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For Your Health: ARHS Providers sound off on COVID-19 vaccination (Video Series)

For Your Health: ARHS Providers sound off on COVID-19 vaccination (Video Series)

In response to questions we’ve heard from community members, we asked our trusted ARHS providers to share information about the COVID-19 vaccine, side effects, efficacy, and more. Additional videos may be added. For more information about vaccines, visit apprhs.org/vaccine

COVID-19 Vaccine and Women

Is there any evidence the COVID-19 vaccine affects fertility or pregnancy in women? Dr. Beverly Womack, a trusted gynecologist and obstetrician for more than 25 years shares her knowledge.

Getting vaccinated helps our community’s children

Is being vaccinated against COVID-19 safer than getting the disease? How does vaccination affect the children of our community? Hear from 40-year Avery County family physician (retired) Dr. Charlie Baker.

COVID-19 Vaccine and the Delta Variant

Sean Burroughs, ARHS Director of Pharmacy answers the question, “Is the COVID vaccine still effective against the Delta Variant?”

COVID-19 Treatment Options

COVID-19 Treatment Options

There is no true “cure” for COVID-19, however, healthcare professionals can treat the symptoms while the disease runs its course. The reality is that there are very few options for treating COVID-19, and the treatments currently available have had mixed results. The following treatment options may be appropriate depending on the severity of symptoms. Talk to your healthcare provider if you experience moderate or severe symptoms, or are at high risk for serious illness.

Prevention is our best weapon against COVID-19: 

Mild Infection

Symptoms include fever, body aches, cough, head or nasal congestion, sinus pressure.

Moderate Infection

Mild symptoms plus shortness of breath

Severe Infection

Moderate symptoms plus either:

  • oxygen saturation (“O2 Sats”) < 94% without being on oxygen
  • need for supplemental oxygen or ventilation support (needing oxygen or on a ventilator)

At-Home Treatment Options for COVID-19

Although there is no “cure” for COVID-19, you can manage your mild symptoms at home

    • Stay hydrated (drink fluids)
    • Control fever; options include acetaminophen (Tylenol) or other fever reducers
    • Get plenty of rest
    • Lying on one’s stomach can help support the lungs
    • Supportive medications for symptoms can include cough suppressant, decongestant, vitamins
      ***Before taking any over the counter medications, we recommend consulting with a healthcare provider

 

Outpatient Treatment Options for COVID-19

Promising treatment: Monoclonal Antibodies may be a treatment option for patients who are high risk with in the first 10 days of mild-moderate COVID-19 illness. Monoclonal Antibodies have been shown to help a small percentage of people stay out of the hospital. For more information, or to see if you are eligible for this treatment option ask your doctor or healthcare provider.

Unproven interventions: At this time, no well-done studies have shown that Famotidine, ivermectin, and garlic help with COVID-19. These are experimental treatments that continue to be researched.

What NOT to do: These options won’t help and could be dangerous!

    • Good research has shown that hydroxychloroquine does not help and may increase risk of heart problems
    • Do not subject your body to very hot or cold temperatures, consume bleach, or expose UV light on the body/skin

ARHS Virtual Hospital: Patients who are not critical but still require physician care are treated via telehealth in our virtual hospital. Providers can communicate with patients via video, audio and secure message to keep them on the road to recovery.

 

Hospitalized Treatment Options for COVID-19

Dexamethasone

    • Studies showed that when used in patients on a ventilator or on supplemental oxygen there was a significant reduction in death.
    • Studies also showed that when used in mild cases there was not much benefit

Remdesivir (Veklury)

    • Studies did not show a significant reduction in death.

Tocilizumab (Actemra) or other similar agent.

    • May reduce the risk of ventilation or death but more studies are needed to prove this benefit.

 

Vaccine Information

Pfizer and Moderna were ~90%-95% effective in preventing COVID-19 against the original strain. J&J was somewhat less effective at preventing COVID-19 but all 3 showed they were close to 100% effective at preventing death from COVID-19.

Current data shows that between April and August the effectiveness of the vaccines to prevent the disease dropped against the Delta variant. Event with increased chance of infection, it still seems that the effectiveness of the vaccines to prevent hospitalizations and most importantly death are still very high.

Learn more about vaccines >

 

Rehabilitation after COVID-19

From Johns Hopkins Rehabilitation Network: Common impairments of COVID-19 include weakness, fatigue and shortness of breath with activity, and difficulty with walking and performing daily tasks. When you experience these physical impairments, it can lead to stress, which negatively affects the mind. Fear and depression can both impact the health of the body. Early intervention through exercise and activity aimed at treating the whole person will play an important role in the recovery process and can be started at home during self-isolation.

