BCHHS Public Health Provider COVID-19 Update

January 7, 2022

Local and State COVID-19 Update

  • As of today, there have been 35,549 confirmed cases of COVID-19 and 458 COVID-19-related deaths in Buncombe County residents since the start of the pandemic.
  • Cases continue to increase dramatically locally and across NC and the US. We are seeing daily case numbers and case rates significantly higher than any we’ve seen during the entire pandemic. The case rate in Buncombe County has skyrocketed to 758 cases per 100,000 population in the last 7 days. The 14-day percent positivity has increased to 17.4% in Buncombe. The daily percent positive is 31.2% statewide. Testing demand remains extremely high.
  • Of course, Buncombe County is still considered to have a high level of community transmission, per the CDC.
  • COVID-related hospitalizations and IDU admissions in WNC continue to trend up.
  • Per the NCDHHS dashboard, there were no changes to the vaccination percentages in our county yet this week:  68% of the total Buncombe County population is partially vaccinated and 64% is fully vaccinated. When considering only those eligible for vaccination (5 years of age and older), 71% of this population in Buncombe County is partially vaccinated and 68% is fully vaccinated.
  • The NCDHHS weekly Respiratory Disease Surveillance Report that was published yesterday states that for the week ending 12/25/2021, Omicron represented 40% of sequenced SARS-CoV-2 viruses in NC.


Vaccine Updates

  • CDC now recommends that those who received the Pfizer-BioNTech AND Moderna COVID-19 vaccine receive their booster shot 5 months after completing their primary series.
    • The Moderna booster timing was just changed by the CDC this afternoon.
    • The booster interval recommendation for people who received the J&J vaccine (2 months) has not changed.
  • CDC also recommends that moderately or severely immunocompromised 5–11-year-olds receive an additional primary dose of vaccine 28 days after their second shot.
    • At this time, only the Pfizer-BioNTech COVID-19 vaccine is authorized and recommended for children aged 5-11.
  • CDC now recommends Pfizer vaccine booster for 12-15 year-olds.
  • I’ve combined all the current vaccine recommendations into a document (attached) which you may find useful. It contains tables from these CDC webpages:
  • CDC has updated their Interim Clinical Considerations for Use of COVID-19 Vaccines to include these changes as well as updated recommendations for people who received COVID-19 vaccines outside the United States that are not FDA-authorized or approved.


Isolation and Quarantine Guidance

  • The CDC provided some additional information about their recently updated isolation and quarantine guidance, including rationale for shortening the duration of I&Q for the general population.
    • I encourage you to review this information, including the FAQs at the bottom of the rationale webpage. A few key points from those FAQs:
      • As I mentioned last week, there is different updated guidance for healthcare personnel.
      • The new guidance applies to K-12 schools and colleges/universities.
        • Yesterday, the CDC updated their K-12 guidance.
        • Updates to the StrongSchoolsNC Toolkit were posted today to reflect the new CDC guidance. Pages 15-16 have the table with management of cases and contacts. We are working with the School Nurse Manager now to update isolation & quarantine algorithms used by the local schools.
      • The new general population guidance does not apply to high-risk congregate settings such as long term care, residential care, correctional and detention facilities, and homeless shelters.
      • The shorter I&Q recommendations also do not apply to:
        • Children < 2 years of age or others who are unable to wear a mask
        • People with moderate to severe COVID illness
        • People who are immunocompromised
      • People who had lab-confirmed COVID within the past 90 days and subsequently recovered, do not need to quarantine following an exposure, as long as asymptomatic.
      • People ages 5–15 years who have completed a Pfizer-BioNTech vaccination series, or others who are not currently eligible for a booster but have completed a Moderna, Pfizer-BioNTech, or Johnson & Johnson/Janssen vaccination series do not need to quarantine after coming into close contact with someone with COVID-19.
      • Adolescents ages 16-17 years who have completed a Pfizer-BioNTech COVID-19 vaccination but have not received a booster dose do not need to quarantine after coming into close contact with someone with COVID-19.
        • This differs from guidance for adults, because CDC recommendations say that adolescents ages 16-17 years may get a booster, not that they should get a booster.
      • Clarification on when the clock starts on the 5 days of isolation & quarantine
        • For isolation
          • If asymptomatic, day 0 is the day tested and day 1 is the first full day following the day tested.
          • If symptomatic, day 0 is the day of symptom onset and day 1 is the first full day following date of symptom onset.
        • For quarantine
          • Day 0 is the date of last close contact to the person with COVID-19 and day 1 is the first full day following last close contact.
  • Until the CDC issued updated childcare guidance, the existing interim guidance posted on NC DHHS website will still apply.
  • We anticipate more CDC guidance updates in the coming days/weeks for these special populations.


Updates on Buncombe County COVID-19 Vaccination Efforts

  • Walk-in COVID-19 Vaccine Clinic
    • BCHHS building, 40 Coxe Avenue in downtown Asheville
    • All FDA-authorized or FDA-approved COVID-19 vaccines and all doses are available here.
    • The clinic is open Monday-Friday from 9am-4pm.
    • No appointment is needed.
  • COVID-19 vaccines for the homebound
    • We continue to work with the Mission Health Partner CaraMedics to administer COVID-19 vaccine to those living in Buncombe County who cannot easily leave their homes to access vaccination.
    • If you know someone in need of this service, have them or their caregiver call the Buncombe County Ready Team at 828-419-0095.


Influenza Update

  • For the week ending 1/1/2022, influenza-like illness remained at low levels although there was a statewide increase in emergency department visits for influenza-like illness. The geographic spread in NC continued to be categorized as widespread. Influenza A remains predominant. Influenza data is part of the NCDHHS weekly respiratory surveillance report.
  • Two flu-associated deaths have been reported in NC so far this flu season.
    • Remember that all influenza-associated deaths are reportable to the local health department in the patient’s county of residence.
  • Please continue to encourage influenza vaccination to all those 6 months of age and older and follow the recently updated CDC guidance regarding the use of antiviral treatment and post-exposure prophylaxis.
  • Resources:

During this unprecedented surge in cases, stay safe and take care of yourselves.

Thank you for all your hard work, 


Jennifer Mullendore, MD, MSPH


Health & Human Services – Medical Director

(828) 250-6308 cell (828) 989-6145

40 Coxe Ave., Asheville, NC 28801 

Respect. Integrity. Collaboration. Honesty. Equity.

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