BCHHS Public Health Provider Alert: COVID-19 update

September 21, 2020

Situation Update:

  • Visit the Buncombe County COVID-19 dashboard and the state’s dashboard for the most up-to-date county and state data related to COVID-19.
  • The number of cases identified daily in county residents had been decreasing since late July, although we are seeing a slight plateau so far in September, with just under 20 new cases identified daily. Labor Day gatherings may be playing a role in that plateauing. Demographic data for cases & deaths is available on both the county and state dashboards.
  • Over the past month, while the number of COVID-19 tests performed on Buncombe County residents has remained steady at an average of just over 4000 tests per week, the percent of those tests coming back positive has continued to decrease from 5% in early August to 2% during the week of 9/6. This demonstrates decreasing community spread of COVID-19 in our area. Face coverings, physical distancing and other preventive measures are making a difference!


COVID-19 Testing Recommendations:

  • Recommendations on who should be tested for COVID-19 have not changed in NC since early July:
    • Anyone with symptoms suggestive of COVID-19
    • Symptomatic and asymptomatic close contacts of known positive cases (the ideal time for asymptomatic close contacts to get tested is 5-7 days after last exposure to the case)
    • Symptomatic and asymptomatic individuals in the following populations who think they may have been exposed to COVID-19:
      • People who live in or have regular contact with high-risk settings (e.g., LTCF, homeless shelter, correctional facility, migrant farmworker camp)
      • Historically marginalized populations (Black, Indigenous, and People of Color)
      • Frontline and essential workers in settings where social distancing is difficult (e.g., those who work in restaurants, grocery stores, child care facilities, construction sites, processing plants, etc.)
      • Healthcare workers or first responders (e.g., EMS, law enforcement, fire department, military)
      • People who are at high risk of severe illness (e.g., people over the age of 65 and people of any age with underlying health conditions)
      • People who attended protests, rallies, or other mass gatherings where social distancing was difficult to maintain
  • Please be sure to review and provide the handout “Steps for People to Take After COVID-19 Testing”, available in English, Spanish and Russian, to those who are tested so they know what they should be doing before and after getting their test results.
    • Public health staff are following up with all lab-confirmed cases promptly upon receiving case reports, but it is crucial that you provide patients with guidance so they prevent spread while waiting on their results.
  • If you identify a Buncombe County resident who cannot safely isolate or quarantine at their place of residence, please call Buncombe County Communicable Disease staff at 828-250-5109 to inquire about obtaining free isolation/quarantine housing for that individual or family.
  • More details on COVID-19 testing in Buncombe County can be found here.


Antigen Testing (see updated guidance from NCDHHS – attached):

  • Be mindful that antigen testing is less sensitive than PCR-based methods, in general. Therefore, antigen testing is best used when there is a high pre-test probability of SARS-CoV-2 infection (e.g., symptomatic individual in whom COVID-19 is suspected).
  • If COVID-19 is suspected, but the antigen test result is negative, confirm that result with a PCR test.


Reporting Test Results to Public Health:

  • Remember that, per NC statute, providers are responsible for reporting cases of COVID-19 immediately to the local health department in the county where the patient lives.
    • Please complete the recently updated Communicable Disease Report Form (attached and available online, now as a fillable PDF) and fax it and a copy of the lab result to BCHHS Communicable Disease staff at 828-250-6169.
    • This is required even if the outside lab performing the test sends results to the state.
  • If your clinic is performing point-of-care (POC) COVID testing, NC DHHS is developing an online survey that providers will use to report the aggregate number of positive and negative PCR and/or antigen tests per day.
    • Until that is available, per the State Health Director’s temporary order and accompanying guidance document, providers are to report both positive and negative COVID POC test results to the local health department in the county where the patient lives. We want this to be as easy for you as possible, so your clinic can fax a log of these tests (like the one you maintain for CLIA) with the name of your clinic, the name of the person tested, their DOB, test date, and test result weekly to Buncombe County Communicable Disease at 828-250-6169.


Flu vaccination:

  • Please review the CDC’s flu information for healthcare professionals and consider participating in or reviewing materials from the CDC’s COCA calls (free CE credits are available for both the live and recorded versions).
  • We aren’t sure what flu season will look like this year in the setting of the COVID-19 pandemic, but we know that we want to get as many people immunized as possible. Please encourage flu vaccination for your staff, patients, friends and family members, ideally by the end of October.
  • Buncombe County is working with community partners to increase access to flu vaccination for all members of our community this season.


Please continue to encourage everyone to follow the 3 W’s when they leave their home – Wear a cloth face covering. Wait 6 feet apart from others. Wash hands often or use hand sanitizer. These simple, but powerful preventive measures remain the key to our success.


This global pandemic remains an ever-changing situation. Please continue to check the CDC and NC DHHS websites for more information.

Contact the Buncombe County Communicable Disease staff at 828-250-5109 (available 24/7) or the NC Division of Public Health epidemiologist on-call line at 919-733-3419 (available 24/7) for additional consultation about COVID-19 or other public health concerns.



Thank you for all you are doing to help our community members,

Jennifer Mullendore, MD, MSPH


Health & Human Services,

Medical Director &

Interim Health Director


p. (828) 250-6308  c. 828-989-6145

40 Coxe Ave. - Asheville, NC 28801


Respect. Honesty. Integrity. Collaboration. Equity.