For information about recovering from COVID-19, download “Bouncing Back from COVID-19” from Johns Hopkins Medicine. Contact your primary care provider to see if you would be a candidate for Post-COVID Cardiac and Pulmonary Rehabilitation services through ARHS.

 

References:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters?gclid=Cj0KCQjwg7KJBhDyARIsAHrAXaFEp3brVpgEF0xxfdr1fIjXdE2IRcBjmOc3FXVsGPBJI5V8ArffnGUaAv0vEALw_wcB#medicines

https://www-uptodate-com.libproxy.highpoint.edu/contents/covid-19-outpatient-evaluation-and-management-of-acute-illness-in-adults?search=COIVD-19%20%20treatment&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H3812963281

https://www-uptodate-com.libproxy.highpoint.edu/contents/covid-19-management-in-hospitalized-adults?search=COIVD-19%20%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Monoclonal Antibody Therapy (mAb) for certain high-risk COVID-19 patients

Monoclonal Antibody Therapy (mAb) for certain high-risk COVID-19 patients

Monoclonal Antibody Suite

August 31, 2021

The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) to permit the emergency use of Monoclonal Antibody Therapy to treat mild to moderate COVID-19 in certain patients who test positive for COVID-19 and who are at high risk for progression to severe COVID-19, including hospitalization or death. It’s important to note that this treatment is not a substitute for vaccination against COVID-19.

Before you are exposed to COVID-19, The best way to reduce the chances of severe illness, hospitalization, or death, including from the Delta variant, is to be vaccinated. Learn more about how to receive a vaccine in Watauga and Avery Counties.

High-risk patients who have recently tested positive for COVID-19 and have had symptoms for 10 days or less, should talk to their healthcare provider to see if monoclonal antibody treatment is right for them.

This treatment is currently available at Appalachian Regional Healthcare System (ARHS) by referral only. 

 

What is Monoclonal Antibody Therapy (mAb)?

Your body naturally makes antibodies to fight infection. However, your body may not have antibodies designed to recognize a new virus like SARS-CoV-2, the virus that causes COVID-19.

Monoclonal antibodies, or mAbs, are lab-produced molecules that help your body fight off illness. Monoclonal antibodies can restore, boost or imitate your immune system’s response to the virus by replacing your natural antibodies. This treatment is administered by infusion. (source)

 

Who can receive mAb therapy?

High-risk adults ages 18 and older may be eligible for treatment through ARHS. The FDA has approved treatment for high-risk youth patients between the ages of 12-17 and weighing less than 88 pounds, however, ARHS does not currently administer pediatric mAb therapy.

High-risk factors can include:

  • Older age
  • Obesity or being overweight
  • Pregnancy
  • Chronic kidney disease
  • Diabetes
  • A weakened immune system or taking medicine that weakens your immune system
  • Heart disease including high blood pressure
  • Lung disease such as COPD, asthma, or cystic fibrosis
  • Sickle cell disease
  • Cerebral palsy or other developmental conditions
  • Regular use of a feeding tube or ventilator

Other medical or non-medical factors may also put individuals at higher risk for severe COVID-19.

 

Who cannot receive mAb therapy?

Monoclonal antibodies are not authorized for use in patients who:

  • Are hospitalized due to COVID-19
  • Require oxygen therapy due to COVID-19
  • Require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic oxygen therapy due to an underlying non-COVID-19 related condition

 

How to receive mAb therapy through ARHS:

With 10 days of the first COVID-19 symptoms:

 

  1. Get tested for COVID-19
  2. If your test is positive, contact your primary care provider to ask if Monoclonal Antibody Therapy is right for you.
  3. If appropriate, your provider will send a referral to ARHS to schedule your mAb infusion appointment.
Healthcare System Responding to new COVID-19 Surge

Healthcare System Responding to new COVID-19 Surge

August 18, 2021

Appalachian Regional Healthcare System (ARHS) officials are extremely concerned about the latest surge of COVID-19 cases and encourage everyone to get vaccinated to protect themselves and those they love.

“COVID-19 rates are going up, again, in the High Country and hospitalization rates have followed,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System. “Our staff are working 24/7 to plan and manage this latest surge but we are experiencing a shortage of staff.”

