Appalachian Regional Healthcare System’s first COVID-19 vaccines were administered on Tuesday, December 22 at Watauga Medical Center. Occupational health nurse, Crystal Minton, RN, vaccinated Kevin Wolfe, MD, a pulmonologist who is treating COVID patients at the hospital, followed by Emergency Department nurse Madison Bakken, RN.
Kevin W. Wolfe, MD, Pulmonologist Watauga Medical Center, receives the vaccine from ARHS Occupational Health Nurse Crystal Minton.
“We feel so fortunate to be able to begin vaccinating our frontline workers who are taking care of COVID patients each day,” said Chuck Mantooth, President and CEO of ARHS. “Protecting them means they will stay healthy and continue to be available for the community.”
There was an air of excitement in the room as Dr. Wolfe received his dose, and those within view erupted in applause. Many healthcare workers see these vaccinations as a first step in defeating this virus, and have a renewed sense of hope.
When asked why Dr. Wolfe decided to take the vaccine, he stated, “When you look at the risk and you look at the benefit of taking the vaccination, I believe the benefits far outweigh the risks.” Dr. Wolfe is proud to be a role model for the rest of the community in taking this important step to fight the pandemic.
Madison Bakken, RN, Emergency Department Watauga Medical Center receives the vaccine
“I’m incredibly honored to have had this opportunity,” said Bakken. “Today is the first glimmer of hope for us in this dark year.” Madison said she is proud to receive the vaccine in support of her fellow healthcare workers and excited that one day soon she may be able to safely embrace her parents and loved ones again.
The State of North Carolina’s plan to distribute COVID-19 vaccines
North Carolina is currently in Phase 1a of the state’s four-phase plan, which calls for vaccines to be available to healthcare workers and long-term care staff and residents. Phase 1b calls for vaccinating adults at highest risk of severe illness and those at highest risk for exposure according to the North Carolina Department of Health and Human Services (NCDHHS). Those seeking more information about the state vaccine distribution plan should visit covid19.ncdhhs.gov/vaccines.
For more information about the ARHS COVID-19 situation, including testing and vaccination, visit: apprhs.org/covid19/.
On Tuesday, December 15, Appalachian Regional Healthcare System (ARHS) was notified by the North Carolina Department of Health and Human Services (NCDHHS) that it would receive 800 doses of the Moderna COVID-19 vaccine, as part of NCDHHS’s December 21 weekly allocation.
“We were told yesterday (December 15) that our first allocation of vaccines will ship to us next week,” said Chuck Mantooth, President and CEO of ARHS. “So it appears that Christmas will come early. Our organization has been anxiously awaiting this news for several weeks. This is overwhelmingly good news,” he added.
This first shipment assumes that the Food and Drug Administration (FDA) will grant Emergency Use Authorization (EUA) for the Moderna COVID-19 vaccination at its hearing on Thursday, December 17. When the FDA grants the EUA, Moderna will immediately begin shipping nearly 6 million doses of the vaccine across the US.
Distribution of the COVID-19 vaccination is part of the federal government’s Operation Warp Speed initiative. At the direction of the U.S. government and the Centers for Disease Control, the State of North Carolina and NCDHHS has been working on a COVID-19 Vaccination Plan.
This first 800 dose allocation for ARHS is Phase 1a of the State’s four-phase Vaccination Plan, which calls for vaccinating frontline healthcare workers first.
ARHS has been preparing to receive these vaccinations for months. However, until this week, ARHS was not sure if it would receive the Pfizer or Moderna vaccination. Because both vaccines have unique storage and dosing requirements, ARHS needed to plan for both.
“We began thinking about how to operationalize it. From shipping and logistics — to how and where we would store it. We ordered an ultra-low temperature freezer. We began evaluating the roles of our workers to ensure that those on the front lines would receive it first. We planned how and where our vaccine clinics would occur. We want to make it as easy as possible for our employees to get the vaccine,” Mantooth said.
