be enforced with the help of law enforcement.
- The response team is also instructed to don personal protective equipment.
- If a spare ambulance is available, it will be used to transport the PUI. Any transporting unit will be prepared ahead of transportation. The patient also will be given a face mask and coveralls.
- All transports of a possibly infected patient will be done "non-emergency." No passengers will be allowed.
- For patients who need more immediate care, EMS command will coordinate with Mission's Emergency Department staff.
Read the full plan here:
Isolation and Quarantine plan
What it is: This plan defines roles and responsibilities for isolation and quarantine plans in the event of a severe outbreak of a communicable disease. It establishes the criteria the health director will use to determine when such measures are necessary.
Related: Coronavirus: Don't freak out, but you might want to buy some extra food
The highlights:
- Isolation and quarantine measures range from passive monitoring, in which one subject isolates themselves and performs self assessments, to widespread quarantine, which is a "legally enforceable quarantine of a large area, generally beyond the authority of the county health director."
- Isolation and quarantine may require the involuntary detention of those who do not cooperate with orders from the health director if certain conditions are met.
- An individual's cooperation will be assumed unless there is evidence otherwise, but HHS will still check in with individuals for symptom checks.
- EMS may be required by the health director to transport patients to a designated facility instead of the facility of the patient's choosing.
- Health officials will determine the most appropriate location for quarantine or isolation, which could include the person's home or another facility.
- If a small number of individuals who do not have housing need to be isolated or quarantined, HHS will use hotel resources to accommodate them.
- If many individuals who do not have housing need to be isolated or quarantined, HHS will work with local shelters to designate one shelter for those needs or may look into opening a temporary shelter in coordination with Public Health.
- If a large group of people — for example, tourists — require isolation or quarantine, HHS will work with the N.C. Department of Health to find an appropriate location.
- Those under isolation or quarantine will be supported to the extent possible through temporary financial assistance, food and other necessities. This will necessitate contracting with human services agencies or other community organizations.
- Health officials will determine when isolation or quarantine is no longer necessary.
Read the full plan here:
Buncombe Public Health all hazards response plan
What it is: The public health all hazards response plan provides general organizational and procedural framework for Buncombe Health and Human Services in the event of a variety of threats. It does not provide specific recommendations for county staff, but gives chain-of-command roles and responsibilities required for response needs.
The highlights:
- In the case of a high consequence pathogen crisis, Health and Human Services will be the lead local coordinating agency.
- "The overall direction and control of emergency activities in a crisis situation is vested with the chairman, county commissioners," the plan says.
- If an emergency is declared, the commissioners chairman — which is currently Brownie Newman — will operate from an emergency operations center.
- At first, emergency operations will be conducted locally with little or no outside input.
Read the full plan here:
High Consequence Pathogens plan
What it is: This plan describes roles, responsibilities and relationships at a jurisdictional level and responsibilities of organizations.
The highlights:
- HHS is to compile initial information on populations at-risk or, if known, information on individuals at-risk.
- If active monitoring is in place, HHS is to make initial contact to determine symptoms.
- It is the responsibility of all health care workers to immediately report suspected or confirmed cases to HHS.
- Health officials will interview patients to identify individuals who may have had contact with them.
- CDC guidance on the use of personal protective equipment is to be followed.
- If an infected person has had diarrhea, vomiting and/or bleeding at their residence, the waste must be removed by infectious waste haulers, authorized through the United States Department of Transportation.
Read the full plan here:
Continuity of Operations plan
What it is: The continuity of operations plan was developed to provide structure and guidance in the event that routine operations are significantly impacted to the point that HHS cannot maintain its core responsibilities. It gives powers to departments to minimize impact and loss of services during a significant event or catastrophe.
Related: No confirmed Coronavirus in Asheville, but officials tell public to prepare
The highlights:
- Buncombe HHS is committed to ensuring that essential functions will be continued even under the most challenging emergency circumstances.
- Activation of the plan may involve movement of selected key staff and personnel to an alternate facility, the implementation of temporary work procedures, the delegation of emergency authorities to senior management and technical personnel who are unavailable during the emergency and the assignment of continuity of operations plan teams to perform necessary activities.
- During the plan's activation, non-essential functions may be suspended.
- It may be in the best interest of HHS to have certain employees work from home.
Read the full plan here:
Mackenzie Wicker covers Buncombe County for the Asheville Citizen Times. You can reach her at mwicker@citizentimes.com or follow her on Twitter @MackWick.
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