What ARHS has done

  • Per federal regulations, ARHS continues to require masks be worn by all staff and visitors regardless of vaccination status.
  • Watauga Medical Center (WMC) has established three COVID-19 isolation units with the capacity to care for up to twenty-five critically ill COVID patients. WMC does have the ability to increase the number of beds to care for COVID and non-COVID related conditions.
  • Leaders meet daily to discuss how and where to expand capacity next if the surge moves beyond our current capacity.
  • ARHS contractors are working tirelessly to complete the renovation of the new ICU space early in order to provide an additional 10 ICU beds.
  • ARHS reinstated vendor restrictions on Monday, August 16th.
  • ARHS has established a pediatric work group that consists of hospitalists, pediatricians, and staff from the birthing center, respiratory therapy and critical care management to prepare for a potential surge in pediatric populations.
  • ARHS continues to enforce visitor restrictions at Watauga Medical Center and Cannon Memorial Hospital. Persons under the age of 18 are not allowed to visit or accompany a visitor. Visitors are required to wear a mask, at all times, while in an ARHS facility.
  • ARHS leaders have begun participating in daily WebEx meetings with regional partners and hospitals to discuss capacity and transfer options. Most large healthcare systems are at capacity and are currently “closed to transfers.”
  • ARHS has established a COVID Virtual Hospital to assist in helping less acute COVID patients recover while quarantined at home. These patients receive oxygen, a pulse oximeter, daily calls from nurse navigators to check vital signs – and are provided an emergency number if their symptoms worsen. We are currently working with the County to augment those services.
  • ARHS has developed a vaccination program for employees to ensure patient and co-worker safety. Until all staff are fully vaccinated, we have enhanced mask requirements to reduce the risk.
  • ARHS continues to allow isolated COVID patients to communicate with their family via FaceTime calls.

What We Have Seen

  • On July 13th, WMC did not have any patients hospitalized with COVID. As of today, there are twenty-one COVID patients at WMC. We have tripled our COVID patients in the last two weeks.
  • Non-vaccinated patients who are hospitalized during this COVID-19 surge exhibit greater symptom severity.
  • In this surge, approximately 80% of hospitalized COVID-19 patients are unvaccinated. These patients are requiring higher levels of respiratory support.
  • Patients who have received the vaccine generally have less severe symptoms, and typically require less intensive levels of care.
  • Patients range in age from infants to 90 years of age. Most patients are between 50-60 years of age.
  • WMC has reported 2 COVID deaths in the past three weeks.
  • The number of patients in the COVID Virtual Hospital have been increasing by four each day.
  • ARHS is competing with hospitals across the country in recruiting additional staffing resources, including nurses and support staff. On-boarding typically takes 3-4 weeks.

Hospital Capacity and Supplies

  • WMC has twenty-five isolation beds for COVID patients. Through a Centers for Medicare and Medicaid Services (CMS) 1135 waiver, WMC has the ability to increase the number of beds available to care for patients with COVID and non-COVID related conditions.
  • WMC has space that could be converted for additional COVID units, however more ICU-level trained staff would be needed to manage the units.
  • WMC has 20 ventilators.
  • Leaders meet daily to discuss how and where to expand capacity if the surge continues.
  • ARHS continues to monitor supplies to mitigate any shortages that may be encountered.

Our Challenges

  • As with many hospitals across the U.S., ARHS staffing is at a critical level. There are not enough ICU-level trained medical professionals to care for the current surge of COVID patients.
  • Staff are working longer hours and covering more shifts.

Outlook

  • ARHS anticipates an extreme increase in Emergency Room volumes as students return to class the next few weeks. As of August 18, 2021, the CDC reported that only 8% of individuals aged 18-24 have been fully vaccinated.

For the most up-to-date information about COVID precautions, visitor restrictions, obtaining medical records and more, visit apprhs.org/covid19

 

Masks required inside all ARHS facilities

Masks required inside all ARHS facilities

Updated July 23, 2021

 

Please wear a mask inside ARHS facilities

To comply with federal and state regulations, Appalachian Regional Healthcare System (ARHS) requires masking by all employees, volunteers, patients and visitors in all facilities, regardless of vaccination status. For the continued safety of our patients and visitors, all employees, visitors and contractors should continue to mask when in hallways, public spaces, and patient care areas.

Covid positive cases and hospitalizations have risen in the High Country and face coverings have been proven to slow the spread of the disease, including the Delta variant, which we are seeing in our community according to AppHealthCare (Health Department).

 

Protect yourself with the COVID-19 vaccine

Vaccines are readily available throughout the community. ARHS has Moderna and Johnson & Johnson vaccines available. Adults age 18 and older are welcome to request an appointment online or walk into one of the following clinic times. Scheduling an appointment is preferred.