ARHS has more than 1,400 employees but also works with hundreds of contractors and non-employed providers in caring for the community. To ensure that frontline workers receive the vaccine quickly, ARHS stratified employees, contractors and non-employed providers into high- and low-risk categories and pre-loaded those high-risk employees into the State’s COVID-19 Vaccine Management System (CVMS) database. Mantooth added, “the 800 doses we get this week will not be enough—so even within the high-risk group, we placed priority on personnel who lay hands on patients. The risk of being exposed to the virus is greater for them, so they will receive the vaccine first.”
ARHS employees in the high-risk category who wish to receive the vaccination in Phase 1a will receive an email from CVMS to confirm their registration and a separate communication from ARHS to register for a time slot to receive the vaccination.
“At this point, COVID-19 vaccinations are not mandatory for our employees. However, we are doing all we can to educate them, so they’ll be able to make an informed decision. Of course, our hope is that they will see the vaccine as our best option for fighting the virus,” said Mantooth.
ARHS is still awaiting information about the availability of additional shipments of the vaccine to support subsequent phases of the vaccination plan.
Summary of the four phases of North Carolina’s vaccination plan:
Healthcare workers at high risk for exposure to COVID-19—doctors, nurses, and all who interact and care for patients with COVID-19, including those who clean areas used by patients, and those giving vaccines to these workers.
Long-Term Care staff and residents—people in skilled nursing facilities and in adult, family and group homes.
Adults with two or more chronic conditions that put them at risk of severe illness as defined by the CDC, including conditions like cancer, COPD, serious heart conditions, sickle cell disease and Type 2 diabetes, among others.
Adults at high risk of exposure including essential frontline workers (police, food processing, teachers), health care workers, and those living in prisons, homeless shelters, migrant and fishery housing with 2+ chronic conditions.
Those working in prisons, jails and homeless shelters (no chronic conditions requirement).
Essential frontline workers, healthcare workers, and those living in prisons, homeless shelters or migrant and fishery housing.
Adults under 65 with one chronic condition that puts them at risk of severe illness as defined by the CDC.
College and university students.
K-12 students when there is an approved vaccine for children.
Those employed in jobs that are critical to society and at lower risk of exposure.
Everyone who wants a safe and effective COVID-19 vaccination.
Mantooth concluded by asking for continued diligence from the community. “The arrival of the vaccines represents hope for all of us…a bright light, at the end of what has been a long, dark tunnel. But it will take time to get everyone vaccinated. In the meantime I want to respectfully ask that everyone continue to practice the 3Ws. Wear a mask. Wait six feet apart. Wash your hands. It’s the best way to protect each other until everyone has had their shot.”
On Tuesday, April 28, Appalachian Regional Healthcare System (ARHS) began requiring masks for all who enter an ARHS facility. This new requirement applies to all employees, even those in non-clinical areas, patients and vendors. Additionally, in those rare instances where visitors may be allowed inside an ARHS facility, they too will be required to wear a face mask.
“We understand it may feel different to wear a mask. However, the smallest things can sometimes make the biggest difference,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System. “Masks help prevent people spreading COVID-19 to others before they know they are sick, and we all have a part to play in protecting each other. Our employees are leading by example because we deeply care about our community. We will continue to adapt and do everything we can to ensure the health and safety our patients, staff, vendors and visitors.”
Why is ARHS implementing this requirement?
The CDC updated their recommendations for healthcare personnel on April 13 by communicating, “as part of source control efforts, healthcare personnel should wear a face mask at all times, while they are in the healthcare facility.”
The Joint Commission also believes that universal masking within healthcare settings is a critical tool to protect staff and patients from being infected by asymptomatic and pre-symptomatic individuals and should be implemented in any community where coronavirus is occurring.
What type of face mask is required and how can I get one?
Patients will be encouraged to arrive wearing a cloth face mask. If they do not, they will be provided with a cloth (or OSHA approved yellow) face mask when they enter the entry checkpoints at Watauga Medical Center (WMC) and Cannon Memorial Hospital (CMH).
Patients entering an outpatient medical office will be provided with a cloth (or OSHA approved yellow) face mask at check-in.
Per CDC guidelines, face masks should not be placed on young children under age 2, anyone who has trouble breathing, or anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
If you have additional questions about wearing a face mask to your appointment, please call the appropriate facility prior to your arrival.
