BCHHS Public Health Provider Alert: Updated COVID-19 Provider Guidance

April 21, 2020

Situation Update as of 12pm today:

  •          There have been a total of 48 lab-confirmed cases of COVID-19 in Buncombe County residents, including 3 fatalities. Basic demographic information on Buncombe County cases is updated regularly on the county website.
  •          There have been no lab-confirmed cases of COVID-19 in any nursing homes or congregate living facilities in Buncombe County.


Lab Testing for COVID-19:

  •          Please see the updated clinician guidance related to COVID-19.
  •          Because testing capacity has increased over the past several weeks, the guidance has been updated so that clinicians now can consider testing for COVID-19 in any patient in whom the illness is suspected.
    •    There remain restrictions on who can be tested through the State Lab of Public Health (detailed below), so you will need to continue to conduct most testing through commercial or health system laboratories.
      •   Turnaround time for test results has improved significantly (typically 1-3 days now) at commercial labs due to streamlining of processes.
  •          Issues remain with testing and PPE supply chains, so we acknowledge that individual practices will have different abilities to conduct testing.
  •          The County is reaching out to local healthcare partners to assess their capacity for expanding testing to the broader community (i.e., setting up community-based specimen collection sites where providers could refer individuals for testing; deploying mobile testing units into under-resourced areas).
    •    BCHHS Public Health’s efforts will remain focused on surveillance, contact tracing of cases, and responding to cases/outbreaks in congregate living settings and priority populations.
  •          Testing through the State Lab remains limited to symptomatic individuals within these prioritized populations:
    •    Healthcare workers or first responders (e.g., EMS, law enforcement, fire departments, military)
    •    Persons who live in or have regular contact with a high-risk setting (e.g., long-term care facility, homeless shelter, jail/correctional facility, migrant farmworker camp)
    •    Persons who are at higher risk of severe illness and for whom a clinician has determined that results would inform clinical management
    •    Hospitalized patients
    •    Post-mortem specimens from patients in whom COVID-19 was suspected but not confirmed prior to death.
  •          Please continue to report suspected cases of COVID-19 to BCHHS Communicable Disease staff (Phone 828-250-5109, available 24/7; Fax 828-250-6169) when a Buncombe County resident is tested for COVID-19.
    •    Continue to give patients who are tested the home isolation guidance (link on attached provider guidance).
    •    If you are performing a point-of-care test, there is no need to report the test unless the result is positive for COVID-19.
    •    If you are a non-Mission-affiliated provider reporting a suspected case, we would appreciate you completing and faxing us the CDC’s PUI form (attached). (Mission’s Public Health Epidemiologist is providing us similar information for patients tested by Mission providers.)
      •   While no longer required by the state, the PUI form has critical info on it that facilitates our investigation, allowing us to more quickly identify close contacts and potentially reduce spread of the virus.
      •   To help us track testing by race/ethnicity, please be sure to complete that information on the PUI form.
  •          If a provider identifies a symptomatic person who falls into one of the prioritized populations for State Lab testing (see above) but is unable to test them, the provider should call the Buncombe County Communicable Disease line and we will facilitate getting that person tested by us or another local healthcare facility.


PPE Requests

CDC COVID-19 PUI and Case Report Form 3-8-2020

Continued thanks for all you are doing to care for our community,


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.