Emergency Department Staff COVID

Emergency Department Nurses practice COVID-19 precautions

AppFamily:

  • Wednesdays, 3:30pm-6:00pm
  • Saturdays, 8:30am-11:00am

Baker Center:

  • Thursdays, 10:00am-4:00pm
  • Saturdays, 8:30am-11:00am
Updated ARHS COVID-19 Visitor Guidelines

Updated ARHS COVID-19 Visitor Guidelines

ALERT: Please do not bring children under the age of 18 to visit hospitals or healthcare facilities. For their safety, please do not leave children unattended on ARHS property, including inside cars. 

Updated: September 9, 2021

Masks are still required inside ARHS patient care areas

We know that many of our patients are happy to see a decline in COVID-19 infections in our community and were excited to hear the CDC’s recent mask updates. However, the new CDC guidance states that certain settings would still require masks and other safety measures.

Everyone, including individuals who are fully vaccinated, are still required to wear a mask in healthcare settings such as hospitals and doctor’s offices. As ARHS continues to follow CDC guidelines, all patients and visitors are required to wear a face mask over the mouth and nose, during their visit to any of our facilities.

 

General COVID-19 Visitor Guidelines

At Hospitals, Outpatient Offices and other ARHS Locations, visitors must:

  • Wear a mask that covers their nose and mouth at all times (except while eating in select areas).
  • Have a health screening check when they enter the building.
  • Be at least 18 years old.
  • Be in good health (free from respiratory illness, fever, cough, etc.).
  • Stay in the patient room visiting the patient, they cannot roam the hospital.
  • Follow all social distancing and safety guidance. This includes wearing masks, staying six feet from others and hand washing.
  • If a visitor does not follow the guidance above, it can cause serious safety concerns. They will be escorted out of the building in order to keep our patients and staff safe.
  • Special circumstances will be managed by the House Supervisor or Practice Manager.
  • Visitors may NOT enter If they have COVID-19 or are waiting on COVID-19 test results.

 

Watauga Medical Center & Cannon Memorial Hospital

Adult Patients
Visiting hours are 7:00 a.m. to 8:00 p.m. Two (2) visitors will be allowed for adult patients at any given time. Each room will have two visitor badges, which must be worn by visitors at all times. Visitors may change throughout the day and may leave the facility and return during the same day. If both badges are checked out from a room, additional visitors may not enter.

Patients having surgery may have one (1) visitor with them until they are in their patient room, even if they arrive before 7:00 a.m. Once they are in their patient room, they may have up to two (2) visitors from 7:00 a.m. to 8:00 p.m.

Pediatric Patients
Patients under 18 may have two (2) parents or guardians visit any time of day, however these visitors may not change and must remain the same throughout hospitalization. This is to minimize any risks to newborns and to allow for rapid tracking should a COVID infection occur.

 

WMC Birthing Center

Laboring patients may have two (2) designated visitors, which may not change and must remain the same throughout hospitalization. After the birth of the baby, only one (1) designated overnight visitor may stay. The second visitor may return at 7:00 am and must leave by 8:00 pm. A doula will be considered the second visitor.

 

Emergency Departments

Emergency Departments patients are allowed one (1) visitor any time of day, unless otherwise approved by the clinical team. Two (2) parents or guardians are allowed if patients are under 18. Visitors must wear a badge with the room number identified.

If the Emergency Department is busy, visitors will not be allowed in waiting rooms. Visitors will have to remain outside the Emergency Department (in their vehicle) until the patient is placed in a room.

Exceptions will be managed by the ED Charge Nurse.

 

Inpatient Behavioral Health

Visiting hours are 3:00 p.m. to 9:00 p.m. One (1) visitor will be allowed for a period of 30 minutes, by appointment only. Potential visitors should call (828) 737-7000 to schedule an appointment.

 

Medical Practices/Doctor’s Offices

One (1) visitor will be allowed to come to doctor visits with adult patients. Two (2) parents or guardians are allowed to come to visits if patients are under 18.

For special situations, the Provider will work with the office manager to find the best solution for the patient.
Patients and/or Visitors may be asked or choose to wait in their vehicles and be called on their cell phones when a room is ready if space is limited or they do not wish to wait in the public area.

 

End of Life Situations

Patients with COVID-19 (End-of-Life Situations)

  • One (1) visitor is allowed during end-of-life situations. Otherwise, visitors are not allowed.
  • Visitors must wear a gown, gloves and a surgical mask.
  • Physician and House Supervisor will determine what is considered “end of life”

Non-COVID-19 Patients (End-of-Life Situations)

  • End-of-Life visitation will be considered and approved on a case-by-case request and need.
  • Visitors must wear a surgical mask.
  • There are no visitation time limits.