Lindsey Henley, FNP-C of AppGastro with her medical office assistant Kayla Welch, CMA
Appalachian Regional Healthcare System (ARHS) has launched a new telehealth program to ensure patients have safe, convenient access to their providers during the COVID-19 pandemic and beyond. Through telehealth visits, patients can meet with a healthcare provider using a computer or mobile device from the safety of their own homes. Telehealth is most appropriate for routine visits such as simple acute care (sick visits), follow-up, wellness visits, and behavioral health concerns like depression, anxiety or grief.
Dr. Anderson of AppOrtho with his medical office assistant Amelia Lowe- CMA
Appalachian Regional Medical Associates providers have been piloting the program and are pleased with the results. Telehealth appointments are available throughout the week during regular office hours. In-person appointments will be alternated with telehealth appointments to limit the number of patients in each office in accordance with social distancing guidelines.
“We are incredibly proud of our providers and staff for moving quickly to implement this telehealth program for the benefit of our patients,” said Dr. Danielle Mahaffey, Chief Physician Executive, “They were asked to drastically adapt how they practice medicine, completed training, and began seeing patients within 14 days.”
During the telehealth visit, if the healthcare provider determines that an in-person visit is needed, they will stop the virtual visit and schedule the patient for an in-person appointment. The patient and their insurance will not be billed for the telehealth visit if an in-person appointment is required
Dr. Price of Davant Medical Clinic with his medical office assistant Lacon Parsons, CMA
The first ARHS providers to utilize telehealth visits were Dr. David Kimmel of Elk River Medical Associates, Dr. Lynda Gioia-Flynt of Harmony Center for Women, and Dr. David Brendle of AppFamily Medicine. Since its launch, the program has expanded to about 30 providers throughout the healthcare system.
Dr. Steven Anderson, orthopedic surgeon at AppOrtho has been participating in telehealth visits with his patients. Patients of all ages were easily able to log on and complete the telehealth visit. “For a time like this, it’s a great way to communicate with patients while abiding by social distancing guidelines,” said Anderson, “There are also instances where telehealth makes sense in general, such as reviewing MRI results.” According to Anderson, every patient he has seen via telehealth has enjoyed the visit.
For Dr. Lynda Gioia-Flynt of Harmony Center for Women, telehealth is appropriate for things like medication follow up, contraception counseling, procreative counseling, STD prevention and exposure counseling, postpartum depression and postoperative visits with incision checks. “Telemedicine has helped bridge the gaps that would occur otherwise with social distancing,“ said Gioia-Flynt, “If we delay too many visits we could not only miss caring for our patients now, but also might over-burden the system later once restrictions lighten.”
“The telehealth visits felt more personal than I anticipated, and I was able to really connect with my patients well through the platform,” said Dr. Grasinger, a gynecologist at Davant Medical Clinic in Blowing Rock, “This option is safer for patient as well as staff, and patients have been happy with the visits.”
Patients will not need to download apps or software to participate. To request a telehealth visit, patients should call the office directly or request an appointment online as if they were scheduling an in-person appointment.
While the telehealth program was launched as a way to increase access to care during the COVID-19 pandemic, we hope to continue in the future as a safe, convenient way to receive care at any time. ARHS is continually looking for new ways to serve the community and telehealth is the latest result of that commitment.
Pictured below are some of our providers, joined by their medical office assistants, who have enjoyed telehealth visits with their patients so far.
Dr. Califf of AppOrtho with Susan Young, RN
Dr. Chidester of Baker Center for Primary Care with Leslie Pollard, MOA
Dr. Stark of Appalachian Regional Internal Medicine Specialists with Tracey Berner, MOA
Amber Stern, NP-C of The Heart & Vascular Center
Sarah Seaver, MSN, NP of Baker Center for Primary Care
Dr. Smith of Appalachian Regional Internal Medicine Specialists with Hailey Beshears, CMA
Dr. Parker of AppOrtho with Kaitlyn Walker, CMA
Dr. Bullers of AppOrtho with Brandy Rawson, CMA
Shauna Stadelmaier, PA-C of AppOrtho with Santana Buchanan, CMA
At the time of the visit, they will receive an email with a link and instructions for how to join the visit.
Which patients can request a telehealth visit and for what types of visits?
Telehealth visits are available for patients who do not require a physical exam. Patients must reside in North Carolina and have reliable internet access, an email address, and a device with a camera and microphone such as a smartphone, computer or tablet.
Providers can usually address the following types of issues through telehealth:
Medication management/refill visits
Simple acute (sick) visits
Upper respiratory symptoms
Urinary tract infections
Behavioral health visits
Which practices and outpatient clinics offer telehealth options?
The following practices and outpatient clinics currently offer telehealth services. More clinics may add the service in the future. Call the office or clinic to ask about specific offerings.
AppHealthCare and Appalachian Regional Healthcare System (ARHS) are following the guidance for use of cloth masks or face coverings by the general public as issued by the recommendations recently issued by the CDC. The CDC recommends “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
“We know that community transmission is occurring in North Carolina and even though we have a lower number of identified cases in our communities at this time, we believe additional tools should be added to our toolbox to help lessen the effects of COVID-19. The use of cloth masks or face coverings by the general public should not replace social distancing and other everyday prevention measures like handwashing, covering your cough or sneeze or staying home when you are sick,” stated Jennifer Greene, Health Director, AppHealthCare.
“The use of cloth masks makes so much sense toward combating the spread of COVID-19. As such, we encourage everyone to use them, particularly in public locations where social distancing is difficult to maintain,” stated Rob Hudspeth, Senior Vice President, Appalachian Regional Healthcare System (ARHS).
The use of cloth face coverings will not protect you from other people’s germs. It is meant to protect other people in case you are infected. This would be important if someone is infected with COVID-19 but does not have symptoms. According to the CDC, recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms (asymptomatic or presymptomatic). This is why it remains important for people to stay home as much as possible and only go out for essential trips.
Important Points about Cloth Masks and Face Coverings
They should cover your nose and mouth.
They can be worn when out in public where you may be near people like grocery stores or pharmacies.
They are not a substitute for social distancing. People should still keep 6 feet of distance and stay home to the greatest extent possible.
They can be made from household items with common materials at low cost.
They should not be used on children under the age of 2, people who have trouble breathing or anyone who would be unable to remove the covering without assistance.
They should be routinely washed depending on the frequency of use. You can wash the face covering in the washing machine.
After you remove a cloth covering from your face, you should be careful not to touch your face and wash your hands immediately after removing.
Due to the short supply of personal protective equipment (PPE), surgical masks and N95 respirators should be reserved for healthcare workers and other first responders. A healthcare worker or first responder should continue to use surgical masks and N95 respirators since these provide better protection from infectious diseases.
We are encouraging people to protect themselves to help lessen the spread of COVID-19 in our communities. There are many ways we can all protect ourselves and our communities.
How to Protect Yourself
Practice social distancing which means avoiding gatherings of more than 10 people, keeping 6 feet or more between you and others and remaining at home to the greatest extent possible
Frequent hand washing
Stay home when you’re sick
Keep distance from others who are sick
Avoid touching your face
Clean and disinfect high touch surfaces in common areas like doorknobs, remotes, light switches, tables and handles
Wear cloth mask or face covering when out in public where you may be around people like grocery stores or pharmacies
If you have surgical masks or N95 respirators and are willing to donate them, they can be dropped off at the front entrance of Charles A. Cannon, Jr. Memorial Hospital in Linville or at the security checkpoint at Watauga Medical Center in Boone.
We appreciate those in our community who are willing and able to make homemade face coverings.
AppHealthCare is available and on-call 24/7 to respond to public health emergencies. To reach us, call (828) 264-4995 anytime and follow the prompts. We will continue to monitor COVID-19 in our community and will work to keep the public informed. Please visit our website for more information – www.AppHealthCare.com. You can also follow us on Facebook and Twitter.
Appalachian Regional Healthcare System (ARHS) began its COVID-19 vaccination clinics in January and they are fully underway for first and second doses. Community members in Groups 1 and 2 of North Carolina’s rollout plan are currently receiving vaccines – frontline healthcare workers and those age 65 and over. Read More: Vaccine clinics underway at ARHS, dependent on supply from state